Fluoride Toothpaste vs Non-Fluoride Toothpaste – Which is Healthier?

Fluoride beats non-fluoride in our tests; hydroxyapatite comes close but carries higher toxicity—choose wisely for safe, effective dental care.
Image titled "This or That?" features a side-by-side comparison of two toothpaste tubes. On the left, there is a tube of Crest Pro-Health, a fluoride toothpaste. On the right, there is a tube of Boka Ela Mint, a non-fluoride toothpaste. The tubes are placed against a light green background with "VS" in the middle.

Our Verdict

When comparing fluoride toothpaste to non-fluoride toothpaste, we picked the fluoride.

Why?

Fluoride is indeed toxic; that’s why it’s in toothpaste (to kill things; namely, bacteria whose waste products would harm our teeth). However, we are much bigger than those bacteria.

Given the amount of fluoride in toothpaste (usually under 1mg per strip of toothpaste to cover a toothbrush head), the amount that people swallow unintentionally (about 1/20th of that, so about 0.1mg daily if brushing teeth twice daily), and the toxicity level of fluoride (32–64mg/kg), then even if we take the most dangerous ends of all those numbers (and an average body size), to suffer ill effects from fluoride due to brushing your teeth, would require that you brush your teeth more than 23,000 times per day.

Alternatively, if you were to ravenously eat the toothpaste instead of spitting it out, you’d only need to brush your teeth a little over 1,000 times per day.

All the same, please don’t eat toothpaste; that’s not the message here.

However! In head-to-head tests, fluoride toothpaste has almost always beaten non-fluoride toothpaste.

Almost? Yes, almost: hydroxyapatite performed equally in one study, but that’s not usually an option on as many supermarket shelves.

We found some on Amazon, though, which is the one we used for today’s head-to-head. Here it is:

Boka Fluoride-Free Toothpaste

However, before you rush to buy it, do be aware that the toxicity of hydroxyapatite appears to be about twice that of fluoride:

Scientific Committee on Consumer Safety Opinion On Hydroxyapatite (Nano)

…which is still very safe (you’d need to brush your teeth, and eat all the toothpaste, about 500 times per day, to get to toxic levels, if we run with the same numbers we discussed before. Again, please do not do that, though).

But, since the science so far suggests it’s about twice as toxic as fluoride, then regardless of that still being very safe, the fluoride is obviously (by the same metric) twice as safe, hence picking the fluoride.

Want more options?

Check out our previous main feature:

Less Common Oral Hygiene Options

(the above article also links back to our discussion of different toothpastes and mouthwashes, by the way)

Take care!

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  • Stop Cancer 20 Years Ago

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    Start now

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    What this means for those of us without breast cancer (or a history therof) is: start now

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    To oversimplify: cancer occurs because an accidentally immortal cell replicates and replicates and replicates and takes any nearby resources to keep on going. While science doesn’t know all the details of how this happens, it is a factor of genetic mutation (itself a normal process, without which evolution would be impossible), something which in turn is accelerated by damage to the DNA. The damage to the DNA? That occurs (often as not) as a result of cellular oxidation. Cellular oxidation is far from the only genotoxic thing out there, and a lot of non-food “this thing causes cancer” warnings are usually about other kinds of genotoxicity. But cellular oxidation is a big one, and it’s one that we can fight vigorously with our lifestyle.

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    “and now for those things that usually come together: antioxidant, anti-inflammatory, anticancer, and anti-aging”

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    See: How to Prevent (or Reduce) Inflammation

    Don’t settle for “normal”

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    We can be all the way over on the healthy end of the distribution curve. We can do that!

    (so can everyone else, given sufficient opportunity and resources, because health is not a zero-sum game)

    If we’re going to get a cancer diagnosis, then our 60s are the decade where we’re most likely to get it. Earlier than that and the risk is extant but lower; later than that and technically the risk increases, but we probably got it already in our 60s.

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    See: Focusing On Health In Our Sixties

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    See: Intermittent Fasting: We Sort The Science From The Hype

    While this calls back to the previous “fight inflammation”, it deserves its own mention here as a very specific way of fighting it.

    It’s never too late

    All of the advices that go before a cancer diagnosis, continue to stand afterwards too. There is no point of “well, I already have cancer, so what’s the harm in…?”

    The harm in it after a diagnosis will be the same as the harm before. When it comes to lifestyle, preventing a cancer and preventing it from spreading are very much the same thing, which is also the same as shrinking it. Basically, if it’s anticancer, it’s anticancer, no matter whether it’s before, during, or after.

    Dr. Simmons has seen too many patients get a diagnosis, and place their lives squarely in the hands of doctors, when doctors can only do so much.

    Instead, Dr. Simmons recommends taking charge of your health as best you are able, today and onwards, no matter what. And that means two things:

    1. Knowing stuff
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    So it becomes our responsibility (and our lifeline) to educate ourselves, and take action accordingly.

    Want to know more?

    We recently reviewed her book, and heartily recommend it:

    The Smart Woman’s Guide to Breast Cancer – by Dr. Jenn Simmons

    Enjoy!