What is demineralization?
Think back to chemistry class in junior high school. Do you remember the pH scale? On the pH scale, a 7 represents a neutral (non-acidic and non-alkaline/basic) solution. The range for a healthy salivary pH is 6.2-7.6. If your dental health is good, we do not need to look at your salivary pH. But if you are having dental problems, we might want to consider your salivary pH and in general, we improve it by making it more alkaline/basic. Not acidic.
Many nutritionists are also trying to get your system more alkaline/basic for gut and systemic health. Often, these recommendations are great systemically, but as they pass through your mouth, the foods are often acidic, which is not good for your teeth.
So the challenge is to get a good systemic environment and make sure we maintain a more basic alkaline salivary pH. Common foods that create more acidic environments are apple cider vinegar, lemons, citrus fruit, coffee, sodas, and juices.
Your tooth enamel is incredibly strong, but it is susceptible to a process known as demineralization. Acid slowly breaks down the outer layer of the tooth, making it more susceptible to decay, cavities, and disease. The more acidic your saliva, the more you will find demineralization.
Traditionally, dentistry has recommended fluoride to remineralize teeth. We like hydroxyapatite instead.
Fluoride is a chemical compound that reacts with the calcium, phosphate, and other minerals in your saliva. This reaction produces fluorapatite, a crystal that bonds with the structure of your teeth to reverse the demineralization process.
The result is stronger and healthier teeth that are more resistant to acid and decay.
Hydroxyapatite is a natural compound that makes up 97% of your tooth’s enamel. Toothpaste with hydroxyapatite aids in the remineralization of your teeth. Because hydroxyapatite particles are much smaller than fluoride molecules, they can penetrate deep within the tooth, remineralizing it from within.
Does hydroxyapatite work as well as fluoride?
A recent study showed that hydroxyapatite was just as effective as fluoride. In addition, hydroxyapatite has other benefits, too:
- It’s not antibacterial – Fluoride kills bacteria, including some of the beneficial bacterial flora in your mouth.
- There’s no risk of fluorosis – Hydroxyapatite won’t cause white spots on your teeth.
- It’s safer for kids – Unlike fluoride, there are no known side effects of excessive hydroxyapatite.
- It lightens teeth– Some research shows that hydroxyapatite may aid in whitening teeth a bit.
Who should use hydroxyapatite toothpaste?
Because it offers similar benefits, everyone should consider hydroxyapatite toothpaste. However pregnant women and young children (who can’t spit out fluoride toothpaste) may see the biggest benefit of avoiding fluoride toothpaste.
Traditional practices say “of course it is safe.” Biologic practices say “it is never safe.” As an integrative practice, we say let’s talk about it. We think the debate is based on the understanding of topical vs ingested fluoride. We do not recommend ingesting fluoride, but topically, it might be worth considering if you are challenged with lots of cavities.
But we do not recommend this without also considering your systemic health. Excessive ingested fluoride can lead to fluorosis, a condition that produces white spots on the teeth. In addition, here in Chicago, our tap water is fluoridated in addition to the natural fluoride found in our groundwater supply.
What brand of hydroxyapatite should I buy?
RiseWell has a natural hydroxyapatite toothpaste that we recommend to any patient who’s interested in alternatives to fluoride. There’s even one designed for kids with a yummy (and natural) cake batter flavor!
