What’s Really in Your Toothpaste — And What to Use Instead

A guide to the ingredients worth avoiding, why they matter, and the cleaner brands worth knowing.

Most of us have been brushing our teeth twice a day since we were old enough to hold a toothbrush. It’s one of those habits that feels so automatic, so routine, that we rarely stop to think about what’s actually in the tube.

But here’s something worth knowing: the lining of your mouth — the oral mucosa — absorbs what you put in it at over 90% efficiency. That means the ingredients in your toothpaste are not just sitting on the surface of your teeth. They are making their way into your body, twice a day, every day. For most people, that’s never been part of the conversation. And that’s exactly why we’re having it today.

 This is not about fear. This is about information — and the simple reality is that once you know better, you can do better. Switching your toothpaste is one of the easiest low tox swaps you can make. And there are great options out there that clean just as well without the ingredient concerns.

 Let’s walk through what to look for, what to avoid, and some of my favorite cleaner brands so you can make the choice that feels right for your family.

The Ingredients Worth Knowing

Conventional toothpaste has a long ingredient list — and most of us have never looked past the flavor on the front of the box. Here are the ones that come up most often in functional health conversations, and why they matter.

 ❌ Fluoride

For decades, fluoride has been presented as non-negotiable for dental health. And while the intention was always cavity prevention, the conversation around fluoride has grown more over time. A 2025 meta-analysis published in JAMA Pediatrics reviewed 74 studies and found associations between higher fluoride exposure and cognitive development in children. It has also been linked to thyroid disruption and organ system toxicity at higher exposures. There are gentler, well-researched ways to support enamel health — and that conversation deserves space.

❌ Sodium Lauryl Sulfate (SLS)

SLS is the ingredient that makes your toothpaste foam. It is a detergent — the same family of ingredients used in cleaning products — and it has been shown to irritate the soft tissue lining of the mouth and contribute to canker sores. The foaming sensation feels like something is being cleaned, but your teeth do not actually need foam to get clean. It’s there for the feeling, not the function. 

❌ Triclosan

An antibacterial and antimicrobial chemical that was commonly added to toothpaste to support gum health. Research has raised concerns about its ability to disrupt thyroid hormone metabolism, and it has also been linked to antibiotic resistance. While the FDA banned triclosan from hand soaps, it has not been comprehensively removed from all oral care products.

❌ Parabens

Preservatives used to extend shelf life. The CDC has detected parabens in nearly all Americans tested, and they are associated with endocrine disruption and reproductive toxicity. Something to be aware of, especially for women in their reproductive years.

❌ Artificial Dyes and Sweeteners

Synthetic dyes serve no functional purpose in toothpaste. Many are derived from petroleum and can accumulate in the body over time. Artificial sweeteners like saccharin and aspartame have been linked to insulin resistance, disrupted gut bacteria, and systemic inflammation with long-term use.

❌ Propylene Glycol

A texture smoother also found in antifreeze and paint. It is associated with skin irritation and organ toxicity. There are plenty of cleaner ways to create a smooth toothpaste texture.

A Note on Hydroxyapatite

You are going to see hydroxyapatite showing up in a lot of cleaner toothpaste formulas right now. It is a naturally occurring mineral that makes up a large portion of tooth enamel, and the research around its remineralizing properties is genuinely interesting. At Healthie, we like to look at all perspectives. So while hydroxyapatite is a significant step up from conventional toothpaste and is far cleaner than fluoride, some research suggests it may interfere with the body’s own natural remineralization process. Our philosophy is always to support what the body already knows how to do — not to override it. So we tend to prefer formulas that work with your biology rather than adding in a synthetic version of something the body produces on its own. However, there are few to no options here that are clean without this ingredient. My hope is that more companies will start finding alternative options that leave out this ingredient.

That said, if a hydroxyapatite toothpaste is the swap that gets you away from a conventional formula full of SLS and artificial sweeteners, that is absolutely a step in the right direction. Progress over perfection, always.

The Brands Worth Knowing

Here is an honest, in-depth look at six brands that come up often in the low tox community. Some I actively recommend. Some are worth knowing about with a few nuances in mind. I want to give you the full picture so you can make the choice that feels right for your family.

💛 Revitin — My Top Pick

Revitin was founded by biologic dentist Dr. Gerry Curatola and is backed by years of clinical research. What sets it apart is its philosophy: rather than killing all mouth bacteria, Revitin is built around nourishing the oral microbiome — the delicate ecosystem of beneficial bacteria that actually protect your teeth and gums.

The formula is fluoride-free, SLS-free, paraben-free, dye-free, and sweetener-free. It is formulated with seaweed and cranberry seed oil as prebiotics, Vitamins C and E as antioxidants to support remineralization, and CoQ10 as an anti-inflammatory ingredient for gum health. It does not contain hydroxyapatite — which is one of the reasons I appreciate it so much. It works with the mouth’s own biology.

EWG rates Revitin as low hazard. It is not currently EWG Verified, but it scores well across cancer and developmental toxicity categories. For women focused on gut and oral microbiome health, this one is a great fit.

✨ This is the formula that feels most aligned with the Healthie philosophy. Prebiotic, nourishing, and genuinely functional.

💛 FYGG — Functional Dentist-Founded, Hydroxyapatite-Based

FYGG stands for “Feed Your Good Guys” — a name that tells you exactly where their heart is. Founded by functional dentists Dr. Mark Burhenne and Dr. Staci Whitman, this brand is built around supporting the oral microbiome while cleaning and remineralizing without fluoride, SLS, essential oils, or artificial ingredients.

