🦷 Mondays with Mark: Can I whiten my teeth with hydroxyapatite? (2024)

Back when I started my dental career, the discovery of hydrogenperoxidefor teeth whitening was groundbreaking. It felt great (and was lucrative to boot) to make our patients feel more confident and happier with their whiter, brighter smiles.

Butcarbamideperoxide, a common whitening agent, has its issues—oxidizing tissue and releasing free radicals that harm the tooth’s living tissue as well as the oral microbiome. It started as an in-office procedure but now, anyone can use it at home, leading to misuse and damage.

In Europe, regulations are stricter. No whitening under 18, and only low-strength options (10%) are allowed. That’s why I recommend the same 10% strength for safer, longer-term use. It’s gentler but takes longer to show results. Avoid the stronger, riskier versions you find online—they can cause tooth pain and also disrupt your oral microbiome, potentially leading to oral disease. As we know, the oral microbiome affects heart health, brain health, the gut—just about everything.

Enter hydroxyapatite (HAP) in the 1990s. Unlikecarbamideperoxide, which bleaches teeth, nano-HAP works by integrating with your enamel—filling in the enamel with the same minerals teeth are made of. This method supports natural remineralization, making teeth stronger and healthier without the risks of over-whitening.

I’ll compare whitening methods at-a-glance below:

1. CarbamidePeroxide:

• Mechanism for whitening: Bleaches teeth by oxidizing organic compounds in the enamel.
• Pros: Fast results, and ability to whiten teeth many shades lighter than their original shade. (Many folks don’t realize that a Hollywood-white smile is actually not a “natural” color.Carbamideperoxidewhitening is the only way to achieve this.)

• Cons: Releases free radicals, can damage living tissue and disrupt the oral microbiome, leading to potential oral and systemic health issues. It can also make your teeth VERY sensitive—achy for months. Anecdotally, we know that people who whiten a lot tend to have bad breath, which is likely due to disruption of the oral microbiome and disruption of the nitric oxide-producing bacteria on the back of the tongue—very similar to themouthwash and high blood pressure connection.Carbamidealso has a drying or “desiccating” effect on the tooth which makes the tooth look whiter, but this effect is very temporary—lasting a day at the most—and during that period of time, your tooth is very prone to staining with wine, coffee, blueberries, etc.

2. Hydroxyapatite (HAP):

• Mechanism for whitening: Fills in enamel with minerals, supports the body’s natural remineralization process.
• Pros: No risk of over-whitening, improves enamel strength and appearance, promotes oral microbiome health. Results last longer (assuming you continue using the nano-HAP toothpaste).

• Cons: Hydroxyapatite takes longer to show results compared tocarbamideperoxide. If you prefer an ultra-white aesthetic (like the Hollywood smile I reference above) then hydroxyapatite might not achieve that. Some beauty standards favor teeth that are much whiter than natural. Hydroxyapatite restores teeth to theiroriginalshade, but it won’t necessarily make them any whiter than they were to begin with (although, one study says you can get a little bit whiter than original—but I don’t want to overpromise.)

3. Fluoride:

• Mechanism: Strengthens and remineralizes enamel by incorporating into the enamel structure as fluorapatite.
• Pros: Effective in preventing cavities and strengthening teeth.
• Cons: Remineralization with fluoride results in a wavy, brittle pattern in the enamel, less aesthetically pleasing results compared to HAP due less reflection of light. Not to mention the damage to the developing brain, even if a child doesn’t swallow fluoride toothpaste, as it gets absorbed through oral mucosa.

In other words, whitening with hydroxyapatite doesn’t just make your teeth whiter—it restores them to their natural sheen and smoothness. This enhances the reflectivity index, giving your teeth a natural shine and healthier appearance. Nano-hydroxyapatite particles, which are naturally occurring in your teeth, fill in the micro-defects in enamel, creating a smoother surface that reflects light better. This results in teeth that look naturally brighter and healthier.

The advantage with nano-HAP toothpaste is that you’re using a biomimetic material that is naturally occurring in enamel.Nano-hydroxyapatite particles are naturally occurring in your teeth. While some are concerned about nano-HAP in toothpaste, remember that the particles in your toothpaste are nearly identical in size and shape to those already in your tooth. These minerals—phosphate and calcium—are suspended in saliva, the storage system for remineralization. Think of hydroxyapatite toothpaste as filling up the lego box. When your teeth remineralize, they need building parts. A full lego box means your teeth have the building blocks they require to repair themselves.

P.S. TryFygg hydroxyapatite toothpastefor effective, enamel-safe whitening. Use code “ATD15” at checkout to save 15% on your first order!

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