What’s Really in Your Toothpaste (and Should You Care?)

This past month, some loved ones and I have been facing dental issues. As my nature rarely allows these life events to just pass by without contemplation, I began a deep dive in how we might each be able to do something small, every day, to increase our odds of better oral outcomes. My search was for the best possible toothpaste that might help with remineralization and therefore possibly reduce the occurrence of cavities and such.

It’s made me start thinking more about the small, everyday choices that quietly add up over time.

📌 Save this post for later — you’ll want to come back to this.

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What You Should Know About Toothpaste

Did you know that Toothpaste doesn’t typically require FDA approval, as it’s classified as a cosmetic product rather than a drug?

Common toothpaste ingredients like xylitol, glycerin, nano-hydroxyapatite, fluoride, and artificial sweeteners are generally sold to the public as having low risks but can cause specific adverse reactions. Major concerns include gastrointestinal distress (xylitol), possible cavity-preventing barrier issues (glycerin), potential over-mineralization (nano-HAp), dental fluorosis (fluoride), and digestive issues or allergies (artificial sweeteners).

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Common Ingredients & Considerations

Here is a very brief summary on reported negative side effects and considerations for some of the most common toothpaste ingredients. There is always more to learn and research so use this as a launching pad for your own curiosity 🙂

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1. Glycerin

Controversy: Some natural dentistry proponents argue that glycerin leaves a coating on teeth that prevents remineralization. It is often used for moisture but it can leave a thin, sticky film on teeth, which may theoretically inhibit the natural remineralization process of saliva, potentially promoting plaque buildup if not properly rinsed.

Alternative: Some users choose glycerin-free toothpastes to ensure active ingredients like hydroxyapatite have direct access to enamel.

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2. Fluoride

Dental Fluorosis: Ingesting too much fluoride, especially in children under 6, can cause white spots or streaks on teeth.

Systemic Toxicity: High levels of fluoride consumption can lead to dental or skeletal fluorosis.

Environmental/Safety Concerns: Some users prefer to avoid fluoride due to concerns regarding toxicity, seeking alternative ingredients like hydroxyapatite.

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3. Artificial Sweeteners

Oral Irritation: Certain additives, including sweeteners, can sometimes irritate the gums or cause sensitivity and allergic reactions like burning, swelling (edema), rash (perioral dermatitis), sloughing of tissue, (so if you have a gunky film coming off your cheeks, this is often why), and mouth ulcers.

Health Concerns: Some artificial sweeteners used in dental products can be harmful, particularly for those with specific metabolic conditions or sensitivities.

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4. Sodium Lauryl Sulfate (SLS) and Triclosan

A common foaming agent known to cause canker sores and dryness.

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5. Microbeads

Some older or cheaper toothpastes use plastic particles that can be abrasive and environmentally harmful.

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6. Xylitol

Although a safe cavity-fighting sweetener, high ingestion can cause digestive problems like bloating, gas, or diarrhea. Recent studies have associated very high blood levels of xylitol with an increased risk of cardiovascular issues, such as heart attacks and strokes, though this risk is low from toothpaste alone.

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7. Nano-Hydroxyapatite (nHAp)

Safety Profile: High biocompatibility with minimal adverse effects reported.

Concerns: While effective for remineralization, potential for over-mineralization, (hypermineralization: creating white, chalky spots), exists.

Other considerations: It is often more expensive, has a chalky texture, and some studies suggest it is less effective than fluoride in specific conditions, though it is excellent for treating sensitivity. There are also ongoing discussions about the, as yet unknown, long-term impact of nanoparticles, though most research indicates excellent biocompatibility.

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What do dentists think about hydroxyapatite?

Dentists are increasingly supportive of hydroxyapatite toothpaste, especially because it offers an alternative to fluoride that still strengthens enamel and protects against cavities. Dentists who focus on natural or holistic care often recommend it because it’s effective without relying on more conventional chemicals.

One thing to keep in mind is that hydroxyapatite toothpaste may not foam as much as conventional toothpastes because it often avoids harsh detergents like sodium lauryl sulfate. If you’re used to the foamy feeling, this might take some getting used to.

Also, hydroxyapatite is typically more expensive than regular fluoride toothpaste, but I believe the benefits for enamel health are well worth the price. Hydroxyapatite can help reverse early-stage cavities by demineralizing the enamel.

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What is better, hydroxyapatite or nano-hydroxyapatite?

Both hydroxyapatite and nano-hydroxyapatite are effective at remineralizing teeth, but nano-hydroxyapatite (nHA) is even smaller in particle size, meaning it can better penetrate your enamel to help repair and strengthen your teeth.

Personally, I find that both are great depending on what you’re looking for, but if you want deeper repair, nano-hydroxyapatite might be the way to go.

Some countries in Europe have regulations around the use of nano-sized particles in cosmetics due to concerns about how they might be absorbed into the body. However, nano-hydroxyapatite is generally considered safe when used in toothpaste, as it mimics a natural component of teeth and doesn’t appear to pose significant risks.

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TRENDING: Prebiotics Toothpastes

There’s tons of mixed literature on prebiotics, probiotics, how to best take them, etc. We have good bacteria in our mouths that we’ve accidentally been targeting to kill with many of our oral health care products.

Revitin brand toothpaste is one that is designed to clean the teeth while allowing the good bacteria to do their job, supporting a healthy microbiome. It also tastes like orange creamsicle, so that is a bonus if that is your jam. The silica in it leaves teeth feeling super clean.

I’ve included a few microbiome-focused options here if you want to explore them further.

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Key Considerations

Hydroxyapatite: Many holistic dentists recommend traditional ingredients with hydroxyapatite, which makes up 97% of tooth enamel.

