If you’ve gone hunting toothpaste recently, you can confirm that your choices are “no SLS, no fluoride”, “nanohydroxyapatite but no fluoride”, “xylitol and nanohydroxyapatite”, but in no world can you get fluoride, nanohydroxyapatite, and Xylitol in the same package.

Fluoride is a requirement, as it’s an extremely effective antibacterial that’s not fucking Triclosan, that nth-generation horror used to accelerate bacterial resistance the world over. Floride kills bacteria by completely hosing their mitochondrial mechanisms in acidic environments, a pathway that’s… unlikely to be evolved past UNLIKE TRICLOSAN.

Xylitol is also a requirement, insofar as it’s a bacterial growth inhibitor via mechanisms that aren’t completely understood despite their well-documented nature. The best we know so far is that Xylitol inhibits attachment of bacterial mats to the teeth, and that it disrupts some cellular energy production mechanism, but we’re fully in the space of “it works! but we have NFI how.”

Nanohydroxyapatite (speciifcally, hydroxyapatite that has been milled down to a really really fine powder so that it dissolves efficiently) is our third core requirement! It’s a (if you’ll forgive the hyperbole) magical compound that dissolves in water and saliva, and recrystallizes onto the tooth surface. This recrystallization solves a lot of the painful experiences deriving from open dental tubules and uneven thermal expansion of tooth materials.

Hydroxyapatite and fluoride behave amazingly together to support tooth health: if you have a solution of fluoride and hydroxyapatite in your mouth, the fluoride will embed itself into the hydroxyapatite matrix as that deposits onto your tooth surface. Normally, the fluoride would rinse through your mouth and nuke the bacterial population that had built up overnight or whatever. Embedded in the matrix of this secondary coating you’re applying, it sticks around and continues to deliver the same antibacterial properties as the hydroxyapatite layers break down over the course of the day. Which they will, by the way, and this is why it’s not a one-and-done solution. I believe they build up faster than they erode if you brush at least twice a day, but I don’t have any science on that.

SLS, or “sodium lauryl sulfate” is one of those reprehensible compounds that cosmetic companies add to everything. It’s used, at least in toothpaste, as a foaming agent to achieve a very particular mouthfeel during brushing. I’ve found that it produces canker sores in my mouth, and other folks online are far more sensitive to it. Therefore, I’ve banned it from my family’s toothpastes (and other things that we put in our bodies).

So there you have it: the fluoride+nanohydroxyapatite+xylitol trick. The fluoride kills bacteria, the hydroxyapatite remineralizes the tooth surface (embedding fluoride in the outer layers for additional protection), and the xylitol inhibits bacterial mat formation. I personally use Verve for SLS-free fluoridated toothpaste, and Periogen for the xylitol and hydroxyapatite.

Here’s to your mouth health!