Key Considerations for Pharmacists on Hydroxyapatite Toothpaste Tablets

Jordan Harper, DMD, discusses how hydroxyapatite-based toothpaste tablets reflect a growing shift in oral care away from fluoride while maintaining strong clinical performance. He discusses the science behind hydroxyapatite, its safety profile, and its benefits for sensitivity reduction, as well as why this delivery format can be especially useful for diverse patient populations, including those with restorations and individuals who need simpler, more accessible oral care options.

Pharmacy Times: Consumers are increasingly interested in sustainability and ingredient transparency. How does ENML balance environmental considerations with safety, efficacy, and clinical expectations?

Harper: We’re always researching, like, what the latest research is with the hydroxyapatite wave that’s kind of taken over now that everyone’s kind of steering away from fluoride. Obviously, lots of research is being done on micro hydroxyapatite and nano hydroxyapatite, and our goal, as forefront leaders in that, is to stay on top of it.

And so, we’re constantly tracking down new studies that are being done and new articles that are being published to both make sure, one, it’s safe. Our first formulation of our toothpaste tablets just had micro hydroxyapatite in it, because the literature wasn’t fully supporting nano just yet.

And so, there were some things to be ironed out still in the nano spectrum world that, over the last year, have been ironed out. More studies have come out, and it came down to less the particle size; the more the particle shape was the problem.

So, we definitely like to try and stay on top of the literature so that it obviously is both clinically effective for the patient and also safe for them. We don’t want it to harm other parts of the body, right?

And then, from the environmental standpoint, we source as many of our ingredients as possible from organic-type stuff. Obviously, some of the things in toothpaste are synthetic, right? Hydroxyapatite. The only real way to get hydroxyapatite naturally occurring in the world is to grind up teeth, which no one wants to do, or grind up oyster shells or something like that.

So, it is going to be synthetic materials. But when you have that lab control, again, you can control the shape of the hydroxyapatite, which effectively controls the safety of it.

Pharmacy Times: Pharmacists are often one of the most accessible healthcare professionals for patients. How do you see pharmacists helping consumers navigate newer oral care formats like toothpaste tablets?

Jordan Harper, DMD: I think with pharmacists, I think the big way I see them inserting a role is as I see people asking their pharmacist questions about fluoride because it has become very much. It used to be something just that dentists talked about. Now it’s like all over the papers and everything else.

And so, I think pharmacists should definitely educate themselves on fluoride. Does fluoride still work on teeth? Absolutely, it works on teeth. The problem is we started finding it in areas of the body, like the thyroid and stuff like that, where we don’t necessarily want fluoride ions, right?

And so, the stance we kind of take as a company is like, look, okay, yeah, fluoride scientifically still works, right? That’s great. However, we have something that has been around since the 70s that actually is better.

Japan is the only country that widely adopted hydroxyapatite in the 1980s after NASA produced a white paper on it in the 70s. And so, it’s new to all of us, with the exception of Japan, but it is something that is clinically just as effective, if not better, than fluoride.

And I think it’s important, as pharmacists begin to get approached more about, “Hey, I want something with fewer chemical additives or all this type of stuff,” that it’s very important for them to have an education on what’s out there that’s a fluoride-free alternative that is also still going to prevent against cavities, tooth decay, and all that type of stuff, like traditional toothpaste would.

Pharmacy Times: For patients considering a switch to toothpaste tablets, what guidance would you recommend pharmacists share when helping them evaluate whether this option is right for their oral health needs?

Harper: So, the beauty of our enamel toothpaste tablets is they legitimately can be used by any and everyone. I think of things for them, talking points and things you’re going to think about.

It’s safe. We have something in our industry called RDA value. It’s called relative dental abrasion value, and basically, it’s a metric we use to compare the abrasiveness of pastes. We have the same abrasiveness as Sensodyne, right? So, it’s very, very gentle on your teeth but still very clinically effective.

The other thing is, with our toothpaste tablets having hydroxyapatite in them, the sensitivity reduction that you get from using hydroxyapatite is way better than anything that has fluoride in it.

And then lastly, it’s safe on restorations of any kind. So, patients obviously go throughout their life; they get fillings, crowns, bridges, implants, dentures, and all these types of things, right? And I think it’s important to know that these toothpaste tablets we manufacture are safe on all of those, as well as your natural teeth.

So, I think it’s just important to know that it is extremely safe to use for anyone and everyone that it’s not a swallowing risk for? Like little Johnny, who’s two years old, maybe not ready for a tablet yet, because they might be afraid, he might swallow it. But if you’re not going to swallow it, toothpaste tablets are definitely super beneficial.

And the other two patient populations that often get forgotten about are, one, the blind. Have you ever considered how a blind person puts toothpaste on a toothbrush? So, a tablet is way easier for them to use.

And then two, I get a lot of patients that are in their 90s that are in assisted living facilities, all these types of things. Oftentimes they can’t brush their teeth themselves because of arthritis and all that type of stuff. And again, they’re not going to be able to squeeze the toothpaste tube to get the paste on the brush. So, the tablet is just an easier, more convenient delivery system.