Is Fluoride in Toothpaste Toxic? Here’s What You Should Know

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Medically reviewed by Danielle Romatz, RDH

Cleaning your teeth is an essential part of maintaining good oral hygiene, as it removes plaque, which causes tooth decay. However, some doubt the safety of toothpaste brands that use fluoride and other ingredients they consider toxic. While some ingredients are vital in the cleaning process, they could also be doing harm to the body. This explains the growing demand for toothpaste made with natural products.  

While fluoride is considered a toxin, it’s safe when ingested in small amounts. So, you don’t need to worry if you accidentally ingest toothpaste while brushing your teeth. That said, non-fluoride toothpastes are a viable alternative for keeping your teeth clean and are helpful for young children.

Fluoride is added to drinking water in small amounts to minimize tooth decay and cavities. If that’s the case, why do some people want to avoid it in toothpaste? Let’s take a look at the properties of fluoride, how it works in toothpaste, and what the alternatives are for using it while brushing.

What Is Fluoride? 

Young woman s hands hold a toothbrush and toothpaste

Fluoride is found naturally in foods, water, and soil. It’s also created synthetically for use in toothpaste, drinking water, mouthwash, and other chemical products. Water authorities use fluoride in drinking water as low amounts of the substance can reduce tooth decay. This practice is regulated by the Environmental Protection Agency in the United States.

Often, fluoride is used in dentistry to strengthen the enamel, the outer layer of teeth. The role of fluoride is to prevent cavities and tooth decay.

If you get a lot of cavities, the dentist will likely recommend using a prescription fluoridated toothpaste or a mouth rinse with fluoride. Usually, these rinses contain a higher concentration of fluoride, so this should only be done under the direction of a licensed professional.

The way fluoride works to protect and strengthen your teeth is simple. When bacteria in the mouth break down sugar and carbohydrates, they produce acid that eats away minerals in the tooth enamel. When you lose these minerals, your teeth are damaged through a process called demineralization.

A weak enamel leaves the teeth vulnerable to bacteria that lead to cavities.

The benefit of fluoride is that it remineralizes the tooth enamel, thereby preventing cavities and reversing signs of tooth decay. While fluoride is available naturally, it can trigger side effects if consumed in large doses. Dental fluorosis occurs when children under the age of 8 consume excessive amounts of fluoride while their teeth are forming under the gums. This causes white spots on your teeth.

You could also get skeletal fluorosis, which occurs similarly to dental fluorosis. The difference is that it affects bones. Symptoms of skeletal fluorosis include stiffness and joint pain.

Over time, this will alter the bone structure and could calcify your ligaments. However, these cases are rare in the States because of regulations on products containing fluoride.

Is Fluoride in Toothpaste Toxic?

Fluoride is added to toothpaste to prevent tooth decay and cavities. It’s also used in drinking water for the same reason. However, the amounts used in toothpaste and drinking water are safe.

The problem with fluoride arises when you consume it in large amounts. While accidental ingestion while brushing will not cause health problems, you should keep in mind some of the dangers of consuming excessive fluoride.

Among children aged 8 and younger, exposure to fluoride in high concentrations can cause mild dental fluorosis. This shows in the form of white streaks in the tooth enamel.

While it will not affect the health of your teeth, discoloration from dental fluorosis will be noticeable.

If you’re breastfeeding, give the baby fluoride-free water to protect them from fluorosis. Children under 6 years should not use mouthwash with fluoride, and they should be supervised when brushing to ensure they don’t swallow toothpaste. It’s recommended to use a non-fluoride toothpaste until children get into the habit of spitting out toothpaste.

Though the risk is low due to regulations of fluoride-containing products, excessive exposure to fluoride can also cause skeletal fluorosis, a bone disease.

Over time, this could result in damage to your bones and pain. The bones become hardened and lose their natural elasticity, which increases the risk of fractures. If your bones thicken and tissue accumulates, you can get impaired joint mobility.

Fluoride exposure could also lead to thyroid problems, as it can damage the parathyroid gland. This results in hyperparathyroidism, and uncontrolled secretion of parathyroid hormones. The result is the depletion of calcium and higher concentrations of calcium in the blood. Having low calcium concentration can make bones susceptible to fractures.

What Other Ingredients are Found in Toothpaste?

Tube of toothpaste

Besides toothpaste, there are other ingredients added to toothpaste. While most people know more about fluoride toxicity, some ingredients used in mainstream toothpaste brands can also cause health complications in higher concentrations.

These are some of the common ingredients you’ll find in most types of toothpaste.


To give teeth a clean shiny feel, toothpaste brands add abrasives. The abrasives remove food debris and stains on the tooth to make them clean. Modified silica and calcium carbonate are some of the common abrasives used in modern toothpaste. 

Baking soda

Toothpaste containing sodium bicarbonate (baking soda) shows excellent results in reducing plaque and slightly decreasing gum bleeding. This makes the toothpaste a better choice than brands without baking soda. 


