Just Because It’s In Toothpaste
Doesn’t Mean It’s Safe
– Xylitol, Nano-hydroxyapatite, Fluoride, Activated Charcoal –

Dr. Al Danenberg Nutritional Periodontist

May 8, 2022 [printfriendly]

If you want to put something into your mouth, it should be compatible and healthy. Not just for your mouth, but also for the rest of your body! If it’s not, then why would you subject yourself to potential harm?

  • Would you drink water that contains lead?
  • Would you gargle with gasoline?
  • Would you eat arsenic?

Of course, you wouldn’t since you know that these elements could kill you.

But what if you didn’t know what you didn’t know?

What if you were told something is beneficial but the potential harm was not disclosed and intentionally hidden from you?

You’d be more than angry – you’d be irate!

So, let me bring this reality to you.


Teeth & Dental Plaque Are Unique

Here is a little-known fact. The only area of the body where a hard structure pierces the skin and enters the sterile bony structures is the tooth. Think about this for a moment …

Can you imagine the potential havoc that could occur if infection were to move down the tooth into the jawbone? Your jawbone could rot, and you could die.

But the body has solutions.

The body created a “healthy biofilm” to protect this susceptible area to prevent bacteria from sliding down the tooth into the bone. There are other protective structures under the gum that can alert the immune system to fight infections.

But first, this protective and healthy biofilm is the initial defense. It is called “dental plaque” and is composed of several hundred bacteria is a state of balance.

This natural biofilm serves at least three main functions. Healthy dental plaque …

  1. Allows necessary nutrients and minerals from the saliva to enter the root of the tooth to remineralize it as necessary 24/7.
  2. Produces hydrogen peroxide to kill any potentially pathogenic microbes in the mouth from getting to the gum/tooth margin
  3. Buffers the acidity around the gum/tooth margin to maintain an acid level of no more acidic than pH 5.5 to prevent decay of the root surface.

So, you don’t want to disturb or destroy this healthy dental plaque. Proper oral hygiene using a healthy toothpaste will not remove the thin layer of healthy dental plaque. Proper oral hygiene will only remove any excessive, unhealthy dental plaque.


Four Potentially Toxic Ingredients in Toothpastes

Four specific ingredients in various toothpastes are promoted as healthy and disease fighting.

  • Xylitol
  • Nano-hydroxyapatite
  • Fluoride
  • Activated Charcoal

But most people are confused about these ingredients because there are many published scientific papers that proclaim the benefits of them for the prevention of tooth decay and gum disease. But the far-reaching damage that these additives may cause to other parts of your body as well as to the garden of balanced bacteria in your mouth is not disclosed. And you need to be informed before you decide to use them in your mouth or to avoid them.



Xylitol will prevent a specific mouth bacterium (Strep mutans) from growing. Strep mutans is one of the bacteria that is responsible for tooth decay. But in a healthy mouth with a balance of bacteria, Strep mutans is part of the homeostatic community in healthy dental plaque without causing any harm. To destroy Strep mutans could disrupt the overall balance of bacteria and create an unhealthy overgrowth of other microbes.

Xylitol also prevents healthy dental plaque from forming and attaching to the root surface near the tooth/gum margin.[1] But healthy dental plaque is protective as I described above.

In addition, xylitol can damage the gut microbiome and create GI (gastrointestinal) disturbances.[2]



Hydroxyapatite is the calcium-phosphate mineral structure of tooth enamel. Nano-hydroxyapatite has a much smaller size than hydroxyapatite and can adhere to the existing hydroxyapatite in teeth and “fill in holes”. The effect is that it can reduce root sensitivity and mineralize and repair early tooth decay. Nano-hydroxyapatite is marketed as the healthier alternative to fluoride.

