Before we get to Calcium Hydroxyapatite, let's talk about cavities.
Cavities are a hole in the tooth created by bacteria. When bacteria in the mouth metabolize carbohydrates, they produce an acid that wears down the enamel of the tooth, creating little crevices. If left untreated the crevices continue to grow and eventually wear through the enamel, creating a cavity. This causes pain, can lead to dangerous infections, and eventually the loss of teeth.
There are two ways to fight cavities, preventing destruction of existing enamel (demineralization) and promoting buildup of new enamel (remineralization). Demineralization can be prevented by controlling the acid produced by the bacteria, either by limiting fuel (carbohydrates) or by removing more bacteria (as well as limiting acidic food/drink). Remineralization naturally occurs through the calcium and phosphate ions in saliva. These ions attach to the teeth to fight against the relentless demineralization, but it often isn’t enough (especially with modern diets). The imbalance of these processes lead to cavities, and is why humans have been in search of solutions to balance it out. Then we found Fluoride.
Fluoride works by attaching to the tooth enamel to create a thin protective coating of fluorohydroxyapatite. This coating fills in the little crevices (reducing surface area) and protects the enamel from acid. The widespread use of fluoride has massively reduced the rate of cavities, and is considered one the greatest public health accomplishments of the 20th century. But Fluoride can also be very toxic to humans if too much is ingested. Some people choose to avoid fluoride, but run a significantly higher risk of tooth decay. Few people are aware of alternatives remineralizing agents, such as Calcium Hydroxyapatite. (For more information on fluoride, check out The Fluoride Debate: The Pros and Cons of Fluorination)
Our tooth enamel is made up of 97% Calcium hydroxyapatite, 2% binding proteins and some water. So what better substance than Calcium Hydroxyapatite to help repair and protect the enamel?
When brushing with Calcium Hydroxyapatite the particles bind with the teeth, essentially building up “new enamel”, instead of a layer of fluoride, in order to protect the teeth. This 6 -month RCT(clinical trial) showed no significant difference between Fluoride and Calcium Hydroxyapatite on the progression of cavities. Calcium Hydroxyapatite is also effective at remineralizing primary teeth (children are the most at-risk population for fluoride toxicity), and provides a “fuller remineralization” than fluoride, as shown in this Nature article. For more on Calcium Hydroxyapatite, check out this review of remineralizing agents in oral care cosmetics(2020). Calcium Hydroxyapatite has been shown to be as effective as fluoride in protecting our teeth...but it also has other benefits!
It’s also shown to significantly reduce Tooth sensitivity. Sensitive teeth occur when nerve endings are exposed and get aggravated. The Calcium hydroxyapatite attaches to the tooth, protecting the nerve ending so it’s no longer exposed, working as a long term solution for sensitivity. “Thanks to its safety, ease of use, and home application, n-HAp (Calcium Hydroxyapatite) dentifrice can be considered a prime choice treatment for managing dentin hypersensitivity” (Quote from this double-blind RCT)
The use of Calcium hydroxyapatite can also help to create Whiter Teeth. As the Calcium Hydroxyapatite attaches to the surface of the enamel it smoothes out the surface, increasing shine. The common ways of creating whiter teeth is either mechanical abrasion (polishing the rough surface) or chemical bleaching (bleaching stains embedded in the tooth), but these methods are destructive and commonly cause tooth sensitivity. Calcium Hydroxyapatite helps to create whiter teeth through building up tooth enamel, so it reduces sensitivity and whitens simultaneously!
There is an ongoing debate about the Safety and Toxicity of Fluoride. Calcium Hydroxyapatite provides an alternative that is “safe to be used in oral care products” (from this Nature article). The Calcium Hydroxyapatite can’t enter through the lining of the mouth, so the only way in is down the hatch! Stomach acid quickly breaks it up into calcium and phosphates which are commonly found in foods we eat.
For people concerned about Fluoride, Calcium Hydroxyapatite provides a safe and effective alternative to maintaining their oral health.