There has been some discussion in recent years about the levels of fluoride Americans are exposed to on a daily basis. Experts do agree that ingesting too much fluoride can lead to fluorosis, which can cause white flecks on teeth, or even weak bones and susceptibility to fractures. Fluorosis can be a significant health issue for babies and children whose teeth are still developing, but it's also quite rare. Experts also agree that some fluoride is important for helping a child develop strong teeth and avoid dental diseases that were common in children before the advent of fluoridated water. For most people, the ADA says the benefits of fluoride toothpaste far outweigh any risks -- for that reason, no fluoride-free toothpastes are ADA approved.
Your need, and your child's need, for fluoride will depend upon a number of factors, not the least of which is the area in the U.S. where you live, the type of water access you have, and other lifestyle issues. The best way to make an informed decision is to speak with your dental care provider and follow his or her recommendations.
However, if you do prefer a fluoride-free toothpaste you're in luck. More and more manufacturers are making toothpastes that keep fluoride out of the mix. Among those, reviewers say the best of the bunch is Tom's of Maine Fluoride-Free Toothpaste (Est. $7 for 2). It's made with zinc citrate sourced from zinc, a naturally occurring mineral, and xylitol, which is derived from birch trees or corn. This toothpaste does contain sodium lauryl sulfate (SLS), a dispersant that can cause canker sores in some sensitive individual. Tom's toothpaste comes in three different flavors: peppermint, spearmint or fennel. The product is gluten-free, cruelty-free, and halal and kosher-certified. It contains no artificial dyes, sweeteners or flavors.
Several experts give Tom's of Maine products rave reviews, although most focus on the toothpaste options that contain fluoride. GoodGuide.com gives this Antiplaque and Whitening Fluoride-Free Toothpaste a respectable health score of 6.7 out of 10.
The thousands of user reviews we saw for Tom's of Maine Antiplaque and Whitening are mostly positive; however, many users are displeased about the addition of SLS to the toothpaste's formula. Otherwise, most are happy with the product's light, natural-tasting flavor and say that the paste cleans teeth effectively.
Kiss My Face Whitening Toothpaste (Est. $15) is fluoride- and SLS-free. It's also certified organic and contains no artificial dyes, flavors or sweeteners. Its active ingredient is aloe vera, and its other ingredients are natural, although it does contain sodium lauroyl sarcosinate, a cleanser that is considered to be milder than SLS.
In a roundup of natural toothpastes, Good Housekeeping praises the product's fresh, minty taste, which "approximated conventional toothpaste brands." Users also love the pleasant flavor and say the product provides long-lasting fresh breath. A few users claim that it is effective at whitening teeth naturally.
Nature's Gate Natural Toothpaste (Est. $23 for 6) is another alternative if you're looking for a fluoride-free option. It comes in four flavors: Crème de Peppermint, Crème de Mint, Crème de Anise and Crème de Cinnamon. It contains no artificial colors or sweeteners and no preservatives; like the Kiss My Face Triple Action Whitening Toothpaste, it does contain sodium lauroyl sarcosinate. The product is formulated with baking soda and a number of natural ingredients.
User reviewers give Nature's Gate Natural Toothpaste stellar marks, saying they love the product's flavor formulations and that it provides a long-lasting freshness and clean feeling. There were some complaints, as with every product: some users criticized the product's stringy, goopy texture and consistency, and there's some debate among reviewers as to whether it foams up effectively. Overall, though, the product is a hit with owners.
Elsewhere in this report: