$4.99
Target
$3.19
CVS Pharmacy
Should you use fluoride-free toothpaste? Dentists explain
Not using fluoride toothpaste is like leaving one of your best cavity-fighting tools in the toolbox.
$4.99
Target
$3.19
CVS Pharmacy
As its name implies, fluoride-free toothpaste is toothpaste without fluoride in it. It’s formulated with detergents and abrasives that scrub teeth clean of dirt, grime and stuck-on food when you brush with it, but it doesn’t have anticavity benefits, says Creaven.
Many fluoride-free toothpastes are made with nano-hydroxyapatite, the synthetic form of hydroxyapatite, which is a compound in tooth enamel, says Messina. Using nano-hydroxyapatite in over-the-counter dental care products is still being studied, but evidence currently shows that it can help remineralize (add minerals back to) eroded areas on teeth, says Tomar. It doesn’t chemically change the crystalline structure of enamel to make it more acid-resistant or offer antibacterial properties like fluoride does, however. That gives fluoride an advantage over nano-hydroxyapatite as far as preventing decay is concerned, says Tomar.
The dentists I spoke to unanimously agree that you should not use fluoride-free toothpaste. “If you brush twice a day with fluoridated toothpaste, floss once a day, maintain a healthy diet and regularly see your dentist, you’re going to keep your teeth for a lifetime,” says Messina. “But if you use a fluoride-free toothpaste, you’re leaving one of your best tools in the toolbox.”
That said, if you opt to use fluoride-free toothpaste, you need to practice near-flawless tooth brushing and flossing, cut out as much sugar from your diet as possible and potentially visit the dentist more often, says Messina. “Can you survive without fluoride? Sure, but you make your life harder,” he says.
Additionally, the FDA regulates fluoride in dental products, so brands have to follow strict guidelines around marketing claims — for example, all fluoridated toothpaste and mouthwash must be labeled “fluoride” and/or “anticavity.” Brands can’t make any anticavity claims about fluoride-free toothpaste, per the FDA, but their marketing is otherwise unregulated. Dentists say this can lead to misleading information on fluoride-free toothpastes’ packaging, so be extra cautious if you’re shopping for it.
“Adding fluoride to water is very much like adding vitamins and minerals to certain foods and drinks: it’s a step that helps us get the nutrients we need,” says Tomar. “Fluoride is a natural element found in groundwater and oceans, so when we add it to drinking water, we’re adjusting it to the level that science shows will help prevent tooth decay.”
The Environmental Protection Agency’s current recommendation for fluoride levels in drinking water is seven parts per million. To understand how low that level is, think of it like a minute in 1,000 days, says Messina. “This concentration provides the best balance of protection from dental cavities while limiting the risk of dental fluorosis,” says Tomar. “It would be very difficult for the average person to reach dangerous fluoride levels, even in conjunction with fluoridated toothpastes.”
In most parts of the United States, communities add fluoride to water to reach the EPA’s recommended level. But in some areas, the amount of fluoride in water is naturally higher than the recommended level, so some is taken out before it gets to you.
Overall, fluoridating water is one of the most studied public health measures in history, says Tomar. “Fluoride in water benefits everybody,” says Messina. “It helps you get the benefits of fluoride without doing anything, which is great from a health equity perspective.”
At NBC Select, we work with experts who have specialized knowledge and authority based on relevant training and/or experience. We also ensure that all expert advice and recommendations are made independently and without undisclosed financial conflicts of interest.
I’m a reporter at NBC Select who has covered oral care since 2020, including articles about adults and kids toothpaste, floss, water flossers and teeth whitening. To write this article, I interviewed three dentists about fluoride-free toothpaste, fluoride and water fluoridation.
Catch up on NBC Select’s in-depth coverage of tech and tools, wellness and more, and follow us on Facebook, Instagram, Twitter and TikTok to stay up to date.
