If you are at higher risk of tooth decay, you may want to start using high fluoride toothpaste. Some of the best toothpaste you can buy from most shops in the UK contains 1,450ppm fluoride; however, if necessary, your dentist may prescribe a toothpaste with up to 5,000ppm fluoride.
Fluoride is a mineral found in water across the UK, but although it is naturally occurring, is it safe to use in high quantities?
This article will discuss the benefits and risks of toothpaste with high fluoride and answer the following questions:
- What is high fluoride toothpaste?
- What does this type of toothpaste do?
- Why might you be prescribed a high fluoride toothpaste?
- What is the best high fluoride toothpaste in the UK?
- Are there any high fluoride toothpaste side effects?
We hope this article will help you better understand the advantages and disadvantages of prescription toothpaste and how they might benefit you.
Table of contents
- 1 What is high fluoride toothpaste?
- 2 What does high fluoride toothpaste do?
- 3 Why might you need high fluoride toothpaste?
- 4 Is high fluoride toothpaste safe?
- 5 What are the commonly prescribed high fluoride kinds of toothpaste available?
- 6 Can you buy high fluoride toothpaste over-the-counter in the UK?
- 7 Conclusion
- 8 FAQs
What is high fluoride toothpaste?
Toothpaste can come containing all different levels of fluoride, and some are completely fluoride-free. High fluoride toothpaste refers to the types that have a higher amount of fluoride than the regular amount of 1,450ppm. These are usually in the form of sodium fluoride or sodium monofluorophosphate.
Fluoride is measured in PPM which stands for parts per million. This is because the amount you need for it to work effectively is very small. Most adult toothpaste contains between 1,300 and 1,500ppm and toothpaste for babies and children have, on average, 1,000ppm of fluoride.
According to the NHS, children aged six years and under should use toothpaste with fluoride. They recommend that adults use those with between 1,350 to 1,500ppm fluoride. However, your dentist can prescribe a toothpaste with a higher amount of fluoride which contains up to 5,000ppm of fluoride.
Prescription fluoride-containing toothpaste may be suitable for some, but it isn’t a replacement for a good dental hygiene routine and regular dental check-ups.
What does high fluoride toothpaste do?
Toothpaste with high fluoride helps to defend against tooth decay and dental caries. It does this by remineralising your teeth, strengthening your enamel, and helping to defend your teeth against acids from food and drinks.
While high fluoride can’t rid your teeth of tooth decay or reverse cavities, it can help to strengthen your enamel against decay and protect against cavities.
Fluoride works to remineralise your teeth by stimulating the production of fluorapatite. This is a type of enamel particularly resistant to acid and bacteria. It also has antibacterial properties that help slow down the growth of bacteria and its ability to stick to your teeth.
Maintaining a good oral hygiene routine by regularly brushing and flossing your teeth will go a long way in protecting your teeth from tooth decay and cavities. However, if you need a little extra help for any reason your dentist may prescribe toothpaste containing extra fluoride.
Why might you need high fluoride toothpaste?
A dentist has to prescribe high fluoride toothpaste containing 5,000ppm of fluoride. This is because overuse of fluoride can cause dental fluorosis in developing teeth. To get a prescription for high fluoride toothpaste, your dentist needs to do a dental check-up and assess whether you can benefit from it.
The main reason your dentist may prescribe toothpaste is if you are at high risk of tooth decay. Generally, those at a higher risk of tooth decay include the following people:
- People who regularly skip dental check-ups
- The elderly
- Those with a history of dental decay or who are currently are struggling with dental decay
- People who eat a lot of high-sugar foods and drinks
- Sufferers of dry mouth
- People with diabetes
- Those with poor oral hygiene
- Patients undergoing orthodontic treatment
- Those with receding gums or who are in need of restorative treatment
- People who are on medications containing sugar
There are a few other reasons that you may need toothpaste with high fluoride if you don’t think you fit into one of these categories. These reasons include:
- Tooth sensitivity
- If you have any dark spots on your teeth
- A strange taste in your mouth that isn’t going away
If you think you need extra fluoride toothpaste for any of these reasons, book an appointment with your dentist. They will assess your teeth to determine if you would be a good candidate for prescription-only high fluoride toothpaste.
Is high fluoride toothpaste safe?
In the UK, 63% of people brush teeth twice a day and 47% brush with fluoride toothpaste – the highest figure globally.
There have been many studies conducted on the safety of fluoride use in toothpaste. The general consensus seems to be that they are safe when used following the manufacturer's guidelines.
Due to high fluoride toothpaste side effects it’s important not to swallow any. It should also not be used by children under the age of six. Children under the age of six are more likely to accidentally swallow toothpaste, which can cause dental fluorosis over time.
Dental fluorosis is when changes occur in the tooth enamel due to hypermineralisation. One of the major symptoms is when white spots develop on the teeth. The following table summarises the recommended amount of toothpaste to use and what fluoride quantities for different ages:
Amount to use
Children under 3
At least 1000ppm
At least 1000ppm
A pea-sized amount
Children over 6 and adults
1350ppm – 1500ppm
A pea-sized amount
What are the commonly prescribed high fluoride kinds of toothpaste available?
