Current Research on Hydroxyapatite Toothpaste Efficacy and Safety

Studies on Hydroxyapatite Toothpaste Efficacy & Safety

Biomimetic hydroxyapatite and caries prevention: a systematic review and meta-analysis (2021)
Based on this systematic review and meta-analysis of over 291 studies of micro-Hydroxyapatite, the authors concluded there is good evidence that micro-Hydroxyapatite in oral care products in the absence of fluoride effectively reduces caries. They do not conclude on how much micro-Hydroxyapatite is ideal, but this more recent study (conducted after this review was published) mentions it should be around 10-15% for micro-Hydroxyapatite.

Nano-hydroxyapatite and its applications in preventive, restorative and regenerative dentistry: a review of literature (2014)
Dr. B’s Notes: Great summary of the literature about nano-hydroxyapatite, specifically the benefits of using nano-hydroxyapatite for its preventive, restorative, and regenerative applications in dentistry. Will give you an idea of the wide usage of nano-Hydroxyapatite in not only dentistry, but a wide range of applications in medicine as well.

Remineralization potential of fully demineralized dentin infiltrated with silica and hydroxyapatite nanoparticles
Demineralized dentin infiltrated with silica NPs appears to encourage heterogeneous mineralization of the dentin collagen matrix following exposure to an artificial saliva solution.

Reconsidering remineralization strategies to include nanoparticle hydroxyapatite.
This in-vitro study documented the deposition of nanoparticle hydroxyapatite on demineralized enamel surfaces after treatment with an experimental remineralization gel. This finding supports consideration of an additional approach to remineralization that includes pH neutralization strategies and nanoparticle hydroxyapatite crystals.

Effect of nano-hydroxyapatite concentration on remineralization of initial enamel lesion in vitro (2009)
Dr. B’s notes: This is an older study out of China which studied four different concentrations of nano-hydroxyapatite (1%, 5%, 10% and 15% by weight). The 10% and 15% demonstrated efficacy (in other words, worked well) but it’s not clear what kind of nano-Hydroxyapatite was used, including particle size and particle shape, unfortunately. The important thing to understand here is that the concentration of hydroxyapatite was calculated based on weight, not volume, like toothpaste manufacturers do. So, in reality, the therapeutic dose is between 1 and 3% if calculating by volume.

Remineralization Potential of Nano-Hydroxyapatite on Initial Enamel Lesions: An in vitro Study (2011)
Dr. B’s Notes: The remineralization effect of nano-Hydroxyapatite increased significantly when the pH was less than 7. Why is this important? You’re going to hear a lot of people say that for remineralization to occur, pH needs to be neutral or higher, but this incorrect; the pH must be between 5.5 and 6.5 in order for there to be ion exchange (in this case, remineralization). The percentage of surface microhardness recovery and integrated mineral loss obtained from CSMH tests demonstrated that nano-HA provides better remineralization than micro-HA.

Combined Effects of Nano-Hydroxyapatite and NaF on Remineralization of Early Caries Lesion
The aim of this study was to evaluate the combined effects of a nano-HA and fluoride mouthrinse on an early caries lesion in human enamel using an in vitro cycle remineralization and treatment model.

Effectiveness of nano-hydroxyapatite toothpaste in reducing dentin hypersensitivity: a double-blind randomized controlled trial
A double-blind randomized clinical trial that compared the efficacy in reducing dentin hypersensitivity of a dentifrice formulation containing nano-hydroxyapatite with a fluoride dentifrice and a placebo.

Comparison of Nano-Hydroxyapatite and Sodium Fluoride Mouthrinse for Remineralization of Incipient Carious Lesions
Nano-HA and NAF mouthrinses can greatly enhance remineralization and increase tooth microhardness.

Remineralization Potential of New Toothpaste Containing Nano-Hydroxyapatite
The results showed that there were no significant differences in Vickers Hardness Number values between the two toothpastes (P>0.05). A toothpaste containing nano-sized hydroxyapatite has the potential to remineralize an incipient caries lesion. In addition, the addition of fluoride had no synergistic effect on remineralization.

Enamel remineralization and repair results of Biomimetic Hydroxyapatite toothpaste on deciduous teeth: an effective option to fluoride toothpaste (2019)
Dr. B’s Notes: This study was performed in vitro and in vivo—you don’t see that too often!

Comparison of hydroxyapatite and fluoride oral care gels for remineralization of initial caries: a pH-cycling study (2020)
Dr. B’s notes: Peer-reviewed study demonstrating 15% micro-Hydroxyapatite-based gel (15% HAP) was as effective as fluoride-based gel (at 12,500 ppm, which is even stronger than Prevident 5000) in remineralizing initial caries lesion.
Enamel and dentine remineralization by nano-hydroxyapatite toothpastes
Toothpastes containing n-HAp revealed higher remineralizing effects compared to amine fluoride toothpastes with bovine dentine, and comparable trends were obtained for enamel.

Remineralization of early caries by a nano-hydroxyapatite dentifrice
The purpose of this randomized, double-blind, crossover, in situ study was to evaluate the efficacy of nano-hydroxyapatite (nHAP) dentifrices on caries remineralization and demineralization inhibition. nHAP dentifrice caused remineralization comparable to a fluoride dentifrice, and inhibited caries development, thus suggesting that an nHAP dentifrice can be an effective alternative to fluoride toothpaste.

Synthetic Biomimetic Carbonate-Hydroxyapatite Nanocrystals for Enamel Remineralization (2008)
Dr. B’s Notes: Just another early study out of Italy that supports the idea that nano-Hydroxyapatite is great at remineralizing teeth.

Fabrication and characterization of remineralizing dental composites containing hydroxyapatite nanoparticles

HApNPs allowed Ca2+ and PO43− release in low pHs.
HApNPs enable remineralization of caries-like enamel lesions.

Effect of hydroxyapatite nanoparticles on enamel remineralization and estimation of fissure sealant bond strength to remineralized tooth surfaces: an in vitro study
This study investigated the ability of hydroxyapatite nanoparticles (nano-HA) to remineralize enamel, and their effect on sealant microleakage and shear bond strength (SBS).

Comparative efficacy of a hydroxyapatite and a fluoride toothpaste for prevention and remineralization of dental caries in children (2019)
In vitro determination of the remineralizing potential and cytotoxicity of non-fluoride dental varnish containing bioactive glass, eggshell, and eggshell membrane
Nano-hydroxyapatite toothpaste ingredient for teeth remineralization and sensitivity
Nano Hydroxyapatite Powder
SCCS Final decision
Bionic effects of nano hydroxyapatite dentifrice on demineralised surface of enamel post orthodontic debonding: in-vivo split mouth study

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