Prebiotic focus: Some brands, like Revitin, use a unique prebiotic formula, while other brands, like Boka and RiseWell, are often cited alongside it for a similar holistic, oral-microbiome-conscious approach.

Ingredients: Look for fluoride-free, SLS-free, and cruelty-free options for similar natural profiles, as well as hydroxyapatite-based options that support the oral microbiome. These alternatives typically share a goal of nourishing beneficial oral bacteria while avoiding harsh chemicals like SLS and fluoride.

Key Ingredients: Features nano-hydroxyapatite (n-Ha) for remineralization and is fluoride-free.

Microbiome Support: Look for products that use Lactobacillus paracasei probiotics to promote the growth of good bacteria.

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Top Recommended Alternatives

If you’re anything like me, you might just want a simple place to start.

I’ve gathered a few of the options I came across while researching here.

Finding toothpastes that exclude all those ingredients—fluoride, xylitol, glycerin, nano-hydroxyapatite, and artificial sweeteners—is challenging because many natural brands use at least one of them (especially glycerin or xylitol) for texture or flavor. However, some organic and clay-based options meet these strict criteria.

Radius Mint Aloe Neem Organic Toothpaste

https://amzn.to/48tIf59
Formula: USDA Organic/certified toothpaste that explicitly avoids fluoride, glycerin, artificial sweeteners.
Ingredients: It uses organic coconut oil to prevent bacteria, along with organic erythritol as a safer sweetener
alternative to xylitol.
Expert/User Opinion: According to users on Radius, it provides a “fresh-from-the-dentist” feeling but lathers
poorly compared to traditional brands.

Native Cinnamon & Mint Fluoride Free Toothpaste

https://tr.ee/CxYGoV
Formula: Native states this product is free of fluoride, SLS, parabens, and artificial sweeteners.
Ingredients: It is thoughtfully crafted with only 12 ingredients, featuring a warm cinnamon and mint flavor.
Expert/User Opinion: Reviewers from Target and Walmart praise it for its “good consistency” and ability to
“lather well,” which is rare for many natural toothpastes.

Hello Activated Charcoal Whitening Fluoride Free Toothpaste

https://amzn.to/4mf74rs
Formula: This formula is free from fluoride, artificial sweeteners, artificial flavors, and dyes.
Ingredients: It utilizes activated charcoal from sustainable bamboo to naturally whiten teeth and remove plaque.
Expert/User Opinion: Many users find it effective for cleaning and leaving teeth “sparkly clean,” though some
noted that the lathering is minimal and produces “black suds”. 
Specialty Options with Specific Benefits

MooGoo Skincare Moothpaste Fluoride-Free Toothpaste

https://tr.ee/s8C–QjCjY
Ingredient Note: While it avoids glycerin, fluoride, and saccharin, it does contain Xylitol and Calcium
Hydroxyapatite (a larger-particle version of hydroxyapatite).
Benefits: It is designed for those who want a remineralizing alternative to fluoride without synthetic additives.

Redmond Earthpaste Toothpaste

https://tr.ee/xkLfJvlz4M
Ingredient Note: This is an all-natural clay toothpaste that avoids fluoride and glycerin, but it does
contain Xylitol.
Benefits: It uses bentonite clay to draw out toxins and essential oils for an anti-inflammatory and antibacterial
effect.

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Some other Solid Contenders:

Hydroxyapatite-based brands remineralize enamel without fluoride

RiseWell Mineral Toothpaste

https://amzn.to/47ElQSw
Highly recommended by holistic dentists for its use of hydroxyapatite and xylitol to strengthen enamel and
tackle cavity-causing bacteria without fluoride.

Boka Probiotic Toothpaste Toothpaste

https://amzn.to/41OUfuh
Another popular fluoride-free hydroxyapatite toothpaste.

Natural, fluoride-free options; alternatives that focus on maintaining a healthy oral microbiome and using safe ingredients. 

Welada Natural Salt Toothpaste

https://amzn.to/41c88md
contains baking soda and salt, appealing to those seeking natural, herb-based cleaning.

Auromere Herbal Toothpaste

https://amzn.to/4veLYxa

Fygg Nano Toothpaste

https://tr.ee/wpKXHYA3nH
Nourishing Ingredients: Formulated with biomimetic and oral microbiome-nourishing ingredients, specifically
targeting bad breath and cavities.
Notable Features: It is a non-foaming, non-burning formula free from essential oils and surfactants.
User Feedback: According to Feed Your Good Guys, users appreciate the gentle, non-irritating feel and the
coconut cream flavor.

Davids Natural Toothpaste

https://tr.ee/PlFPzRRNfu
A popular fluoride-free choice that uses baking soda for whitening and vegetable glycerin instead of SLS. It is
often cited for leaving the mouth feeling “fresh and clean” with a generous froth.

Sensodyne Pronamel Mineral Boost Toothpaste

https://tr.ee/PlFPzRRNfu
A sensitive-teeth formula focused on remineralization. 

Desert Essence Prebiotic Plant-Based Toothpaste

https://tr.ee/50h8f1YNwv
Prebiotic Plant-Based

If you’re going down this rabbit hole too, I’ve put everything I found in one place for easy reference.

Sources & Further Reading

There’s always more to learn — here are a few places I started.

• Balanced Dental Studio – What’s the Best Toothpaste to Use?
• Felt Family Dentistry – Beware of Toothpaste Containing These 8 Ingredients
• Mouthology – Harmful Toothpaste Ingredients You Must Avoid for Better Oral Health
• NIH – Xylitol may affect cardiovascular health | National Institutes of Health (NIH)

There’s always more to learn, and new information coming out all the time.
For me, this was just a reminder that even the smallest daily habits are worth paying attention to.
Not out of fear — just out of awareness.

A small shift, but maybe a meaningful one.
-Joani