Is fluoride free toothpaste good?

Fluoride free toothpaste is good at cleaning your teeth and freshening your breath, but it does not give you the proven protection against tooth decay that fluoride toothpaste does. Whether it is right for you depends on why you want it and how prone you are to decay. We sell a fluoride free mouthwash, so we have tried to set out the evidence fairly, including the parts that do not favour fluoride free products.

What UK health advice says

The NHS recommends that adults brush twice a day with a toothpaste containing at least 1,350ppm fluoride, and gives age based strengths for children. A Cochrane review found that toothpaste with 1,000ppm fluoride or more reduces tooth decay compared with toothpaste without fluoride, with a larger effect at around 1,450 to 1,500ppm. That is the main reason UK dentists recommend fluoride toothpaste.

Why some people choose fluoride free

People give a range of reasons. Some prefer products with fewer ingredients, some want to limit their overall fluoride intake, some do not like the taste of standard toothpastes, and some have read about recent research on fluoride and want to make their own choice. Whatever the reason, it is a personal decision, and a good one to talk through with your dentist.

What the 2024 US fluoride review found

In 2024 the US National Toxicology Program published a review of research on fluoride and children’s brain development. It concluded, with moderate confidence, that drinking water containing more than 1.5mg of fluoride per litre is linked to lower IQ in children. It said there was not enough evidence to judge lower levels, and it did not look at fluoride toothpaste or at fluoride’s benefits for teeth.

For context, 1.5mg per litre is also the legal limit for fluoridated water in England. A 2026 UK government report on water fluoridation in England found no evidence of an effect on cognitive ability in 5 and 7 year olds, and no convincing evidence of harm to general health at levels within that limit.

What fluoride free toothpaste can and cannot do

  • It can remove food and plaque when you brush properly, freshen your breath and clean your teeth.
  • It cannot give the extra protection against decay that the evidence shows for fluoride toothpaste.
  • It may suit people who are at low risk of decay and keep up good brushing, cleaning between their teeth and regular dental check ups, but that is a judgement to make with your dentist.

What about hydroxyapatite?

Hydroxyapatite is a mineral used in some fluoride free toothpastes. An 18 month trial in adults found a 10% hydroxyapatite toothpaste performed about as well as a standard fluoride toothpaste at preventing new decay, and a 2024 review called the evidence promising. Both were linked to a company that makes hydroxyapatite toothpaste, the trial was in a low risk group, and UK health bodies do not currently recommend it as a replacement for fluoride. It is the strongest fluoride free option so far, but the evidence is still limited.

If you decide to go fluoride free

  • Talk to your dentist, particularly for children or if you have had a lot of fillings.
  • Keep brushing twice a day, including last thing at night, and clean between your teeth.
  • Keep up your regular dental check ups so any problems are caught early.
  • Read labels carefully, as some brands sell fluoride and fluoride free versions in similar packaging.

If you want a fluoride free mouthwash to match, No Fluo is fluoride free and alcohol free, made with peppermint, tea tree, spearmint and lemon oils. Our guide to fluoride free toothpaste in the UK lists where to buy the toothpaste itself.

Buy No Fluo

Safety: do not swallow. No Fluo contains tea tree oil, which is harmful if swallowed. Rinse and spit it out, and keep the bottle out of reach of children.

Frequently asked questions

Is fluoride free toothpaste bad for you?

It is not harmful in itself, but you miss out on the protection against decay that fluoride toothpaste gives. The NHS recommends fluoride toothpaste for adults and children.

Should I use fluoride free toothpaste?

That is a personal choice to make with your dentist. UK health advice recommends fluoride toothpaste, so if you prefer fluoride free, it is worth asking your dentist how best to protect your teeth.

Is fluoride free toothpaste safe for children?

The NHS recommends fluoride toothpaste for children, at a strength that depends on their age. Speak to your dentist before switching a child to a fluoride free toothpaste.

Is hydroxyapatite as good as fluoride?

One 18 month trial in low risk adults found it performed about as well as fluoride toothpaste, but the research is limited and mostly funded by manufacturers. UK health bodies do not recommend it as a replacement for fluoride.

Related guides

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