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Traditional fluoride has long stood unopposed as the champion of dental-care routines. It's been endorsed by dentists and the ADA for decades for its cavity prevention and enamel-strengthening properties. But now, a powerful natural contender called hydroxyapatite is emerging. This mineral offers fantastic benefits for remineralizing and brightening your smile. But which one is the best for your oral wellness?

In this blog, we'll weigh the pros and cons of these two cavity-fighters. Discover how they compare when it comes to improving your oral health so you can make an educated decision  on which suits your smile best.

What Is Hydroxyapatite Toothpaste?

Hydroxyapatite is a natural alternative to strengthen and protect teeth without overexposure risks. You have more hydroxyapatite in your mouth than you realize — it makes up over 90% of tooth enamel. This mineral is crucial for giving our pearly whites their hardness and strength.

The hydroxyapatite toothpaste has the same enamel-strengthening mineral already present in your teeth. When you brush, hydroxyapatite particles get to work, reinforcing your enamel. They fill in weak spots etched by acidic foods and drinks, integrating seamlessly to bolster your enamel's defenses. Hydroxyapatite remineralizes by replenishing vital minerals lost throughout the day. It helps fill weaker spots, strengthening enamel and combating plaque buildup and decay. The calcium and phosphate in hydroxyapatite are also important for fighting cavities and decay.


  • Hydroxyapatite remineralizes enamel the natural way. It attracts calcium and phosphate already present in saliva, redepositing these minerals back into the enamel, just like your body does on its own.
  • Hydroxyapatite is non-toxic and biocompatible since it contains the same calcium and phosphate ions in tooth enamel and bone. Therefore, ingesting it is entirely safe with no risk of overexposure effects.
  • It's kid-friendly with no risk of dental fluorosis, which can permanently damage developing tooth enamel if accidentally swallowed by young children.
  • Clinical studies have demonstrated that hydroxyapatite toothpaste can naturally whiten teeth without using abrasive agents or chemical whitening ingredients.
  • Hydroxyapatite is microbiome-friendly. It prevents harmful bacteria from adhering to the enamel without killing beneficial oral and gut bacteria.


  • It's less widely available than popular fluoride toothpaste, which can be found in most stores.
  • Since the ingredient costs more, hydroxyapatite toothpaste is usually more expensive than fluoride.
  • Hydroxyapatite toothpaste has less long-term clinical data than fluoride toothpaste, but more studies could improve its promising research.
  • Hydroxyapatite may not provide everything you need for complete oral health. Depending on their specific dental needs, people with a high risk of cavities may still benefit from adding fluoride.

A woman holds up her toothbrush in front of the camera with her left hand while her right hand is squeezing toothpaste onto it.

What Is Fluoride Toothpaste?

Fluoride toothpaste works to prevent cavities through a process called remineralization. When acids from food and plaque bacteria erode tooth enamel, fluoride helps repair the damage by redepositing minerals back into the teeth.

Here's how it works: Fluoride combines with calcium and phosphate in saliva and enamel. Together, they form a substance called fluorapatite that is eager to lend a hand (make that a molecule!) to struggling teeth. The fluorapatite attaches itself to porous areas of enamel where minerals have been lost. It then provides a new calcium and phosphate dose to fill the weakened spots and restore mineral density.

It also inhibits the bacteria responsible for the plaque acids that damage teeth in the first place. When the environment turns acidic, fluoride can morph into hydrogen fluoride, allowing it to penetrate through bacterial cell walls. Once inside, the fluoride releases ions that sabotage the bacteria's ability to produce acids and gnaw away at the enamel.


  • The fluorapatite structure formed from fluoride is less soluble than hydroxyapatite, creating a robust shield against demineralization and erosion when teeth are exposed to acidic foods and drinks.
  • People prone to developing cavities may decide fluoride toothpaste is right for them, as it has a proven track record of effectively preventing caries.
  • Due to its widespread endorsement from dental professionals and the ADA recommendation based on proven efficacy, some people feel more comfortable using fluoride toothpaste.
  • Fluoride toothpaste allows parents to proactively strengthen their children's developing tooth enamel, helping prevent early cavity formation that could help them throughout life.
  • Fluoride toothpaste has a long history of safety and efficacy in preventing tooth decay when used as directed — numerous scientific studies and extensive research back up its benefits.


  • Excessive fluoride intake during pregnancy has been linked to potential adverse developmental effects, so it may not be the best choice for pregnant women.
  • Overexposure to fluoride can lead to dental fluorosis, which is a condition that causes brown or white splotches on your teeth. However, using fluoride toothpaste topically as directed is safe and effective.
  • If you reside in an area with fluoridated water, there is a potential risk of ingesting too much fluoride if you use fluoride toothpaste.
  • Though fluoride reduces harmful bacteria, it may also kill beneficial oral bacteria, disrupting your oral microbiome.

A woman wearing a purple sweater smiles with her eyes closed while pointing at her teeth with both hands.

Get Your Brightest Smile Yet with Twice Toothpaste

Both fluoride and hydroxyapatite offer science-backed ways to strengthen your enamel and prevent cavities. While fluoride has decades of proven benefits, hydroxyapatite offers a natural option for those looking to avoid fluoride. Both can be effective solutions - the choice comes down to personal preference.

Want to brighten your smile and prevent cavities, naturally? Try Twice's Fluoride-Free Oral Wellness. Infused with hydroxyapatite, activated charcoal and baking soda, it remineralizes enamel and naturally whitens teeth. Prefer fluoride's cavity-fighting power instead? Twice's 5-in-1 Toothpaste with Fluoride prevents decay while reducing sensitivity and freshening breath for complete oral wellness.