The influence of fluoride in reducing dental caries has been clearly demonstrated. Its use in drinking water and oral care products dates back over 70 years. Fluoridation has been called the single most effective public health measure to prevent new tooth decay, and early U.S. studies showed it reduced caries among schoolchildren by as much as 35-60%. However excess fluoride can lead to problems such as dental or skeletal fluorosis, and the amount permitted in oral care products and community water systems is controlled.

In contrast, nano Medical Hydroxyapatite, used as a remineralizing agent in toothpaste in Japan for the last three decades, was shown in field trials leading to its approval as an active anticaries ingredient to cause a similar reduction in new caries among schoolchildren to that seen with fluoridation in the U.S., namely 36-56%.(Fig 1.T.KANI et al Effect to Apatite-containing Dentifricres on Dental Caries in school Children)

Fig 1. Average increase in new caries using the test toothpaste once daily for 1 year (Group A) and 3 years (Group B)Fig 2. Remineralization effect of fluoride and nanohydroxyapatite toothpastes, by pH cycling

A recent in situ study conducted among healthy adults in the U.S. found that Sangi’s Medical Hydroxyapatite toothpaste not only inhibited development of caries but was not significantly different from fluoride in its ability to remineralize early caries lesions. (Amaechi et al, Remineralization of Early Caries Lesions by Nanohydroxyapatite Dentifrice). This supported the findings of earlier in vitro studies in Hong Kong which showed no significant difference in remineralizing effect between fluoride- and Medical Hydroxyapatite (‹mHAP ›)-containing toothpastes. (NM King et al, Remineralization by Nanohydroxyapatite-containing Dentifirice)

Moreover, hydroxyapatite has been shown to be safe – even edible – and can be swallowed by children without concern, as it has no known toxic or harmful impact.