Hydroxyapatite (HAP) is the mineral your tooth enamel is mostly made of. Toothpastes containing it, often in "nano" form, are the fastest-growing fluoride-free option in Australia. Here's what the evidence says.
What the trials found
- Children (Paszynska, 2021): a double-blind trial of 207 children aged 3 to 7 over 336 days compared a 10% hydroxyapatite toothpaste with a 500 ppm fluoride toothpaste. Decay progressed in 72.7% of the HAP group and 74.2% of the fluoride group. HAP was found "non-inferior". Note: this trial used microcrystalline HAP, not nano.
- Adults (Paszynska, 2023): 189 adults aged 18 to 45 over 18 months, compared with a standard 1,450 ppm fluoride toothpaste. HAP was again non-inferior. Diet wasn't monitored, and some authors have industry links.
- Systematic review (Wierichs, 2022): found the human trials too varied to pool. In lab-style studies in the mouth, fluoride reduced demineralisation while nano-HAP did not differ from a fluoride-free control.
Bottom line: the best trials so far suggest HAP can perform similarly to fluoride toothpaste, but the evidence base is much smaller than for fluoride. Australian dental bodies still recommend fluoride toothpaste.
Is it safe?
The EU caps nano-HAP at 10% in toothpaste. In June 2025 the EU's scientific safety committee concluded it is safe up to 29.5% in toothpaste for rod-shaped, uncoated particles, but not needle-shaped ones. EU law still uses the lower cap for now.
How it's regulated in Australia
Toothpastes that make only cosmetic claims are treated as cosmetics, not medicines, and their ingredients fall under the Australian Industrial Chemicals Introduction Scheme (AICIS). Products making therapeutic claims, such as "prevents decay", can fall under the TGA. Some fluoride toothpastes are on the TGA's register; we found no specific TGA ruling on HAP.
Brands sold in Australia
These are available from Australian retailers (we have not tested them and this is not a recommendation):
- Grin (NZ-made, range with hydroxyapatite)
- Peg Paste (Australian, with hydroxyapatite)
- Davids (nano-HAP range)
- Fygg (nano-HAP)
- Grants Natural Whitening with HA
Who it might suit
People who want to avoid fluoride, parents of toddlers who swallow toothpaste (the main cause of dental fluorosis), and anyone in a non-fluoridated town weighing up options. Talk to your dentist if you or your kids have high decay risk.