However, several medical papers have shown that “nano” particles can penetrate other cellular tissues in the body and become cytotoxic.[3] They also have the potential to damage the balance of healthy bacteria in the gut.[4],[5],[6] All “nano” particles have the potential to do more harm than good. Much unbiased research still needs to be done in this area of medicine before I am convinced that medical nanotechnology is unconditionally safe and proven effective.



For years, dentistry has been a proponent of fluoride in water and in toothpaste. The ideas are that fluoride will kill oral bacteria and prevent tooth decay and gum disease. And the American Dental Association (ADA)[7] and the Food and Drug Administration (FDA)[8] still believe this to be the case.

However, much of the current science demonstrates potential overall harm when fluoride accumulates in the body. The IAOMT (International Academy of Oral Medicine and Toxicology) put together this detailed paper describing the harm of fluoride. And the IABDM (International Academy of Biological Dentistry and Medicine) published this paper about their position on fluoride and republished this paper on the ingestion of fluoride.


Activated Charcoal

Charcoal is a porous black solid form of carbon that is created by burning wood or other organic material. This charcoal can be burned again at higher temperatures to produce “activated charcoal”. Activated charcoal can bind to toxic elements primarily in the gut. It doesn’t remove toxic elements in the mouth and does not prevent tooth decay or gum disease as promoted by some dental product companies.[9] Activated charcoal can also bind to essential nutrients to induce vitamin deficiencies, dehydration, constipation, and even vomiting.[10],[11]

In toothpaste, activated charcoal also is promoted to help whiten teeth. However, it is abrasive and could possibly damage or remove the outer layer of the tooth, which is the enamel. If some of the enamel is removed by activated charcoal, a more yellow under-layer of the tooth called dentin will become exposed. The exposed dentin will stain more easily than the enamel and could cause tooth sensitivity. And the lost enamel will never “regrow”.

If you are interested, I published a blog on teeth-whitening ideas a few years ago.



When selecting a toothpaste, you shouldn’t use one with potentially harmful chemicals that may act as “Band-Aids” to prevent tooth decay and gum disease. Even if some research suggests that these elements may have benefits, they still should not be used if other science shows that they can cause harm.

Choose a toothpaste with no harmful elements and one that can enhance the healthy balance of the garden of bacteria in your mouth. My choice is Revitin.

There are very specific methods to stop tooth decay and gum disease. And they don’t involve chemicals to disturb natural processes in your body. In fact, these methods not only will prevent tooth decay and gum disease, but also assist in overall health and wellness. In this PDF I published, I describe the 4 Steps to a Healthy Mouth.

Tooth decay and gum disease are results from poor diet choices, an unhealthy gut, and inefficient oral hygiene protocols. You wouldn’t paint a rusted pipe with Rust-Oleum to hide the rust. And you wouldn’t take an aspirin to treat appendicitis. You would figure out the cause of the rusty pipe or the appendicitis and treat both correctly.

That’s the way you must approach the problems of tooth decay and gum disease. Treat the real causes of these diseases and repair the damage these diseases have created in the mouth.

Don’t rely on Band-Aids like Xylitol, Nano-hydroxyapatite, Fluoride, or Activated Charcoal to solve the problem.


[1] https://www.ncbi.nlm.nih.gov/pubmed/31361368

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5537870/

[3] https://pubmed.ncbi.nlm.nih.gov/31349397/

[4] https://particleandfibretoxicology.biomedcentral.com/articles/10.1186/s12989-020-00349-z

[5] https://www.mdpi.com/1422-0067/22/4/1942

[6] https://www.sciencedirect.com/science/article/abs/pii/S0048969721001443

[7] https://www.ada.org/resources/research/science-and-research-institute/oral-health-topics/fluoride-topical-and-systemic-supplements

[8] https://www.fda.gov/news-events/fda-brief/fda-brief-fda-proposes-updated-standards-fluoride-added-bottled-water-maximize-health-benefits-while

[9] https://pubmed.ncbi.nlm.nih.gov/32112023/

[10] https://www.ncbi.nlm.nih.gov/books/NBK482294/

[11] https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1745-4557.2004.tb00647.x


