High Fluoride Toothpastes

Overview

High fluoride toothpaste (HFT) refers to toothpastes containing fluoride concentrations above 1,500 ppm F, typically containing 2,800 up to 5,000 ppm F. They are not available ‘over the counter’, and are generally recommended or prescribed by dental professionals.

Use and Application

HFT is used in the same manner as regular toothpaste. Apply 1 cm of paste onto the head of a toothbrush and brush the teeth for 1-2 minutes, ideally twice daily. Spit out and do not rinse, or rinse with a minimal amount of water.

Effectiveness and Efficacy

The anticaries effect of HFT has been estimated in clinical trials and summarized in systematic reviews [1,2,3]. A positive dose response benefit has been observed and HFT is superior to low fluoride toothpaste in reducing caries [1,3]. The anticaries effect of HFT (5,000 ppm F) to arrest root caries lesions is very positive, with 51% more lesions becoming inactive when compared with the use of conventional toothpaste [4].

Safety

HFT toothpaste should be kept out of reach by children and is usually not recommended for use by children under the age of 16 years. Otherwise, HFT is safe when used according to instructions.

Cost Effectiveness

HFT costs more than standard ‘over the counter’ toothpaste. As a self-applied preventive measure, the cost is favourable compared with professional fluoride alternatives. Further health-economic evaluations are required to establish the costs for high risk groups.

Recommendations

HFT is particularly recommended for preventing and controlling caries in high-risk individuals and patients with active disease. Typical cases are patients with impaired saliva functions, frail elderly with exposed root surfaces and cancer patients who have been treated with head and neck radiation.

Key Further Reading

Guidance Document

ACFF Members can download the full reference document for High Fluoride Toothpastes.

Access