Fluoride-free remineralization? Check out HAp

Did you know that incipient dental cavities can be reversed? Tooth structure can be strengthened with remineralization to increase enamel density and resistance to decay!

Dental cavities continues to be one of the most prevalent chronic diseases (Kassenbaum 2015).

  • 92% of adults have had cavities develop in their permanent teeth  
  • Over 50% of children aged 6-11 have had cavities in their primary teeth  

Caries can not only be prevented but reversed as long as no volume of tooth structure has been lost. Saliva has protective effects due to its supersaturation with Ca2+ and PO43– ions. The remineralizing effects of saliva is a slow process and clearly patients with elevated cavity risk could benefit from additional agents to enhance its fortifying effects (Bennett 2019)

In the United States, fluoride is the most established therapeutic used to prevent cavity development (Benson 2013, Shahid 2017) and has a cornerstone of dentistry since 1912. Fluoride remineralization with 5000 ppm sodium fluoride is still the gold standard for high risk patients (Biesbrock 1998, Shmiedlin 2016).

For patients with low or moderate carids risk that are looking for a fluoride-free remineralization modality, there are now oral products powered by Hydroxyapatite (HAp) Ca5(PO4)3(OH) (Meyer 2018, Enax 2018, Hanning 2010). Hydroxyapatite is the basic building block of human teeth and bone. It composes 97% of enamel, 70% of dentin, and 60% of bone (Meyer 2018).

Hydroxyapatite’s medical application began with NASA astronauts returning from space, whose bones and teeth suffered a significant loss in mass after experiencing a zero-gravity environment. HAp has been approved as an anti-caries agent in Japan in 1993 and in Canada in 2015 with randomized controlled trials.

Toothpastes that contain HAp:

Boka: Nano- HAp is a gold standard in Japan and its small size is great for decreasing tooth sensitivity. Ela mint is great for those who prefer lighter flavors. 10% of with code jchiangdds

Risewell: Micro-HAp is derived only from natural ingredients and can be found in higher quantities than Nano-HAp . Wild Mint is a delicious, bright way to start the day. 10% off with code jenchiangdds10

I’ve tried both and love their clean formulations and delicious flavors. I recommend them for patients with low or moderate caries risk. I like how they are both contain xylitol and are SLS and dye free. I’m so excited to see innovation in oral hygiene products and can’t wait to hear what you guys think of these innovative new clean formulations.

Best wishes,
Dr. Jen