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  1. There’s something weird I’ve been doing ever since I had a tooth extraction of an infected tooth. I use triple antibiotic ointment as toothpaste sometimes. I found the idea in an old essay by a dentist saying how crazy it was that we put everything in toothpaste except antibiotics. My scar healed up in record time and with way less pain then I’ve ever had before. And it was a lower molar #30, usually quite painful and slow to heal. I agree with that dentist, it’s kind of crazy we use these pastes instead of ointment. Even just vaseline plain works great when I don’t want chemicals. And oil pulling. I know people think this is “unproven” but it was unproven that the earth circled the sun, before it was proven. I won’t live long enough for all things to be proven. I do what works.

    I’m not a big fan of the burning feeling I get from minty toothpaste. It’s too minty, too soapy, too pasty for me. Why do we all have to love it the same thing? Surely fluoride has no flavor? I have no actual objection to fluoride except that I think it’s unnecessary. Kids were losing teeth because we didn’t understand about vitamins yet. I think it’s an epic misunderstanding. But even if it’s not, I don’t have to put up with mint soap paste for the fluoride do I? Yuck.

    It sounds so savage barbarians doesn’t it? Not liking toothpaste. But it’s not a rebellion about brushing teeth or keeping clean. It’s a dislike of the taste and texture. It’s a rejection of the wall of toothpastes, all alike. 90% of which aren’t even stannous fluoride which works far better.

    Also, don’t forget the PFAS coated dental floss. I tried some of the natural dental flosses and they’re perfectly good. I can’t live without daily flossing.

    Thank you as always for sharing your insights. Stay well!

    • I don’t recommend using an “antibiotic” in the mouth on a daily basis because it will kill bad bacteria as well as good bacteria. It is important to maintain a balance of bacteria in the mouth for health. When there is a large diversity of bacteria working as a community in the mouth as well as in the gut, they can crowed out potentially pathogenic microbes.

      • I agree, mostly. However, my hopes of an ideal gut are slim. Once my Celiac gene activated, my T cell behavior changed and my gut tends to get killed off when I react to food. No antibiotics needed for my gut to go wrong.

        I said mostly because I think everything affects the flora. The flora on your skin and scalp is changed daily when you shower, and even more if you use lotion. Without getting wordy, I try not to overuse any chemical applications.

        I’m not brushing daily with triple antibiotic ointment, don’t worry. Thank you for worrying. I appreciate the sincere kindness.

  2. Hi Dr. Al…can we just use baking soda for toothpaste and avoid the cost of the ‘healthy’ toothpastes?

    • Yes.

  3. I’ve been using a charcoal toothpaste but no more!! I like the idea of using baking soda instead, but do you also have a suggestion of a more affordable toothpaste? I’m on Social Security and can’t afford Revitin. I have CLL and am trying to use as many organic and natural products as possible. Thank you!!

  4. Excellent info as always. Here’s a plaque related question: every since I started taking vitamin K2, every couple of months the healthy plaque buildup on the back of my front teeth will flake off a bit after some significant build up. Is this related to the K2? I’ve heard elsewhere it can cause something like that. And is this a negative thing or just normal?

    • What you are referring to may be supragingival calculus (or tartar). It may be a result of the acidity and minerals in your saliva as well as the foods your are consuming (especially foods containing oxalates).

      • Thank you, I didn’t know that! Is calculus build-up harmful to the teeth or mouth? I’ve never had any issues so far (in fact i’ve never even had a cavity) so I’m hoping it is neutral.

  5. What about the glycerin in revitin toothpaste you recommended? Isn’t that a completely counter intuitive thing to put in your mouth. Doesn’t it cost the enamel and prevent the bacteria from being able to properly remineralize and prevent mineral absorption, as well as become a magnet for plaque? This is what I’ve read from multiple sources.

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