The biggest myths about those fluoride-free toothpastes you're seeing everywhere.

We’ve seen 'free from' labels on products trending for a while now in skincare, haircare, makeup, 'natural' deodorant, and now, they've made their way to toothpaste. 

With more and more 'natural' or 'fluoride free' products popping up in supermarkets and even luxury beauty retailers, you're not alone if you're wondering what exactly fluoride does, and what the go is with those 'fluoride free' options.

Watch: When you've got something in your teeth. Post continues below.

To find out more about the buzz around this trend, I spoke to expert Dr Rita Trak, Facial and Cosmetic Dentist and founder of Melbourne’s Dental and Skin Clinic. Here's what she had to say.

What does fluoride have to do with teeth?

The short version: it helps to strengthen teeth. Our teeth are mostly made up of two molecules, calcium and phosphate, which form a 3D diamond structure called hydroxyapatite. 

When fluoride from our saliva comes into contact with our teeth, the hydroxyapatite crystals are converted into an even stronger diamond structure, called fluorapatite. 

As we live our lives – eating, drinking, chewing, brushing our teeth, sleeping – these diamond structures are constantly losing and regaining minerals, which is normal. If we lose more than we gain, that’s when permanent damage occurs.

Listen: What a cosmetic dentist actually does. Post continues below.

The beauty of fluorapatite crystals is that they slow down the rate of loss, and speed up the rate of gain. For you, this means teeth more resilient to decay, fewer cavities - and when decay does occur, its progression is slower.

According to Dr Trak, "Our toothpaste – the presence or absence of fluoride in the toothpaste we use, how often we use it, when we use it, how long we use it – is the second biggest determinant to our risk of developing dental decay. Since fluoride is not naturally found in our teeth, the best way to get fluoride to our teeth is to apply it topically with toothpaste."

And what’s the first biggest determinant for decay? 

Bad news for me and my sweet tooth. "Our diet – how often we eat processed foods, processed sugar, acidic foods and drinks, processed carbohydrates, how often we consume dairy, raw vegetables and fruit, grains," she says. 

Why would someone want to avoid fluoride?

"Fluoride in high doses is harmful to the body when ingested," says Dr Trak. Emphasis on high doses. Much higher than you’d find in toothpaste or drinking water. 

In fact, recent Australian research shows that access to fluoridated water is a good thing – it’s associated with less tooth decay in adults (Australian Dental Association, 2020). 

Unfortunately, human risk perception is very subjective and most people see 'natural' as 'good' and 'unnatural' as 'bad'. This effect is known in debating and philosophy as the 'natural fallacy'. 

In recent years we’ve seen personal care brands take advantage, by really leaning into terms like 'natural' and even going so far as calling products 'chemical-free'. Taken literally, this is impossible - as your science teacher would tell you, everything is a chemical. 

Dr Trak explains, "My pet peeve is when fluoride-free toothpaste companies market that fluoride toothpaste is 'toxic,' because that is not a science-backed statement... It often confuses consumers."

"It's worse when these fluoride-free toothpaste companies call their toothpaste 'natural' or 'chemical-free'. Fluoride is the best ingredient for our teeth and [fluoride free] products should come with a warning label that 'by using this product, you are putting your teeth at great risk of developing decay', much like the warning labels you see on cigarette packaging."

There you have it. I’d like to see the same warning labels on sun tanning oils, but that’s a chat for another day.

What are the consequences of avoiding fluoride?

This is where it gets ugly. In the short term, "teeth are more likely to develop decay, cavities, teeth sensitivity and… staining at an alarmingly fast rate." 

Yikes. 

In her clinic, Dr Trak sees "bigger and deeper" cavities in children using fluoride-free toothpaste than those using the science-backed, fluoridated kind. This is because “kids’ teeth are far smaller in size, and their enamel is quite thin and weak".

“The extreme cases are when the teeth can’t be treated with a simple filling and the children require a tooth removal, which is a sad way to start a relationship with the dentist.” 

Image: Getty

In the longer term, avoiding fluoride can lead to "toothache, tooth infections, deep and large cavities that reach the pulp, teeth needing extensive and time-consuming treatment such as root canal treatment," warns Dr Trak. Or worse. "Some teeth aren’t salvageable and require removal and a dental implant."

Yikes. I’ve had a dental implant myself (thanks, genetics), and it’s not what I’d call a fun procedure. Not for myself or for my bank account. Toothpaste is much cheaper.

"There is nothing more heartbreaking that having to tell a parent that their child has six or more cavities when the parent thinks they’re doing the right thing by their child and using 'natural' or 'fluoride-free' toothpaste. I’m often finding myself having to educate parents on what products are safest for their children’s dental health."

What should I look for in a toothpaste, to be sure I’m doing the best for my teeth?

Dr Trak is clear on this one – "Use a toothpaste that contains fluoride". On an ingredient list, you might see "sodium mono fluorophosphate", "sodium fluoride", or "stannous fluoride".

For whiter teeth, Dr Trak advises to “avoid any toothpaste that markets itself as a 'teeth whitening toothpaste'.”

"They’re far too abrasive and damaging to our teeth. If you want whiter teeth, consider professional teeth whitening with a dentist and/or dental veneers."

If you have sensitive teeth, "choose a toothpaste for sensitive teeth, but avoid one that is both sensitive and teeth whitening".

And finally, if you had cavities at your last check-up (it’s been a long year, am I right?) you can get extra-strength repairing toothpaste from the pharmacy! 

It’s called Neutrafluor 5000, and Dr Trak suggests to "brush your teeth with this toothpaste at night time and use a regular toothpaste in the mornings. Do this for at least six months until your next dental examination".

As always, it’s important to consult with your dentist and confirm what’s right for you and your teeth. 

Do you use fluoride-free toothpaste? What are your thoughts? Share with us in the comment section below.

Feature image: Getty