More and more patients have been asking me about hydroxyapatite toothpaste. Usually they saw it on TikTok or Instagram, and usually the question is the same: is it better than fluoride?
It isn't proven to be better. But it isn't a gimmick, either. One solid study found it worked about as well as fluoride in healthy adults, so if you'd really rather avoid fluoride, it's a reasonable choice. For most of my patients I still recommend fluoride, and if you get cavities easily, talk with us before you switch.
What Is Hydroxyapatite Toothpaste?
Hydroxyapatite is the mineral that makes up most of your enamel. The toothpaste version is a synthetic form of that same mineral, often made into very small particles (you'll see it listed as nano-hydroxyapatite, or nHA). The idea is that those particles settle into tiny weak spots on the enamel and help the tooth repair itself, a process called remineralization.
It's been around longer than most people think. Japan has sold hydroxyapatite toothpaste since the 1980s and approved nano-hydroxyapatite as an anti-cavity ingredient in 1993. It only caught on in the U.S. in the last few years, mostly through social media.
Why Is Hydroxyapatite Toothpaste Trending on TikTok?
Almost always, it's because people want a fluoride-free toothpaste. Sometimes that comes from something they read online about fluoride. Often it's parents of toddlers who worry about their kids swallowing toothpaste. Others like the idea of a "natural" product, or they're hoping it will help with sensitivity or make their teeth look whiter.
The Viral Brands: Boka, RiseWell, Apagard and More
These are the ones patients bring up most.
Boka is probably the one you've seen. It's sold at Target, CVS and Walmart, and the Ela Mint flavor is all over social media. Boka uses nano-hydroxyapatite but doesn't say how much is in the tube. In 2025, the National Advertising Division, an industry watchdog, recommended that Boka stop claiming its toothpaste remineralizes teeth because the company hadn't adequately supported that claim.
RiseWell is popular with the "clean beauty" crowd. Its PRO Mineral formula uses a mix of nano and larger "micro" hydroxyapatite particles.
Apagard is made by Sangi, the Japanese company that developed nano-hydroxyapatite toothpaste in the first place, which is why people online often call it "the original." It comes in several versions, including M-plus and Premio.
You'll also see Davids, Dr. Jen, Ollie, SNOW and NOBS toothpaste tablets.
I don't have a favorite brand, and I'd be wary of anyone who swears by one. If you're shopping, look for a tube that lists its hydroxyapatite percentage (many of the studies used about 10%), and skip anything very abrasive, especially if your teeth are sensitive or your gums have receded. Flavor and packaging don't matter, and neither does how someone's teeth look in a video.
Is Hydroxyapatite Better Than Fluoride?
Not proven, but the early research is encouraging.
The study everyone cites is an 18-month randomized clinical trial of 189 adults, published in Frontiers in Public Health in 2023. One group used a toothpaste with 10% hydroxyapatite, and the other used a regular fluoride toothpaste (1,450 ppm). By the end, nearly 90% of people in both groups had no new cavities. In other words, hydroxyapatite performed about as well as fluoride.
That's a good result, but I'd keep it in perspective. It's one major trial, in healthy adults at fairly low cavity risk. It was funded by the toothpaste's manufacturer, Dr. Kurt Wolff (the company behind Karex), and three of the authors work there. Fluoride, on the other hand, has decades of research across millions of people, including kids and people who get cavities easily. One study doesn't outweigh that.
Is Hydroxyapatite Toothpaste Safe?
Yes. It's the same mineral that's already in your teeth and bones, and it's considered safe even if you swallow a little. That's part of why some parents like it for young kids.
Does Hydroxyapatite Remineralize Teeth or Reverse Cavities?
It may help with the earliest stage of decay, the chalky white spots that show up before a cavity forms. Once there's an actual hole in the tooth, no toothpaste will fix it. That has to be treated in the dental chair.
Is Hydroxyapatite Good for Sensitive Teeth?
It often helps. Hydroxyapatite can cover tiny exposed spots on the tooth, and many people notice their teeth are less sensitive. If the sensitivity is new, or it's mostly one tooth, come see us first. That can be a cavity, a crack or a gum problem, and toothpaste won't fix those.
Is Hydroxyapatite Toothpaste Safe for Kids?
It's safe if swallowed, which is why some parents reach for it. Fluoride toothpaste is still the standard recommendation for children, as long as you use the right amount: a smear the size of a grain of rice for toddlers, and a pea-sized amount starting at age 3. If you're not sure, ask us at your child's next visit and we'll help you pick one based on their age and how prone they are to cavities.
What Do I Recommend?
For most people, fluoride toothpaste. It's still the most proven option we have.
If you'd really rather avoid fluoride, hydroxyapatite is a sensible choice, and much better than a toothpaste with nothing in it to fight cavities.
If you get cavities often, have a dry mouth, wear braces or have receding gums, please talk with us before you switch. You may be better off with fluoride, or even a prescription-strength fluoride toothpaste.
And you don't have to pick just one. Some people use fluoride in the morning and hydroxyapatite at night. Ask us whether that makes sense for you.
What Matters More Than Your Toothpaste
Whatever's in the tube, the basics do most of the work. Brush twice a day for two minutes, clean between your teeth every day, go easy on sugary drinks and snacks between meals, and keep up with your checkups and cleanings.
Quick Answers
Is hydroxyapatite toothpaste better than fluoride?
Not proven. One 18-month study found it prevented cavities about as well as fluoride in healthy adults, but fluoride has far more research behind it and is still the standard recommendation.
Is Boka toothpaste good?
It's a reasonable fluoride-free option. Boka doesn't list how much hydroxyapatite it contains, and in 2025 an advertising watchdog recommended it stop claiming it remineralizes teeth.
What is the best hydroxyapatite toothpaste?
No brand has been proven best. Look for one that lists its hydroxyapatite percentage (studies often used about 10%) and isn't very abrasive. Boka, RiseWell and Apagard are the best-known brands.
Is hydroxyapatite toothpaste safe?
Yes. It's the same mineral that's in your enamel, and it's considered safe even if a little is swallowed.
Can hydroxyapatite toothpaste reverse cavities?
It may help with very early weak spots in the enamel, but it can't fix a cavity that has already formed. That needs to be treated by a dentist.
Is hydroxyapatite good for sensitive teeth?
It often helps, because it can cover tiny exposed areas of the tooth.
Should I switch from fluoride to hydroxyapatite toothpaste?
If fluoride is working for you and you're not at high risk for cavities, there's no strong reason to switch. If you'd rather avoid fluoride, ask your dentist whether hydroxyapatite is a good fit.
Questions About Your Toothpaste? Ask Your Brushing Coach
If you're not sure which toothpaste is right for you or your kids, bring the tube to your next visit and we'll look at it together. You can also call our Tumwater office at (360) 943-9480. We see patients from Tumwater, Olympia, Lacey and all over Thurston County, and we're always happy to help.
