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As you eat and drink and live your life, your teeth are constantly undergoing demineralization and remineralization.

Demineralization is the process by which your teeth lose minerals. The bacteria in your mouth thrive on the sugars in the foods and beverages that you consume, and they create acids that wear away at your teeth.

Remineralization is the repair process. Think of it as re-hardening your teeth that have become softened by those acids. Your body repairs the enamel on the surface of your teeth and stops mineral loss.

One way that your enamel gets repaired is when your saliva helps fill in the tiny cracks that have been left behind before they can widen and let bacteria slip through, which can eventually lead to cavities.

Toothpastes or mouthwashes that contain fluoride can help with the remineralization process. So can a toothpaste that contains hydroxyapatite.

Toothpaste with hydroxyapatite can form a barrier on your teeth surfaces. This barrier defends teeth against the sugars and acids that tend to wear away at your teeth.

Your teeth are composed of several layers. On the very top, you have the hard outer layer known as enamel. Underneath that is a hard tissue called dentin.

When you get down below the gum line, there’s another hard substance called cementum that covers and protects the roots. These hard tissues are composed of a blend of inorganic and organic substances, along with a little water.

Most of the inorganic part is made of phosphate and calcium ions that create strong hydroxyapatite crystals. As you eat, the crystals allow your teeth to withstand the forces of:

  • chewing
  • crunching
  • grinding

The hydroxyapatite in toothpaste is a synthetic version of the same substance. Using it has several benefits:

Food waste removal

As with any toothpaste, you’re physically sweeping away the residue of food and bacteria that are lingering in your mouth.

Antibacterial properties

Bacteria can lead to tooth decay. They prevent acid from breaking down the traces of food and drink that remain in your mouth when you don’t brush after a meal, and that acid begins dissolving the enamel on your teeth.

A 2017 in vitro study showed that this toothpaste can form a shield against bacteria to protect your teeth, making it more resistant to plaque. And the toothpaste helps fill in those tiny cracks or fissures that develop in your teeth during demineralization, so the bacteria can’t work their way down into your teeth.

Decrease in sensitivity

If you have sensitive teeth, hydroxyapatite toothpaste may make your teeth feel less sensitive, since it’s strengthening your enamel.

A 2013 study showed that your dental enamel is perhaps the hardest substance in your body. But it’s not invulnerable. The following can gradually chip away at enamel:

  • aging
  • eating
  • injuries
  • other processes

Once enamel is gone, you can’t get it back. But you can increase the mineral content of the remaining enamel, which strengthens it, and that’s what remineralization does.

Using a toothpaste with hydroxyapatite does appear to help remineralize your teeth. Your teeth absorb the hydroxyapatite and use it to rebuild.

In fact, a 2019 lab study found that hydroxyapatite toothpaste was as effective as toothpaste with fluoride at preventing demineralization and at remineralizing the early signs of cavities.

The double-blind randomized study above suggested that a hydroxyapatite toothpaste could be a useful tool for people at a high risk of developing cavities because it can promote remineralization without adding extra fluoride. It eliminates the worry about toxicity that comes with higher doses of fluoride.

There may be rare cases of someone experiencing an allergic reaction. But to date, there is no evidence that indicates a likelihood of experiencing any side effects from using toothpaste with hydroxyapatite.

A 2019 study showed that toothpaste with hydroxyapatite not likely to irritate your teeth and mouth, and it does not seem to pose any safety concerns.

Toothpaste containing synthetic hydroxyapatite became popular in Japan after being approved for use as a treatment against cavities around the early 1990s. A version that uses smaller particles, known as nanohydroxyapatite, came along later.

Dentists can offer you a prescription-strength hydroxyapatite toothpaste with a higher concentration of hydroxyapatite. But unless your teeth are at an elevated risk, you might be happy enough with an over-the-counter (OTC) version.

Some kinds of toothpaste contain the nanocrystal form — they’re usually billed as “nanohydroxyapatite remineralizing toothpaste” — while others may contain a version that blends in zinc. There are even versions that claim to have extra-mild aromas for children.

Shop for hydroxyapatite toothpaste online.

If you want to take advantage of the benefits of hydroxyapatite in another form besides a regular toothpaste, you have options.

You can buy a hydroxyapatite tooth powder, or you can buy a tablet that you can crumble and mix with a little bit of water to make a paste.

Then you can brush your teeth with the paste. Some tablets are even available in both fluoridated and nonfluoridated versions.

Shop for hydroxyapatite tooth powder and tablets online.

You can also use a hydroxyapatite mouthwash or mouth rinse. A small 2013 animal study on cows’ teeth showed that a mouthwash fortified with zinc-carbonate hydroxyapatite microclusters was effective at protecting teeth from bacteria.

A subsequent small animal study in 2017 also found that a mouth rinse containing hydroxyapatite kept bacteria from adhering to the dental surface.

Shop for hydroxyapatite mouthwash online.

There’s even chewing gum that contains hydroxyapatite. A 2014 study found that a gum fortified with hydroxyapatite was effective at reducing tooth sensitivity.

Using hydroxyapatite or fluoride toothpaste is an effective way to achieve remineralization of your teeth, making them stronger and healthier.

But it’s not the only way to stop demineralization. Consider these strategies:

  • Stay hydrated. Drink water to rinse out your mouth, especially if you can’t get to a toothbrush.
  • Decrease sugar intake. Eat less sugar for bacteria to feed on.
  • Break your juice habit. Love juice? Citrus fruits and juices with their acids can be hard on your teeth. Drink it in moderation and brush your teeth afterward.
  • Chew sugarless gum. Sugarless gum usually contains xylitol, a type of sugar alcohol, to improve its flavor. A 2004 research review showed that xylitol can improve remineralization of teeth. A 2010 research review showed that xylitol may also prevent cavities from forming. If you’re not a gum chewer, you could try a hard candy with xylitol instead.
  • Cut back on the dairy. Milk and other dairy products contain a type of sugar known as lactose. You may need to look for other sources of calcium, though.
  • Take calcium supplements. Build up strong teeth by taking calcium.
  • Use probiotics. Although more research is needed, a 2013 research review suggested that probiotics may help ward off the bacteria that can lead to tooth decay.
  • Treat dry mouth. If you have dry mouth, talk with a doctor about how to relieve it. Decreased saliva flow in your mouth can lead to increased demineralization and an increased risk of cavities, according to a 2001 research review.

You may be wondering what might happen if your teeth get demineralized and you don’t do anything to stop it. Here’s what could develop:

  • White spots on your teeth. These may appear as the first symptom of demineralization. Think of these as an indication that tooth decay could be on the horizon.
  • Enamel erosion. Your teeth may become weak and begin to look discolored or stained. You might even get some tiny chips and cracks in your teeth. Your teeth might develop some rough edges.
  • Cavities. When the acid in the plaque that’s adhered to your teeth begins to wear the enamel away, your risk of developing cavities increases.
  • Tooth loss. One scenario of the end result of tooth decay is usually the loss of a tooth.

If you’re looking for another way to preserve the health and strength of your teeth, a hydroxyapatite toothpaste might be just the ticket. Or you could always try another oral product containing hydroxyapatite, like a mouthwash.