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Natural, herbal and organic toothpastes are becoming familiar sights on store shelves, often promoted as healthier alternatives to conventional products. Some contain ingredients such as aloe vera, neem or green tea. But before changing toothpaste, there is one important question to consider: does it contain fluoride?

Fluoride is a mineral that helps protect teeth against decay. Some toothpastes marketed as natural contain it, while others do not. The words on the front of the tube cannot tell us whether a product will protect our teeth.

These terms are often used interchangeably, although they mean different things. "Natural" usually describes ingredients derived from natural sources. "Herbal" refers to plant-based ingredients, while "organic" generally describes ingredients produced to particular farming standards. None of these labels, on its own, shows that a toothpaste can prevent tooth decay.

The range of products is considerable. A 2021 U.K. study examined 500 toothpastes from 95 brands, including alternative formats such as tooth powders and solid toothpaste tablets. Nearly a third contained no fluoride, and some did not clearly state their fluoride content. The study examined products available to buy, so it cannot tell us how many people actually use fluoride-free toothpaste.

Tooth decay begins when bacteria in dental plaque , a sticky film that builds up on teeth, feed on sugars from food and drinks. They produce acids that damage enamel, the hard outer surface of the tooth.

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