Enamel and dentine remineralization in the laboratory
LaboratoryNano-hydroxyapatite toothpastesBovine teethArtificial lesions, 2 and 5 weeks
Dentine remineralization is higher than with an amine fluoride toothpaste, but so is that of the group with no toothpaste. On enamel, only pure nano-hydroxyapatite (7%) exceeds the fluoride toothpaste, with no difference from the other groups7.
Caries: 17% protection in a meta-analysis of three trials
Review2021 systematic review22 studies kept, 5 caries trials, 4 randomized
The meta-analysis of three randomized trials shows 17% protection. The other 17 studies use indirect endpoints, and some trials show hydroxyapatite products not inferior to fluoride ones8.
Update: a favorable effect, with no superiority over fluoride
Review2024 review18 studies, 5 clinical trials and 8 in situ studies
According to the independent commentary on this review, hydroxyapatite toothpastes do better than placebo (pooled odds ratio of 2.51). Against fluoride, the advantage is not significant (1.1)910.
Triple-blind trial in 610 children
Clinical trialHydroxyapatite with fluoride versus monofluorophosphate610 children aged 4 to 724 monthsTriple blind, randomized
Toothpastes combining hydroxyapatite and fluoride significantly reduced enamel lesions compared with the standard fluoride toothpaste (p < 0.01). Hydroxyapatite is not tested alone: the effect of the active itself is not isolated11.
Whiter teeth: preliminary evidence
Review2023 systematic review17 studies including 13 in vitro
In vitro and in vivo results point the same way, with enamel whitening. The six clinical trials remain preliminary12.