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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.

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

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Our Verdict

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


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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