Tooth enamel is the outer covering of your teeth. It is the hardest substance in your body, even stronger than bone. Dental enamel is composed mainly of calcium and phosphate forming in a lattice called hydroxyapatite (HA). Hydroxyapatite can be softened and dissolve in an acidic environment. Our saliva, saturated with calcium and phosphate, bathes the teeth to keep adding back the calcium and phosphate to the enamel. The process of adding back the minerals to the enamel is called demineralization.
Fluoride, a natural substance found in water, soil and plants, can react with the calcium and phosphate in saliva to form fluorapatite in the enamel. Fluorapatite is similar to hydroxyapatite but is more acidic resistance than hydroxyapatite. Because of the lower solubility in acid, fluorapatite formed in enamel helps prevent cavities by making the enamel less soluble in acid. It is well established that dental non-cavitated caries in their early stage of formation can be remineralized, provided that there has the right environment, pH and minerals bathing the area. The minerals that can help to fight cavities are calcium, phosphate, and fluoride. However, extensive use of fluoride, mainly in the form of a dentifrice, has contributed to a rising incidence of dental fluorosis, particularly in preschool children, due to chronic ingestion of these products. Some patients may like to avoid fluoride or other substances that they consider not holistic or naturalistic. Hence, there is a need for alternative caries remineralizing and preventive agents as effective as fluoride.
Recent research has been conducted in modern preventive dentistry to attest the biomimetic oral health products containing nano-sized hydroxyapatite particles. Synthetic medical nano-hydroxyapatite (nHAP) has similar chemical-physical properties as the hydroxyapatite structure found in enamel, making it an exciting ingredient for oral health compounds. nHAP shows a strong affinity to the tooth and can readily adsorb on enamel surfaces. In Japan, nano-hydroxyapatite has been used in toothpaste since 1980 and was approved as an anti-caries agent in 1993. Nowadays, several dentifrices and mouth rinse formulations containing nano-sized biomimetic apatite particles are available for North American consumers.
The University of Texas Health Science Center at San Antonio investigated the efficacy and effectiveness of toothpaste containing nHAP in preventing cavities in adults compared to conventional fluoride toothpaste. The results of their investigation have confirmed that nHAP containing toothpaste can be an effective alternative to fluoride-containing dentifrices. Based on the findings here, nHAP-containing dentifrices can be recommended for children or those concerned about dental fluorosis. Since the remineralizing efficacy of topical fluorides is strictly dependent on the availability of calcium and phosphate ions, nHAP dentifrices are strongly recommended to xerostomic patients with diminished amounts of saliva. Nanohydroxyapatite may have the potential to occlude dentin tubules and, as such, may be helpful for the treatment of dentin hypersensitivity.
At Affinity Dental Care, we can provide fluoride-free treatment to our patients using nHAP containing prophy paste and desensitizing/remineralizing agents to our patients who have concerns with fluoride. The product we use is from X-Pur Remin, which has the space age nano-hydroxyapatite as one of its ingredients. The product is also free of sodium lauryl sulphate or triclosan.
As a service to our patients who want alternative home care toothpaste with no fluoride, we also sell the X-Pur Remin toothpaste at cost. Please feel to call or visit our office to find out how we can address your particular needs for holistic dental care.