Applied regularly, ingredients like casein phosphopeptide, sodium citrate, and potassium nitrate can relieve uncomfortable sensitivity. However, their effectiveness can vary from person to person.

Sodium lauryl sulfate (SLS)

SLS creates foam, which helps with the circulation of the toothpaste into all spaces between teeth. However, some people get canker sores or peeling of mouth tissue when they use toothpaste with SLS. If this affects you, consider SLS-free non-foaming options. 


Some of the whiteners found in modern toothpaste include hydrogen peroxide, which lightens the teeth. Also, polyphosphates like sodium hexametaphosphate help with enamel staining. 


Some studies suggest toothpaste with xylitol and fluoride is better at cavity prevention than those that contain only fluoride. 

Are These Other Ingredients Harmful?

While the additional ingredients in toothpaste offer different benefits, they could also be harmful if consumed in higher concentrations.

This has led to many people opting for toothpaste that does not contain most of these ingredients. Some people are even going to the extent of embracing homemade toothpaste options to avoid them.

Some of the ingredients that could cause health problems include titanium dioxide, which is used as an artificial coloring agent. This artificial colorant makes the toothpaste visually appealing, but is controversial because of uncertainty surrounding its genotoxicity (ability to cause mutations that may lead to cancer) when ingested.

The European Commission banned the use of titanium dioxide as a food additive in 2022.

Also, toothpaste contains artificial sweeteners, which are another area of contention. While no one would enjoy toothpaste that tastes bad, the sweeteners added could pose a health risk. Some of the sweeteners used in toothpaste include saccharin, sorbitol, and xylitol.

While xylitol is considered safe, saccharin and sorbitol are among the problematic ingredients. Saccharin has been linked with brain tumors, bladder cancer, and lymphoma.

A thickening agent like carrageenan can cause inflammatory conditions like intestinal issues, acne, cancer, and colon ulcerations. There’s a food-grade option of carrageenan and a degraded form, which is the carcinogen form, so it’s a good idea to stay away from both forms in dental care products.

To ensure the toothpaste contains the ingredients you’re comfortable with, always confirm ingredients when shopping. Alternatively, you can find vegan toothpaste brands with natural ingredients that play the same role.

Will Fluoride-Free Toothpaste Prevent Cavities?

Toothbrush and toothpaste close up

No. Fluoride is the ingredient in toothpaste that prevents cavities.

Besides being effective in disrupting plaque, fluoride also helps with remineralization. It reduces demineralization, which is an early stage in the process of tooth decay. Also, if there’s demineralization before it gets to full-blown cavities, fluoride is taken up into the demineralized area to repair it.

However, you don’t need fluoride toothpaste — or even toothpaste at all — to get rid of dental plaque from the teeth.

Simply the mechanical action of using a toothbrush twice a day and dental floss at least once a day is enough to disrupt dental plaque. If you brush frequently with just a toothbrush and water, you will prevent the buildup of dental plaque. This is important because as it builds up, dental plaque causes gum disease and tooth decay.

But this does not mean it’s entirely a bad idea to use fluoride toothpaste (or toothpaste in general). Toothpaste ingredients do more than clean.

For example, toothpaste contains mild abrasives, which polish your teeth while removing plaque. The result is whiter teeth without stains. It’s not easy to remove stains with just a toothbrush and water.

Fluoride toothpaste brands also contain properties that enhance fresh breath. So, while it might seem enticing to shun toothpaste with fluoride, it’s worth considering these benefits or making sure that whatever alternative you use has similar properties.

There are plenty of toothpastes composed of natural ingredients (and even soaps) that you can use instead, like Dr. Sheffield’s (on Amazon) or Dr. Bronner’s (also on Amazon).

Fluoride vs Fluoride-Free: Which to Buy

To understand what option would work perfectly for you, it’s crucial to look at each and its benefits. There are several reasons you might want to use fluoride toothpaste.

Generally, dentists don’t advise using fluoride-free toothpaste because the mineral offers long-term tooth health benefits. As a consumer, you may want to opt for fluoride-free toothpaste for reasons like:

  • If you have a fluoride allergy or dental fluorosis.
  • If you have a younger child, or a child that has a habit of swallowing toothpaste
  • If you believe fluoride released into the environment is harmful

Fluoride-free toothpaste offers formulas that can clean the teeth and remove plaque buildup. Even toothpastes that don’t contain fluoride can still help with teeth whitening. Also, the toothpaste, depending on its formulation, can target bacteria in the mouth through ingredients like essential oils and calcium phosphates.


Fluoride is a key ingredient in mainstream toothpaste brands. It’s added to help prevent cavities and tooth decay, as it helps with the remineralization process.

However, you can still maintain your oral hygiene using fluoride-free toothpaste. If you’re concerned about the toxic properties of fluoride, you might want to consider brands that don’t add the mineral to toothpaste.

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