With or without fluoride: which toothpaste is best? ATTITUDE
November 23, 2023With or without fluoride: which toothpaste is best?

Amazing, isn’t it, how subjects seemingly as straightforward as toothpaste can generate heated debate? Toothpaste – an essential element of daily hygiene – can provoke controversy regarding the presence of sodium fluoride. What’s better: toothpaste with, or without, sodium fluoride? The jury’s out. Opinions are divided. In this article, we’ll provide you with some advice to help steer you towards making the brightest choice for your smile.



The truth about fluoride toothpaste



What is fluoride?


OK, let’s first take the mystery out of this controversial ingredient: The fluoride ion is simply a mineral, and is naturally present in water, air, food and soil. It’s a crystalline, colourless solid, or a white powder soluble in water. It has numerous uses, including fluoridating drinking water, wood preservation, manufacturing glass and cleaning products and, of course, dental hygiene.



What are Fluoride’s benefits?


Fluoride’s dental health benefits were first discovered in the 1930s, when it was found that individuals in communities that had access to fluoridated drinking water tended to have less tooth decay than individuals that did not have similar access1.

Fluoride was then officially incorporated into dental care a decade later. Today, fluoride is found in a variety of toothpastes, mouthwashes, gels, dental polishes and more. Its use is predicated upon scientific studies that show fluoride strengthens enamel, protects teeth against wear caused by acidity, and promotes the restoration of minerals that make teeth more resistant2.



With or Without Sodium Fluoride person brushing teeth ATTITUDE

Does fluoride have any effects on our bodies?


Researchers have been testing fluoride’s safeness and benefits since the 1940s. Other than dental fluorosis and skeletal fluorosis, there have been no other adverse effects on the human body associated with fluoride2.



Why is sodium fluoride controversial?


Why does fluoride provoke controversy considering its many advantages? Although fluoride is beneficial for teeth, if it is consumed in high amounts or high concentrations, it can cause two health-related problems: dental fluorosis and / or skeletal fluorosis.

According to Health Canada, dental fluorosis is a condition that changes tooth enamel’s appearance, leading to small white spots appearing on adult teeth. This only happens, however, when – as a child – too much fluoride was ingested while permanent teeth were developing under the gums: It cannot develop once permanent teeth have appeared. Dental fluorosis is classified according to degrees of severity: In its mildest form (which is the most common in Canada), the consequences are only aesthetic in nature and have no impact on either oral health or overall health.

Skeletal fluorosis has a higher degree of severity and concerns hardening of the bones and joints: It can occur when there’s a very high concentration of fluoride in the bones, and is caused by ingesting a large amount of fluoride every day over an extended period of time (which is extremely rare in Canada as the concentration of fluoride in water and affected products is limited to a very low level).

So, should using fluoride worry you? No, not if you use it normally. In fact, the World Health Organization, along with international health authorities, recommends using fluoride. The Environmental Working Group – one of the most reputable sources on matters relating to health – rates sodium fluoride between 2 (good) to 4 (average), specifying that it represents no cancer risk, no allergy risk, or any risk of damage to the reproductive system. The EWG simply recommends limiting fluoride’s use to small quantities3.



Do dentists recommend sodium fluoride?


Yes, they do. The Canadian Dental Association (CDA) recommends prudent use of sodium fluoride in preventive treatments and in daily care products to prevent tooth decay. Here are the CDA’s recommendations for optimal oral health:

  • Consult with a dentist to assess your risk of getting cavities and to obtain professional advice on daily products containing fluoride to ensure they meet your specific needs.
  • Begin taking your children to the dentist starting at one year of age or within six months after the appearance of their first tooth. Daily use of products containing fluoride is recommended only if the child (up until three years of age) is at risk of developing cavities.
  • Talk about professional fluoride treatments with your dentist.


Can fluoride help to remove cavities?


Good oral hygiene can help eliminate a cavity once it begins to form. Exposure to fluoride, and good brushing and flossing can help to prevent cavities as well as remove those that are already present at the beginning of a tooth’s demineralization process4.



Which toothpaste should you choose?



With or without sodium fluoride toothbrush ATTITUDE

With such a wide range of dental products available, it can be a daunting task to choose the right toothpaste. The important thing to consider is your specific needs, and to choose products that contain ingredients that are of no concern to EWG scientists. There are toothpastes that use plant and mineral ingredients (such as fluoride) that provide complete care and promote the remineralization of enamel, while also preventing cavities and eliminating bad breath.

Do you have sensitive teeth? If so, then look for toothpaste that contains potassium nitrate, which works as an anti-sensitivity agent.

Do you fantasize about having an even brighter smile? Then opt for a whitening toothpaste with a hydroxyapatite base, which is a naturally derived whitening agent and is gentle and effective.

When it comes to children, it’s important to establish a dental hygiene routine as soon as their first baby teeth appear. Start with a fluoride-free training toothpaste until your child learns to spit well. And always use a soft-bristled toothbrush to avoid damaging the enamel on your little ones’ teeth.



Did you know?


In the United States alone, more than a billion toothbrushes – mostly made of plastic – are disposed of each year5. To combine oral health with preserving the environment, use a toothbrush that’s made from bamboo wood (a renewable, durable and biodegradable resource). That means gentle brushing, not only for you but for our planet as well!



We hope this article has helped you make a more informed toothpaste decision. And even with the debate surrounding fluoride, its regular use is strongly recommended by CDA’s experts. Considering fluoride’s proven benefits in cavity prevention, it’s important to choose products that are tailored to your specific oral health needs. And if ultimately fluoride continues to worry you, or your dentist recommends that you avoid fluoride, remember there are options without sodium fluoride.

To learn more about the importance of choosing a vegan toothpaste, please read the following article:

5 benefits of vegan toothpaste

  1. https://pubchem.ncbi.nlm.nih.gov/compound/Sodium-Fluoride#section=Structures
  2. https://www.canada.ca/fr/sante-canada/services/vie-saine/votre-sante-vous/environnement/fluorures-sante-humaine.html
  3. https://www.ewg.org/skindeep/ingredients/706065-SODIUM_FLUORIDE/
  4. https://www.cda-adc.ca/fr/oral_health/faqs/fluoride_faqs.asp#:~:text=Comment%20le%20fluorure%20aide%2Dt,supprimer%20celles%20qui%20sont%20apparues
  5. https://www.nationalgeographic.com/environment/article/story-of-plastic-toothbrushes

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Written by Team ATTITUDE