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Is There A Synthetic Enamel Paste?

Updated: Jan 19

The only true synthetic enamel paste is a hydroxyapatite-based toothpaste because the enamel is composed of 96% of hydroxyapatite by weight. Therefore, if you had vivid imagery of crushed up teeth you don't have to worry about that!


Shark teeth
Shark teeth

Now let me tell you the fascinating story of the rise, the fall, and the reemergence of synthetic hydroxyapatite toothpaste (HAP).


Table of contents:


History of the first synthetic enamel paste

Believe it or not, but the idea of creating synthetic hydroxyapatite was born out of NASA in the 1960s. Apparently they were trying to figure out a way on how to stop bone loss for astronauts when they journeyed into zero gravity space. Hydroxyapatite which is made of calcium and phosphate, is the primary mineral that is present in your bones and your teeth.


It is certainly not a new product but are you wondering why you've never heard of it despite it being around for over half a century? Well, we don't blame you because NASA never did anything with it and sold the patent to a Japanese company named Sangi Co.


apagard premio hydroxyapatite toothpaste

Consequently, Sangi became the first company in the world to create a hydroxyapatite toothpaste in 1978. Over the years, they've refined it and made the particle size of HAP smaller until its present date of being nano-sized. Now all of their toothpastes are technically nano-hydroxyapatite (n-HAP).


Nonetheless as avant garde as they were, Sangi didn't get the toothpaste officially approved as an anti-cavity toothpaste until 1993. It took them over decades of research for the Japanese government to give them approval. Now that is the story of how the first synthetic enamel paste was born and created.


After its acceptance in Japan, it wasn't until 2006 that it became commercially available in Europe. Then it took until 2015 for it to land in Canada. Then in the last couple of years, it recently resurfaced in the United States of America.


So yeah, it was born in the US and then left for Japan. Then it traveled all around the world and finally made it back into the US after half a century later! Talk about the rise, the fall, and the reemergence of HAP!


Are there other types of artificial enamel pastes?

Currently the only artificial enamel paste in existence are hydroxyapatite based toothpastes. They initially started off with large molecules of HAP but over the years they've been refined down to nano sized particles.


Research have shown that the smaller sized nano-HAP were more effective in preventing cavities. That prompted all of the toothpaste companies to switch over to nanohydroxyapatite in lieu of regular sized hydroxyapatite.


Examples of n-hap toothpastes:

  • Davids nanohydroxyapatite

  • Risewell mineral toothpaste

  • Dr Jens super paste

  • Carifree gel 1100

  • Wellnesse

  • Boka Ela mint

  • APADENT

  • Dr Raven's enrich nano-hydroxyapatite


Only hydroxyapatite toothpastes are enamel pastes

We only consider HAP toothpastes as synthetic enamel pastes because that is literally what your enamel is made of.


Hydroxyapatite is a type of calcium apatite [Ca10(PO4)6(OH)2] and is essentially made of calcium and phosphates. It's not just our teeth but also our bones are made of it too. In fact, there is more of it in our enamel than in bone.

  • Enamel is composed of roughly 96% of this mineral by weight.

  • Bone is composed of 60% HAP by weight.


This calcium based mineral, hydroxyapatite is basically what gives our teeth and bones their structural rigidity. Consequently since enamel has more of it than bone, it makes our teeth the hardest substance in the human body.


Since our enamel is mostly made of HAP, hydroxyapatite based toothpastes can rightly call themselves artificial enamel pastes.


What about calcium phosphate or CCP-ACP toothpastes?

While HAP is literally composed of calcium and phosphates, there are toothpastes which contain them but do not have hydroxyapatite. These products are called calcium phosphate toothpastes or CCP-ACP toothpastes.


However these pastes with individual constituents of calcium and phosphates do not qualify as an artificial enamel paste.


MIPaste Family with recaldent

Yes, both the minerals calcium and phosphate are needed to build strong teeth but in their individual state they do not resemble enamel. Milk has a lot of calcium and leafy green vegetables have a lot of phosphorus but do you consider them close to teeth?


Bet you don't because they need to be combined in a certain way for them to gain the properties of hydroxyapatite. The situation is similar to how butter and flour does not equate to being a croissant. The ingredients need to be mixed and then baked for it to turn into a croissant!


The same concept applies to calcium phosphate, tricalcium phosphate and CCP-ACP toothpastes. They contain the individual components of what it takes to make enamel but they are NOT artificial enamel pastes.


Examples of calcium phosphate and CCP-ACP toothpastes:

  • GC MI Pastes

  • Regenerate Enamel Science Advanced Toothpaste

  • 3M Tri-calcium phosphate toothpaste


Benefits of nano-hydroxyapatite

Using nano-hydroxyapatite toothpaste can have many wondrous benefits for your teeth.

