The Reverie

Should You Avoid Fluoride In Toothpaste? 3 Factors to Consider

Fluoride has been fighting cavities since the 50s, but it's shining reputation just took a sharp turn.
Should You Avoid Fluoride In Toothpaste? 3 Factors to Consider

Quick Facts on Fluoride:

  • Several studies have flagged fluoride as a possible neurotoxin
  • Fluoride may be less effective than hydroxyapatite at improving tooth sensitivity
  • Fluoride kills some of the good bacteria that make up your oral microbiome


The introduction of fluoride to drinking water has long been hailed as one of the greatest public health innovations in modern history. 

But fluoride’s shining reputation has taken a sharp turn. In the past decade or so, many have begun to sound the alarm about the dangers of high levels of fluoride and reevaluate whether the risks outweigh the rewards.

In this article, we’ll learn why fluoride ended up in toothpaste in the first place, examine the possible risk factors, and shed light on the natural alternatives that just may be a better bet. 

Why Is There Fluoride in Toothpaste?

Fluoride is a naturally occurring trace mineral found in soil, plants, and water. Although small amounts of fluoride exist in foods like raisins, shellfish, and potatoes, we don’t tend to get a lot of fluoride from our food. The vast majority of fluoride humans take in comes from fluoridated drinking water and fluoride toothpastes.

In toothpaste, fluoride helps strengthen enamel and protects it against acids, which can cause decay. Sounds pretty great, right? But here’s where it gets a little more complicated.

3 Reasons to Avoid Fluoride in Toothpaste

Let’s break down three reasons you might want to avoid fluoride in toothpaste.

1. Toxicity

In recent years, a number of studies have flagged fluoride as a possible neurotoxin. This (pretty scary) word denotes a compound that has the power to negatively affect neurological development in children. 

This has resulted in some countries issuing a flat-out ban on fluoridated water and oral hygiene products. Furthermore, studies in mice given high doses of fluoride showed a negative effect on a number of bodily systems: including respiratory, cardiovascular, and gastrointestinal.  

But the story isn’t so simple: the amount of fluoride is the key factor to consider. While very high doses of fluoride may be toxic, the majority of research from trustworthy sources suggests that the amount of fluoride present in drinking water and toothpaste is not nearly enough to cause these negative effects.

Long story short: fluoride is potentially toxic in high doses, but the amount in toothpaste isn’t enough to cause significant harm. The main reason to skip the fluoride is actually because there’s a completely nontoxic, evidence-tested alternative that’s both safer and more effective:  hydroxyapatite (more on that later.) 

2. Tooth Sensitivity

When it comes to tooth sensitivity, fluoride isn’t harmful per se, but it’s been proven to be less effective at soothing sensitive teeth than hydroxyapatite. 

In this double-blind study from 2014, participants who were given hydroxyapatite toothpaste reported a significant reduction in sensitivity to cold air and touch when compared to those who were given fluoride toothpaste or a placebo. 

3. Oral Microbiome Compatibility

A healthy mouth means a balanced oral microbiome—and a healthy microbiome contains a mix of good and bad bacteria. Fluoride is an antibacterial, meaning it kills both decay-causing bacteria and some good bacteria. 

On the other hand, hydroxyapatite prevents harmful bacteria from attaching to the enamel, instead of killing it outright. 

3 Fluoride Alternatives

Not a fan of fluoride? Here are three alternatives to consider brushing with.

1. Hydroxyapatite

Hydroxyapatite is a naturally occurring compound that makes up the majority of our teeth: 70-80% of dentin and enamel, in fact. As such, it’s what we call biocompatible. That means that your body recognizes this material, and knows what to do with it. 

Hydroxyapatite fights cavities by remineralizing the teeth and healing them from within—as opposed to just acting as a bandaid on the tooth’s surface, like fluoride. And it does this without a single negative side effect. 

2.  Casein Phosphopeptides-Amorphous Calcium Phosphate (CPP-ACP)

Casein Phosphopeptides-Amorphous Calcium Phosphate (also called CPP-ACP) is a promising newcomer in the field of fighting dental caries. Despite being a mouthful, this group of peptides is derived from a familiar promoter of strong teeth: milk. 

In both human and animal studies, CPP-ACP has been proven to prevent demineralization and promote remineralization, which in turn protects against dental caries. Like hydroxyapatite, CPP-ACP doesn’t kill good bacteria. 

Oral care products containing this compound haven’t hit the mainstream market yet, but it’s a safe bet to imagine that we’ll see them on shelves in the future. 

3. Aloe Vera

You use it to relieve your sunburns, but did you know that aloe vera can also provide relief for teeth? 

One study from 2015 compared a fluoride toothpaste to one containing aloe vera and found that they have an equal degree of antimicrobial properties, making aloe vera an effective substitute for fluoride toothpaste. 

Again, the notable difference here is that aloe vera allows the microbiome to maintain its balance of good and bad bacteria—reducing the bad, but not killing it entirely. Aloe vera can also help curb plaque and fight gingivitis. 

A Better Way to Go Fluoride-Free

In summary, using fluoride is optional, but strengthening your teeth isn’t. Luckily, there’s a better way: using a hydroxyapatite toothpaste like Fortify may be the safest, most effective option on the market for protecting your teeth—without getting tangled up in the global safety debate around fluoride.

A 2014 study found that hydroxyapatite toothpaste significantly reduced tooth sensitivity when compared to fluoride toothpaste.