It is not uncommon to see "fluoride-free" on natural toothpaste tubes: having become a real selling point, the absence of fluoride is supposedly a guarantee of safety for consumers looking for clean oral care products. But what are the harmful effects of fluoride? Can we do without it, and what ingredients can replace it?
We're here to help you understand.

What is fluoride?

Fluoride is an essential trace element found in our bones and teeth. Since the 1950s, it has been used in salt form, namely sodium fluoride (sodium fluoride in INCI nomenclature), in the vast majority of conventional toothpastes and mouthwashes to prevent and treat cavities.

It is still today the most proven anti-cavity active ingredient: it protects and strengthens enamel, the outer layer covering our teeth, and helps stop the cavity process.

Cavities are mainly caused by the consumption of acidic and/or sugary foods, regardless of whether the sugar has been added, like sucrose, or naturally present, like fructose. Specifically, the bacteria in our oral microbiota that make up dental plaque feed on these sugars and convert them into acids. When enamel comes into contact with these acids, it gradually erodes – this is the demineralization process of teeth that begins.

Fluoride incorporates into the surface of the enamel and forms a protective shield, making it much more resistant to acid attacks. Fluoride boosts enamel remineralization by rebuilding minerals previously dissolved by acids. Its antibacterial action also reduces dental plaque, thus greatly decreasing the risk of cavities. During brushing, as toothpaste is never entirely spit out, this allows fluoride to adhere to the teeth and act locally.

During childhood, a fluoride intake is essential to maintain healthy teeth. Indeed, the enamel of baby teeth is much thinner than that of permanent teeth, and therefore more vulnerable to acid attacks. Fluoride thus helps both prevent cavities and strengthen enamel during the development of new teeth. It is therefore crucial to avoid fluoride-free toothpaste as much as possible and to carefully read the different mentions on the tube, especially the age range for which it is intended.

From 3 to 6 years old, it is recommended to use a toothpaste containing 250 to 500ppm* of fluoride, in order to limit accidental ingestion. From 6 years old, the appropriate level is between 1000 and 1450ppm. A dose higher than 1500ppm may be prescribed by a dentist as part of a treatment for a carious infection.

But then, despite its benefits, why is fluoride so controversial and so often decried by natural hygiene product brands?

The dangers of excessive fluoride

Unfortunately, excessive fluoride intake can be harmful and lead to more or less severe long-term consequences.

Too much fluoride supplementation during childhood can cause the opposite effect of what is desired: the enamel becomes fragile instead of strengthened, and becomes porous. This is called dental fluorosis, an irreversible deterioration of the enamel characterized by the appearance of whitish and sometimes brownish spots on the teeth. Since enamel cannot regenerate itself, only a dentist will be able to mask these spots, but only superficially. This is why it is imperative to monitor young children's brushing, not only to control the amount of toothpaste used (pea-sized), but also to ensure they spit it all out.

Even more serious: if this overdose continues for several years, fluoride eventually accumulates in the bones and causes a densification of the skeleton. This painful disease, called skeletal fluorosis, makes bones extremely fragile, much less flexible than healthy bones, and therefore more prone to fractures. In the most severe cases, fluorosis directly impacts the joint mobility of affected individuals and even leads to skeletal deformities.

There is also a theory implicating fluoride in the calcification of our pineal gland. The primary role of this organ is to secrete melatonin, also known as the "sleep hormone," which helps us regulate our biological rhythm. The natural calcification process (i.e., the accumulation of calcium in tissues), which gradually occurs with age, would be accelerated by daily fluoride absorption and would consequently cause a decrease in melatonin production. However, this presumed link between the use of fluoridated toothpaste and the accelerated calcification of the pineal gland has not yet been scientifically proven.

For the sake of public dental health, fluoride is added to many products we consume daily: bottled water, chewing gum, table salts... It is even naturally present in some tap water, many cheeses, certain fish and shellfish, spinach, tea, and dates! We bet you consume at least one of these foods every day 😉

What are the alternatives to fluoride?

If, after all this information, you consciously wish to opt for a fluoride-free toothpaste, know that there are now several naturally sourced ingredients that also offer effective protection against cavities.

Among them is hydroxyapatite, a calcium phosphate that is none other than the main component of our teeth: its structure, almost identical to that of our enamel, allows for remineralization of teeth and filling of carious lesions. It has been the anti-cavity active ingredient used in most Japanese oral care products for over 40 years.

There are also 100% natural sweeteners, such as xylitol derived from birch bark or erythritol from fermented foods, which also help fight against the appearance of cavities. These sugar derivatives are not metabolized by the bacteria in our mouth, which prevents them from being converted into acids responsible for enamel degradation. Even better: they poison these bacteria and greatly contribute to reducing their proliferation.

After much consideration, our choice at Les Petits Prödiges has been to create a 100% natural and fluoride-free toothpaste paste. The performance of these substitutes, not linked to overdose risks, caught our attention: we therefore chose to include erythritol in our formula as an anti-cavity active ingredient, coupled with calcium carbonate for its abrasive action to eliminate dental plaque. We have taken care to offer you a short composition that is both clean and effective, without compromise, guaranteeing impeccable oral hygiene.

Of course, if you have any questions about fluoride or would like recommendations tailored to your personal needs, we advise you to speak with a healthcare professional.

In summary, here are the key takeaways regarding the fluoride-free issue:

• Fluoride added to oral care products has a protective and strengthening action on enamel, very effective against cavities caused by sugar consumption.

• During childhood, when our teeth are not yet fully formed, it is essential to use toothpaste containing fluoride to prevent cavities.

• An excess of fluoride can be harmful and cause diseases, the most common being dental fluorosis, and in the most severe cases, skeletal fluorosis.

• We actually ingest fluoride daily; it is present in many foods, drinks, and condiments!

• A fluoride-free toothpaste can be used safely from the age of 10, provided it contains effective alternative anti-cavity active ingredients.

• Among these are hydroxyapatite, xylitol, and erythritol, which we selected for the formula of our 100% natural mint toothpaste 🌿