The Wellness Industry Is Coming for Your Teeth
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“I haven’t seen many newer brands popping up that have fluoride,” says dentist Dr Mikaela Chinotti, the Australian Dental Association’s oral health promoter.
The peak dental body recommends Australians use toothpaste with fluoride. It’s widely considered the cornerstone of tooth decay prevention and the best way to remineralise and strengthen teeth.
An epidemiological study found that over the second half of last century, the prevalence of tooth decay plunged by more than 75 per cent, crediting this mostly to fluoride use.
“It’s important to … choose products based on proven effectiveness, not because it looks good on your shelf,” Chinotti says.
Dentist Dr James Fernando researches tooth decay at the University of Melbourne and says the lack of fluoride in many new products is “an immediate concern” because when purchasing a toothpaste, it’s the main active ingredient people should be looking for.
Anti-fluoride groups have long claimed that it can affect the bones and brain, and cause dental fluorosis (little flecks on tooth enamel). Fernando stresses that decades of scientific research has shown that fluoride is completely safe in the small doses used in toothpaste. It is only harmful when large amounts are ingested, which is why we don’t swallow toothpaste and why young children use toothpaste with a lower concentration.
The creators of fluoride-free toothpastes, including Lovebyt, ROCC and Gem, say they are catering to consumer demand and that using fluoride is a personal choice.
Gem currently uses a fluoride alternative called hydroxyapatite and cites research on its website. Fernando says that while promising, the few studies that exist are not robust.
While Lovebyt and ROCC don’t plan to start using fluoride, Gem’s founder acknowledges some customers prefer it and says “never say never”.
Some chemicals in mainstream toothpaste have raised concerns in the past, Fernando says, such as antimicrobial triclosan, which was phased out after animal studies found it may disrupt hormones, and sodium lauryl sulfate (SLS), a foaming agent that certain patients find irritating.
Fernando says while being more natural is great, not all chemicals are toxic and many even derive from natural sources. Fluoride itself is a natural mineral.
He adds that a lot of natural toothpastes also contain ingredients that have theoretical benefits but are untested clinically and may be incompatible when combined.
The Therapeutic Goods Administration is only responsible for regulating toothpastes that make specific health claims, such as preventing tooth decay. The rest are classed as cosmetics.
Not all new boutique oral care businesses banish fluoride. Natural brand Tooth Chews, launched in 2020 by Sunshine Coast dentist Rob Wood, includes it. The company sells toothpaste in tablet form, which is more eco-friendly, and will be releasing a paste later this year.
Wood says he hopes to fill a gap in the market for chic toothpastes that also tick the science boxes.
“We wanted to do what we know would still benefit oral health but for people who don’t want to use Colgate,” he says.
Dentist Dr Rita Trak opened the Dental & Skin Clinic in Melbourne’s south-east in February, saying she’s all about making oral hygiene “sexy” rather than just a medical need, but she worries about the anti-fluoride narrative being perpetuated by some businesses that have a similar philosophy.
She says the trend is confusing for consumers, and she likens it to promoting an all-natural, chemical-free sunscreen without any science to prove it helps prevent skin cancer.
Chinotti says people can choose a fluoride-free toothpaste but urges them to be aware of the risks and regularly see their dentist.
Fernando says he won’t recommend a toothpaste until there is evidence behind its formula.
“I’m an environmentalist at heart … [but] for something you’re using twice a day, I would say be careful, it’s not necessarily the safest option.
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