Dentists

ADA position · JADA 2025 ethics guidance

Do dentists recommend hydroxyapatite toothpaste?

Some do, mostly as a fluoride alternative rather than a replacement. The American Dental Association recommends fluoride toothpaste, and its Seal of Acceptance requires fluoride for any cavity-protection claim. In 2025, ethics guidance in the Journal of the American Dental Association said that if a patient refuses fluoride, nano-hydroxyapatite is "likely the second-best option for them, based on the limited studies available."

In practice, many dentists keep fluoride as the standard and discuss hydroxyapatite with patients who want to avoid it, or suggest using both. Your own dentist knows your cavity risk, so ask them.

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JADA, 2025 Likely second-best For patients who refuse fluoride, based on the limited studies available.

01

The ADA standard is fluoride

The ADA recommends fluoride toothpaste, and only fluoride toothpastes can carry its Seal for cavity protection.

02

JADA: likely second-best

The 2025 ethics guidance calls nano-hydroxyapatite the likely second-best option for patients who refuse fluoride, while noting the research is limited.

03

Honest framing matters

The same guidance says dentists should disagree with aggressively anti-fluoride branding. Klyyr doesn't market One+ against fluoride.

Ethics guidance on fluoride refusal

What dental organizations and guidance say about hydroxyapatite toothpaste
Source	Position What it says	In practice What it means
American Dental Association	Recommends fluoride toothpaste; its Seal for cavity protection requires fluoride	No fluoride-free paste can carry the Seal for cavity claims
JADA ethics guidance, 2025	nHA is "likely the second-best option" if a patient refuses fluoride	A reasonable alternative, not an equal
FDA	Anticaries rules list fluoride actives only	Fluoride-free HAp paste is a cosmetic in the US
EU SCCS, 2025	A specified nano-HAp considered safe up to 29.5% in toothpaste	A safety opinion, not an efficacy endorsement
Published trials	One 18-month adult trial found a 10% HAp paste non-inferior to 1450 ppm fluoride on its primary caries endpoint	Promising, from one formula

Positions summarized from the ADA, JADA, FDA, and SCCS sources below, reviewed 27 September 2026. Individual dentists vary. This page does not claim that any dentist or dental organization endorses One+.

Sources behind this answer

The professional sources behind each answer on this page.

Journal of the American Dental Association · 2025
Ethics guidance on fluoride refusal
JADA's ethics column says that if a patient refuses fluoride, nano-hydroxyapatite is "likely the second-best option for them, based on the limited studies available," and that dentists should disagree with aggressively anti-fluoride branding.
Read the JADA guidance
American Dental Association
Toothpaste overview
The ADA requires fluoride for any Seal-accepted cavity-protection toothpaste, sets the RDA limit at 250, recommends rice-grain and pea-sized amounts for young children, and lists ingredients reported as irritants.
Read the ADA toothpaste overview
18-month adult clinical trial · different formula
Caries endpoint
In one 18-month adult study, a 10% HAp toothpaste was non-inferior to 1450 ppm fluoride for the primary caries endpoint. The study tested a different formula.
Read the 18-month non-inferiority study

How to talk to your dentist

Ask about your cavity risk

It's the main factor in whether a fluoride-free paste makes sense for you.

Ask about using both

Some people use a fluoride paste at one brushing and a hydroxyapatite paste at the other.

Bring the label

Show them the hydroxyapatite percentage and full ingredient list so they can judge the actual product.

The Klyyr One+ formula

One+ is fluoride-free toothpaste with a clearly disclosed 10% nano + micro hydroxyapatite blend, 16 listed ingredients, peppermint + spearmint, no SLS, and no artificial dyes.

01
10% hydroxyapatite
Combined nano + micro hydroxyapatite, disclosed on the label. Ten percent is not a universal efficacy threshold.
02
16 listed ingredients
Water, Sorbitol, Glycerin, Potassium Sorbate, Hydroxyapatite (nano & micro), Xylitol, Sodium Cocoyl Glutamate, Cellulose Gum, Xanthan Gum, Zinc Citrate, Aloe Vera, Mentha Piperita (Peppermint) Oil, Mentha Viridis (Spearmint) Leaf Oil, Menthol, Sodium Benzoate, Stevia Rebaudiana Leaf/Stem Extract.
03
What is not in it
0 ppm fluoride. No SLS. No artificial dyes. Sodium cocoyl glutamate is the surfactant.
04
120 g aluminum tube
4.23 oz, approximately 90 brushings. Aluminum tube, HDPE cap. Recycle where accepted locally.

In short

Dentists' default is fluoride. For patients who won't use it, hydroxyapatite is the alternative the ADA's own journal points to.

01 Do dentists recommend hydroxyapatite toothpaste?

Some do, usually for patients who want to avoid fluoride. The ADA's standard recommendation is still fluoride toothpaste.

02 What does the ADA say about hydroxyapatite?

The ADA requires fluoride for its Seal on cavity-protection toothpastes. Ethics guidance in its journal in 2025 called nano-hydroxyapatite likely the second-best option for patients who refuse fluoride.

03 Should I replace fluoride with hydroxyapatite?

Ask your dentist. Many dentists prefer fluoride as the standard, and some suggest using both. See using hydroxyapatite and fluoride together.

04 Why did my hygienist mention hydroxyapatite?

Hydroxyapatite toothpaste has become more common, and some dental professionals discuss it with patients who prefer fluoride-free products. Ask them why they suggested it for you.

05 Does Klyyr work with dental practices?

Yes. Practices can learn about One+ through the Klyyr dental program.

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