Comment by paulgerhardt | Hacker News Reader

Comment by paulgerhardt | Hacker News Reader

I once read an off hand comment[1] from a dental scientist on Reddit that NovaMin® (calcium sodium phosphosilicate) was shown with strong evidence to reverse tooth decay and promote remineralization but due to complex licensing issues was made OTC in Sensodyne toothpaste everywhere but the USA.

I think the effect is subtle but present and slightly more effective than just fluoride by itself. I travel often enough that I find myself looking for and buying Sensodyne with novamin but without whitening agents when I’m abroad but I understand others source it in the US online. Do check the ingredients - it’s in about 1/3rd of the Sensodyne packages I pick up off the shelf outside the US but certainly not all.

I follow the topic very casually - I understand hydroxyapatite, fluorapatite, and biotin were initially reported to be even better (but only through self-reported studies such as Biomin.) I couldn’t tell you why or if there is now more credibility there nor where to source it if it is. BioMin USA’s anti-fluoride stance raises a lot of red flags for me and is probably what turned me off their brand when I looked into it years ago. GSK Sensodyne sells formulations with fluoride and novamin - I wouldn’t use toothpaste without fluoride. (Edit: I see BioMin UK sells toothpaste with fluoride.)

[1] https://elemental.medium.com/why-is-the-internet-obsessed-wi... - Medium Paywall link but gets the general point across

You can buy several varieties of hydroxyapatite toothpaste on Amazon now. Before 2021 or so it was a bit of a pain - a couple Japanese and Singaporean brands with spotty availability.

Edit: as alluded to by sibling comment, there are confusing claims about the exact size and structure of the hydroxyapatite ingredient used. Several brands claim that their particles (?) are smaller than those used by Novamin or by other brands and therefore more effective.

The concept of remineralizing the surface of existing teeth is totally different than what this article is talking about, though.

our saliva already contains hydroxyapatite. What's the reasoning behind including it in a toothpaste? Saliva doesn't contain enough?

Our teeth enamel is in chemical interaction with our saliva. Lower pH favour the dissolution of the apatite (attacking the teeth), and higher pH favour its precipitation (growing enamel). So it’s true that the components are in our saliva as well, in itself it is not enough to make it grow.

These toothpastes change this by providing lots of the building blocks of apatite, saturating the saliva and promoting growth, but also by increasing the pH. It tends to decrease after a meal (or particularly after drinking sugary drinks, which tend to be awfully acidic), which is why it’s useful to have the toothpaste stabilising it.

Not with a modern lifestyle, no.

I've heard and read the same. I noticed this review of studies which seems to indicate benefits are not as strongly present as word-of-mouth reputation may indicate.

I suppose if it was an unambiguously beneficial compound, American toothpaste manufacturers would have been all over it.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7068624/

“American toothpaste manufacturers would have been all over it.”

What’s the incentive to disrupt the status quo unless you can capitalize more than your competitors? And incurring the enmity of the secret society of dentists and hygienists. Hehe.

Dentistry makes me crazy.

Companies have teams upon teams of people desperate to justify their continued employment despite existing products being more than adequate. See: constant UX redesigns, 3-blade razors.

> “Companies have teams upon teams of people desperate to justify their continued employment…”

True—even when they don’t have something new they work to convince consumers (I’m thinking B2B) believe a product will do things it does not do.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7068624/

says it doesnt but also says better trials should be done in future

I've been buying Sonsodyne with Novamin for that exact reason (read on the reddit too) however, after 1 year of use, I see exactly 0 results. I don't think it does anything when used as a part of toothpaste, looks like it needs completely different delivery method.

I used to use Novamin containing toothpastes, but now there is a new compound which is much better, biomin:

https://www.biomin.co.uk/

Citation for that claim?

You can easily look up some studies, but for me personally it has been the impact on sensitivity. It's basically gone since I've been using it.

At least in the US, the argument is that when pressed by the FDA, Novamin was pulled from the market by GlaxoSmithKline instead of doing the required trials whereas Biomin went through and passed all the trials.

And since it's actually gone through the process, there are studies out that compare it to other hydroxyapatite solutions. I've linked one study which compares their two variants against Apacare and karex (two HAp toothepaste which have studies of their own that compare against the others before them like Novamin).

The study shows that Biomin C (the one without Fluoride) is comparable to karex (the one without fluoride) and other similar HAp toothepastes. HAp + fluoride (like novamin) marginally outperforms it. So if you use fluoride (such as by also using a fluoride toothpaste or living in an area with fluoride in the water) the difference should be negligible. Importantly though for people in the US, Biomin C is available here.

Biomin F is wrapping up the FDA approval process however it does seem to generally outperform all other formulations since the fluoride is actually part of the bioglass itself rather than simply an additional active ingredient in the suspension.

TLDR: Biomin C is within marginal differences to comparable no-fluoride HAp toothpastes on the market but Biomin F outperforms other HAp toothpastes that contain fluoride since the fluoride in Biomin F is delivered via the same mechanism that handles remineralisation of the other elements. And to my knowledge Biomin F is the only HAp toothpaste to do that so far. Also Biomin C is the only HAp toothpaste available in the US (with Biomin F apparently soon to follow).

https://doi.org/10.21608/adjg.2021.66174.1346

Unbearably sweet though! I tried BioMin once and worried that using it long term would burn out my taste receptors

The kids version is as effective and less sweet. But more expensive. Another benefit is that it doesn't contain titanium dioxide.

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