  • Remineralizes teeth. Since n-hap is made of the same mineral as your teeth, it can insert itself directly into demineralized lesions. It can also act as a reservoir that releases calcium and phosphates to help remineralize the areas. It reverses tooth decay.

  • Plaque control. It can directly bind to bacteria and prevent them from attaching to your enamel. It is effective for plaque control.

  • Reduces teeth sensitivity. Studies have shown that it can occlude open dentinal tubules, thus effectively reducing sensitivity.

  • Whitens teeth. It doesn't bleach your teeth but it does make it smoother and glossier. It literally fills in all of the porosities and defects in the enamel. Since it is naturally white in color, it gives the appearance of whiter teeth.



tooth remineralization schema with hydroxyapatite
Credit: Lijie Chen, Suma Al-Bayatee, Zohaib Khurshid, Amin Shavandi, Paul Brunton and Jithendra Ratnayake

Fluoride alternative

This is the only other toothpaste in the world that can remineralize teeth aside from fluoride. The anti-cavity mechanism is slightly different but the end result is mostly the same.


Other toothpastes like charcoal or xylitol do not have remineralizing effects because they're not remineralization toothpastes. In fact, aside from fluoride and hydroxyapatite, there are no other remineralizing dentifrices. All of the natural products may freshen your mouth but it won't repair your teeth!


Studies have shown that only HAP is effective as fluoride in fighting cavities. That makes it a valid fluoride-free alternative as a toothpaste. So if you were looking for such a product, here it is.


Can synthetic enamel paste rebuild enamel?

Despite containing the exact same mineral as your enamel, hydroxyapatite cannot rebuild your enamel. Brushing with it won't undo a cavitation in your tooth such as a big hole or if you were missing half the tooth. That is too severe for what this enamel paste can do.


However what it can do is repair the enamel such as small defects or reverse demineralized carious lesions. You can think of the toothpaste as something similar to filling in potholes on a bridge. It is effective at repairing it but if half the bridge was missing, it cannot rebuild the bridge! The same goes for your teeth.


Side effects for hydroxyapatite

Unlike other oral care products, hydroxyapatite is highly biocompatible and biomimetic since it is exactly what your teeth are made of. In other words it is non-toxic and non-irritating so it is safe with virtually no adverse effects.


Even if you swallow it, nothing bad will happen because the gastric acids in the stomach will simply dissolve it. As you may have guessed, what HAP dissolves into is just calcium and phosphates which get reabsorb in the small intestine. From there it probably gets reincorporated into your bones.


The equation for demineralization of hydroxyapatite in the presence of acid whether in the mouth or in the stomach is as such: Ca10(PO4)6(OH)2 + 8 H+ → 10 Ca2+ + 6 HPO42- + 2 H2O


You don't need to think too hard about this because this demineralization process happens on a daily basis to our teeth. It occurs whenever we eat sweets or even after a meal, so the reaction above has been well studied!


NOW foods calcium hydroxyapatite

If you wanted any more convincing, you should also be aware of the fact that some people take calcium hydroxyapatite as a supplement. Yes, they take it for additional calcium!


What research says

Well, it's always good to have research to back up what we're saying and the literature does seem to support it. Studies have shown that hydroxyapatite cannot possess immunotropic or allergenic characteristics. You can't be allergic to it!


Other studies were also in agreement with the finding above. Even when used on skin there were no allergic reactions that occurred.


Takeaway

Synthetic enamel pastes do exist and they're officially called hydroxyapatite toothpastes. What makes them artificial enamel is the fact that it contains the same mineral as our teeth, hydroxyapatite. Those are all of the preventative dentistry tips by our dentists in Long Island City.



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About the author: Dr David Chen, DDS

Hello, I'm Dr Chen and I'm an actively practicing dentist in Long Island City, NY. I graduated from Columbia University College of Dental Medicine in 2016 but prior to going to dental school I was already working in the dental field. It's been more than a decade since I first got to know dentistry and let me tell you, time flies by quickly. Since then I've developed a fondness for writing, which is how this all got started!

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Medical Disclaimer:

This blog is purely meant for information purposes and should not be used as medical advice. Each situation in your mouth is unique and complex. It is not possible to give advice nor diagnose any oral conditions based on text nor virtual consultations. The best thing to do is to go in person to see your dentist for an examination and consultation so that you can receive the best care possible.

The purpose of all of this oral health information is to encourage you to see your dentist and to inform you of what you may expect during your visit. Due to the unfortunate nature of dentistry, there isn't really any true home remedies that will get rid of dental problems. Roughly 99.99% of them require in-person intervention by a healthcare professional.

Hint: That is the reason why you can't eliminate seeing dentists in your life!

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