Toothpaste with hydroxyapatite provides promising results, study shows

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A recent review has concluded that hydroxyapatite toothpaste shows promising results regarding remineralization of enamel lesions. (Image: Tasha Cherkasova/Shutterstock)
Dental Tribune International

By Dental Tribune International

Wed. 22. December 2021

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TORONTO, Canada: The debate about fluoride in toothpaste may have taken another turn. Recently, researchers from the University of Toronto have shown in a narrative review article that, compared with fluoride as the anti-caries agent in toothpaste, hydroxyapatite (HAP) in fluoride-free toothpaste can provide equivalent or better protection.

In the study, researchers from the university’s Faculty of Dentistry reviewed the recent findings of investigations into the remineralization potential of HAP toothpaste in vitro, in situ and in vivo, and in some other dentistry applications. “In comparison to fluorides which are limited to only surface remineralization, HAP particles are able to penetrate into the deeper layers of the lesion,” noted the researchers in the paper.

According to the study, naturally occurring enamel consists of 20–40 nm HAP nanoparticles, and it has been suggested that the use of 20 nm HAP nanoparticles is effective at repairing damaged enamel. In the study, the researchers said, “The idea behind the use of HAP particles as a remineralization agent is based on the principal of dental biomimetics, which is the belief that dental materials should mimic natural properties of the tooth.”

Synthetic HAP-containing toothpaste first came about to aid NASA astronauts who losing mineral content in their bones and teeth while in space. Back on planet Earth, the number of people with caries due to, among other things, sugar-saturated diets and poor oral health is a continual concern. However, the review found that “in vitro and in situ studies are demonstrating promising results of HAP toothpastes on the remineralization of enamel lesions and preventing/reducing demineralization,” demonstrating either HAP’s superiority or equivalency to fluoride in toothpaste. The researchers cautioned though that more research is needed to confirm HAP’s clinical effectiveness regarding caries prevention and arrest.

In an article published on the university’s website, Dr. Kelsey O’Hagan-Wong, first author of the study and a second-year pediatric dentistry resident, noted that some of the issues around HAP toothpaste are its price and the difficulty in finding stores that stock it. “Although this toothpaste has been on the market for a while, most people are unaware of it,” she said.

The study, titled “The use of hydroxyapatite toothpaste to prevent dental caries,” was published online on Nov. 22, 2021, in Odontology, ahead of inclusion in an issue.

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