As mentioned above, prescription extra fluoride toothpaste can contain up to 5,000ppm. However, there are different prescription toothpastes, each with different levels of fluoride from 1,500ppm to 5,000ppm.
They also include different ingredients to suit different dental needs, so your dentist will prescribe the one that best fits your individual circumstances.
Some of the most common types of toothpaste with the most fluoride that your dentist may prescribe include:
- Denta 5000
- Colgate Prevident 5000
- Colgate Duraphat 2800
- Clinpro 5000
- SF 5000 plus
Colgate Prevident 5000 is one of the highest fluoridated toothpaste available, and you can only get it with a prescription from a dentist. It contains up to 4 times the amount of fluoride as other regular toothpastes and mouthwashes on the market.
Colgate claims it is best for those that have a high chance of dental cavities, or for those with dental restorations such as crowns or bridges.
Can you buy high fluoride toothpaste over-the-counter in the UK?
To buy toothpaste with a fluoride content of over 1,500ppm in the UK, you need a prescription. Most over-the-counter adult toothpaste has, on average, 1,450ppm of fluoride.
However, there are kinds of toothpaste available that are specifically designed to help remineralise your teeth, protect against cavities, or help with tooth sensitivity.
Most big toothpaste brands have a selection of fluoride toothpaste specifically designed for tooth decay prevention and tooth remineralisation. They all have about 1,450ppm of fluoride but include different ingredients as well to help protect teeth and strengthen enamel.
In the following video, Dr Marcus Spry discusses what he recommends are the best toothpastes for preventing tooth decay and cavities that you can buy over-the-counter in the UK:
Sensodyne Pronamel Enamel Care Daily Protection Toothpaste
Sensodyne's Pronamel Enamel Care is for daily use to help strengthen your enamel and protect against acid erosion from food and drinks.
Sensodyne claims that its unique formulation helps to lock in minerals and harden your “acid-softened” tooth enamel, which protects against tooth decay and against the formation of cavities.
The active ingredients in this toothpaste are Sodium Fluoride (1,450ppm Fluoride) and Potassium Nitrate. Potassium Nitrate is a key ingredient that helps with tooth sensitivity.
Colgate Sensitive Pro-Relief Enamel Repair Toothpaste
Colgate's Sensitive Pro-Relief Enamel Repair has been clinically proven to reduce teeth sensitivity and helps to repair and protect from enamel damage.
Its pro-argin formula remineralises enamel and the main active ingredient is Sodium Monofluorophosphate (1,450 ppmF).
Regenerate Enamel Science Advanced Toothpaste
Although Regenerate is a lesser-known brand, its fluoride toothpaste formula specifically targets and reverses early enamel erosion. Its NR-5 ingredients combine to help remineralise teeth and strengthen your enamel, leaving them stronger and protecting against tooth decay.
Its main ingredients are Sodium Fluoride 0.315% w/w (1,450ppm Fluoride) and Potassium Nitrate 5% w/w.
Oral-B Gum & Enamel Pro-Repair Toothpaste
Oral-B’s Gum and Enamel Pro-Repair is, as the name suggests, for protecting the gums and remineralising tooth enamel. The active ingredient in this toothpaste is Stannous Fluoride (1,100ppm Fluoride) and Sodium Fluoride (350ppm Fluoride).
This toothpaste provides antibacterial action on the gums, protects teeth from acid erosion, and helps to treat sensitive teeth.
The following table summarises the products discussed in this article that you can buy from any store without a prescription:
Over-The-Counter Fluoride Toothpaste
Colgate Sensitive Pro-Relief Enamel Repair
Regenerate Enamel Science Advanced
Oral-B Gum and Enamel Pro-Repair
Sensodyne Pronamel Enamel Care Daily Protection
High-fluoride toothpaste is any toothpaste that contains over 1,500ppm of fluoride. To get this type of toothpaste, you need a prescription from your dentist. This is because toothpaste with high fluoride is not suitable for everyone, so you need a dental assessment first.
Your dentist will only prescribe a high fluoride toothpaste if they believe you are particularly at risk or struggle with tooth decay.
This type of toothpaste is not a replacement for a good oral hygiene routine. However, some people may still struggle with tooth decay, even with a good oral hygiene routine. Some of these people include the elderly, those with diabetes, people undergoing orthodontic treatment, or those in need of restorative treatment.
You cannot buy high-fluoride toothpaste over-the-counter. However, there are kinds of toothpaste available to help tackle tooth sensitivity, enamel erosion and tooth decay.
Most big brands of toothpaste have a range to choose from and you should find one for your needs. There are also lesser-known brands that specialise in enamel remineralisation and protection against tooth decay, such as Regenerate.
Does high fluoride toothpaste whiten teeth?
Fluoride is good for helping strengthen and remineralising tooth enamel. However, excess fluoride can turn your teeth yellow or brown. This is called dental fluorosis.
Fluorosis is unlikely to be caused by high fluoride toothpaste. If you choose a whitening toothpaste that contains fluoride it may help whiten teeth, but that will be because of the whitening ingredients and not the fact it contains fluoride.
NHS. Fluoride. Consulted 28th March 2022.
Oral Health Foundation. High Fluoride Toothpaste. Consulted 28th March 2022.
Sunstar. Global Healthy Thinking Report 2021. Consulted 13th September 2022.