A 2025 independent study published in the Journal of Dentistry found FYGG to be as effective as prescription-strength fluoride at remineralization — which is genuinely impressive. The formula includes nano-hydroxyapatite, prebiotics like chicory root and xylitol, and L-arginine for microbiome support.

The one thing to know: FYGG is built around nano-hydroxyapatite as its core ingredient. For those who prefer to avoid hydroxyapatite altogether, this may not be the right fit. Additionally, independent third-party lab testing in early 2025 found detectable levels of lead and arsenic in the Vanilla Vibes flavor — within legal limits, but worth being aware of.

✨ Beautiful brand, grounded philosophy, and impressive remineralization research. The hydroxyapatite is worth considering based on your personal preference.

💛 Risewell — Mineral-Rich, Accessible

Risewell is a clean, mineral-forward toothpaste that uses hydroxyapatite as its primary remineralizing ingredient in place of fluoride. It is free from SLS, parabens, propylene glycol, artificial dyes, and artificial flavors. The standard line uses micro-hydroxyapatite (non-nano), which some people prefer for those wanting to avoid nano-particle minerals specifically. 

The EWG picture is a bit mixed: the kids’ line rates as low hazard, while the adult standard and PRO lines rate as moderate hazard — primarily due to some of the flavoring and plant oil ingredients. Not a dealbreaker, but worth knowing when choosing between their specific products.

✨ A genuinely cleaner option than anything conventional, especially for families wanting to ditch fluoride. The hydroxyapatite base means it is most ideal for clients who are comfortable with that ingredient.

💛 Primal Life Organics — Ancestral, Clay-Based

This one feels the most rooted in ancestral health principles. Their flagship product is a tooth powder, not a paste, which is a transition for most people but one that many end up loving.

The Dirty Mouth Toothpowder is formulated with mineral-rich bentonite clay, kaolin clay, aluminum-free baking soda, and certified organic essential oils. It is completely free from synthetic additives, preservatives, foaming agents, artificial colors, artificial flavors, fluoride, carrageenan, triclosan, and SLS. The clays work by gently drawing out impurities and polishing the tooth surface naturally — very much the “support the body” approach.

The formula does include hydroxyapatite, and the allergen rating on EWG flags high due to the essential oils — something to keep in mind for clients with sensitivities. Their Dirty Mouth powder rates as low hazard overall on EWG.

✨ Wonderful for those drawn to a more ancestral or functional approach to oral care. The powder format is different, but the ingredient list is clean.

💛 Boka — Accessible and Widely Available

Boka is probably the most accessible of the group — clean ingredients, a wide range of fun flavors, and easy to find. Like Fygg and Risewell, it is fluoride-free and SLS-free, built around nano-hydroxyapatite sourced from the same European supplier as FYGG.

Most of Boka’s core toothpaste line rates as low hazard on EWG. Some of their newer and whitening formulas have received higher hazard ratings, so it is always worth checking the specific product. Independent testing in early 2025 also found trace heavy metals in Boka’s formula — at legal levels, consistent with the pattern we’re seeing across several mineral-based toothpaste brands.

✨ A great starter swap for someone just beginning their low tox journey — easy to find and infinitely cleaner than conventional options. The EWG rating varies by product, so always check the specific formula you’re reaching for.

💛 Zebra — Clean Philosophy, One Concern

Zebra has built a devoted following in the low tox community, and their philosophy is genuinely aligned with what we talk about here: no fluoride, no hydroxyapatite, no SLS, no artificial dyes or sweeteners. The ingredient list is simple and clean — built around xylitol, calcium carbonate, cacao seed butter, aloe vera, and peppermint oil.

The concern worth knowing: independent third-party lab testing published in April 2025 found that the Zebra coconut flavor tested positive for lead at 336.4 parts per billion, and also positive for mercury. This is still within federal legal limits, and Zebra does conduct their own heavy metals testing — but for a product used twice daily, including by children, it is something I feel is worth sharing transparently. There is a mint flavor, with no reports of heavy metals found in that one.

✨ The philosophy I love, and the ingredient list is clean. Given the 2025 independent lab results, I am holding off on actively recommending it until there is more clarity. Worth keeping an eye on as the brand continues to respond to these findings.

The Big Picture 

I want to leave you with something that has always guided the way I think about low tox living: it is not about being perfect. It is not about finding the one flawless product that checks every single box. It is about making informed choices, one swap at a time, with the information you actually have.

If you are still using conventional toothpaste, any of the brands above is a meaningful step forward. If you are already using a cleaner formula and want to refine further — now you have the information to do that too.

And if you want to go even deeper into how your diet, your mineral status, and your internal nutrient levels affect the health of your teeth and bones from the inside out — Dr. Kate Rhéaume-Bleue’s book on Vitamin K2 is a wonderful place to start. The connection between K2, calcium, and dental health is one of those things that once you learn it, you cannot unlearn it. In the best possible way.

Your body knows how to take care of itself when it has the right support. That’s what we’re always working toward here.

Disclaimer: This post is for educational purposes and reflects my personal research and perspective as a functional medicine nurse. It is not intended to replace individualized medical or dental advice. Always consult your healthcare provider for guidance specific to your health needs.