Product Reviews

Does Fluoride Toothpaste Work?

Regular toothpaste doesn't contain enough fluoride to effectively strengthen teeth. That's because the concentration of fluoride in the water system and in toothpaste are two very different things.

by Dr. Burhenne

Does Fluoride Toothpaste Work?

Does fluoride toothpaste really work? You might be surprised to hear that the answer is, no. While fluoride is proven to be effective in remineralizing teeth, it doesn’t have a strong enough concentration in toothpaste in order to be effective.

Fluoride Toothpaste is Too Weak to Be Effective

Here’s what’s misleading: the concentration of fluoride in toothpaste is too weak to have an effect. That’s because they don’t add that much more fluoride to regular toothpaste than what’s in the water. They add an amount that is safe in case it gets swallowed by a child, but not strong enough to really do the job of remineralizing your teeth topically – as opposed to ingestion of fluoride when your teeth are developing.

The water system contains a fluoride concentration that strengthens teeth by getting absorbed by your body when you drink water. It’s about 1 part per million.

But you’re not swallowing toothpaste; you’re applying it directly to your teeth. This is a very different from swallowing fluoridated water; this is called “topical” application, and you need a higher concentration of fluoride for this to work; around 5,000 parts per million.

Why doesn’t toothpaste just add the higher concentration of fluoride then to make it effective? That higher concentration would severely damage developing teeth if swallowed, so the FDA doesn’t allow it.

This is why you can only get fluoride paste, which contains the right concentration for topical application, by prescription only.

So where does that leave us? If you bought your toothpaste without a prescription, then it’s likely too weak of a fluoride concentration to strengthen your teeth.

So, brushing with non-prescription fluoride toothpaste is just about the same as brushing with regular tap water that has had fluoride added to it.

Fluoride Is Absorbed Best After You’ve Brushed

If you do get a fluoride toothpaste by prescription from your dentist, then you’ll be instructed to brush first before applying the paste.

The uptake of fluoride — in other words, how your teeth absorb the fluoride — isn’t optimal when your teeth haven’t been brushed yet. Teeth naturally grow a covering called biofilm, and this is the stuff you remove every time you brush. You have to remove the biofilm by brushing first, and afterwards, apply fluoride paste. This has to be a two-step process.

In other words, you can’t wash and wax your car at the same time!

You can get a prescription fluoride gel from your dentist that will actually help with remineralization. I recommend (and use myself) Colgate PreviDent 5000 Booster Plus every night before I go to bed to treat the areas of my teeth that are sensitive to cold and acids due to gum recession, and only after I’ve brushed to remove the biofilm. (I’m not affiliated with Colgate in any way. I use it because, according to studies, it’s the best at remineralizing teeth.)

A natural alternative that is just as effective as fluoride, or perhaps even more (depending on the study) would be chewing on cacao nibs or very dark (90%+) chocolate.

Mark Burhenne DDS

What kind of toothpaste do you use? Let me know in the comments below!

read next: The Complete Guide to DIY Toothpaste (And The Recipe I Use)

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Dr. Mark Burhenne DDS


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  1. I’d be interested to know your thoughts about Livionex. I’ve just started using it and hope it’s all it’s made out to be. It’s supposed to be good at remineralizing teeth.

  2. I’m searching for the best (healthy, works, safest for environment) tooth powder or paste. Commercial toothpastes taste fine but have some significant environmental problems: triclosan, plastic microbeads, and the left over plastic tube and cap. Baking soda is noted by many as being too strong/abrasive for regular brushing.

    Currently the most sustainable tooth powder I’ve been able to find is the following recipe:
    4 tbsp bentonite clay
    1 tbsp activated charcoal
    6 drops peppermint (essential) oil
    1.5 tsp stevia, powdered and unprocessed
    1 tsp ground cloves (optional)
    1 tsp cinnamon (optional)

    What do you think of this formulation? How well will it work? Any downsides to this? I’ve got all the ingredients on order (should arrive in a few days). If you want to try some of what I mix up I could drop some off at your office 🙂

  3. My hygienist just recommended the Colgate PreviDent 5000 Booster Plus since Im mid age and have some mild to moderate recession in areas. She said it would help prevent further recession…do you believe this to be true? I do want my teeth to be healthy as we all do.

    • It won’t prevent recession directly but protects from decay and sensitivity of root structure exposed by recession. My blog post here was about over the counter toothpaste. The Prevident has an effective stronger concentration of fluoride and can remineralize tooth structure. But it will not prevent recession. Look to grinding and aggressive brushing as potential causes of recession. DrB.

  4. My dentist sells me Colgate Prevident. Why does it cost $16 when a large tube of regular toothpaste costs $3 or $4? Is fluoride that expensive?

  5. I have been prescribed PreviDent by my Dentist. I also brush with hydrogen peroxide afterwards. Any suggestions on this practice.

  6. My son is 10 and has only had one cavity. His dentist gave him prescription Clinpro 5000. They also told me to have him use it twice a day instead. Now he has what looks like plaque deposits on his teeth. Are kids supposed to be using the prescription toothpaste?

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