Question: Does fluoride toothpaste really work?
Answer: 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 it’s the same concentration that’s in the water system.
The water system contains a fluoride concentration that strengthens teeth by getting absorbed by your body when you drink water. It’s about 1,000 parts 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!