In this current review article, the essential effective ingredients of toothpastes are explained in more detail. The functionality of fluorides in toothpastes is discussed and reference is also made to biomimetic approaches with hydroxyapatite. It is important that the ingredients in toothpastes react with one another and can inactivate one another. This can happen in particular when fluorides are combined with calcium carbonates or similar ingredients.
Statements postulated about fluorides are also frequently taken up and discussed chemically. It is noticeable that the only caries-protective effect of fluorides can be confirmed by improving remineralization. A calcium fluoride top layer or protective layer made of fluorapatite cannot be detected. The incorporation of fluoride into the tooth enamel is equally irrelevant – this only takes place to a very small extent. A hardening of the tooth enamel with fluorides cannot succeed either. The frequently discussed antibacterial effects of fluorides are negligible. Antibacterial effects can, however, be determined by counter ions (tin or amine).
Advantages of biomimetic active ingredients (e.g. hydroxyapatite) are, in addition to the multifunctional effect (anti-adhesive effects are positive for caries and periodontitis prophylaxis, prevention of sensitive teeth, prevention of erosion defects), the non-restriction by the cosmetics ordinance. While fluorides may make up a maximum of 0.15% of the toothpaste formulation, biomimetic active ingredients can also be used several times a day in larger concentrations.
