Hydroxyapatite Toothpaste Rivals Fluoride for Cavities, But the Evidence Comes With Caveats
Hydroxyapatite (HAP) toothpaste performs about as well as fluoride toothpaste for preventing cavities in clinical trials, and it actually outperforms fluoride for tooth sensitivity. That's a genuinely interesting finding. But the strength of that cavity evidence isn't as solid as you might hope, and the details matter if you're trying to decide whether to make a switch. A 2024 meta-analysis pooling 18 clinical and in-situ studies found HAP toothpastes were about 2.5 times more effective than placebo at reducing caries, with a non-significant trend actually favoring HAP over fluoride. "Non-significant" is the key word there: statistically, the two performed similarly. For sensitivity, though, the story is clearer, and HAP has a real edge.