The basics of home care haven’t changed: brush twice a day for two minutes with fluoride toothpaste, clean between your teeth once a day, and see your dentist regularly. But the toothpaste aisle keeps adding new options. Here’s how our Louisville dentists answer the questions patients ask most about hydroxyapatite toothpaste, water flossers, mouthwash and chewing gum.
Hydroxyapatite toothpaste: does it work?
Hydroxyapatite is the mineral your enamel is mostly made of. Hydroxyapatite toothpastes (often "nano-hydroxyapatite") deposit that mineral on the tooth surface to help repair early weak spots and reduce sensitivity. A 2024 systematic review of 18 clinical studies found hydroxyapatite effective at helping prevent cavities without fluoride, and some studies found it performed similarly to fluoride toothpaste.
Our take: fluoride toothpaste is still the most thoroughly studied way to prevent cavities, and it’s what we recommend for most patients. Hydroxyapatite is a reasonable fluoride-free alternative if you prefer to avoid fluoride, and some patients use both. Ask us which fits your cavity risk.
Enamel repair toothpaste vs. gel vs. mouthwash
Enamel can’t grow back once it’s lost, but early weak spots (often white, chalky areas) can be re-mineralized. In general:
- Toothpaste does most of the work because you use it twice a day.
- Prescription-strength fluoride toothpaste or gel gives extra protection if you get cavities often, have dry mouth or wear braces.
- Fluoride mouthwash adds a smaller boost and is a helpful extra, not a substitute for brushing.
Tip: after brushing at night, spit out the extra toothpaste but don’t rinse with water, so the fluoride or minerals stay on your teeth longer.
Water flosser vs. string floss
| String floss | Water flosser | |
|---|---|---|
| Best at | Tight spaces between teeth | Around braces, bridges, implants and gumlines |
| Ease of use | Takes practice and dexterity | Easier for people with arthritis or limited dexterity |
| Cost | Inexpensive | Device purchase, then low cost |
Both clean between your teeth, and some water flossers carry the American Dental Association Seal of Acceptance. The best choice is the one you’ll actually use every day. If you have braces, a bridge or dental implants, a water flosser can make daily cleaning much easier.
Is mouthwash necessary?
No, if you’re brushing and cleaning between your teeth well. Mouthwash can help in specific situations: fluoride rinses for higher cavity risk, and antimicrobial rinses your dentist may recommend for gum problems. Cosmetic rinses mainly freshen breath. If bad breath keeps coming back, it’s worth a checkup — read about the common causes of bad breath.
Is chewing gum bad for your teeth?
Sugary gum feeds the bacteria that cause cavities, so it’s best avoided. Sugar-free gum is different: chewing it for about 20 minutes after a meal boosts saliva, which helps wash away food and neutralize acids. Gums sweetened with xylitol are a good choice. Skip gum if you have jaw pain or TMJ problems, and remember it’s a supplement to brushing, not a replacement.
Signs of healthy gums
Healthy gums are pink and firm and don’t bleed when you brush or floss. Bleeding, puffiness, receding gums or persistent bad breath can be early signs of gum disease, which is very treatable when caught early. September is National Gum Care Month, a good yearly reminder, but any time is a good time for a check. Learn more in our guide to gum disease and about gum care at ADC.
A simple daily routine
- Brush for two minutes, morning and night, with a soft brush and fluoride (or hydroxyapatite) toothpaste.
- Clean between your teeth once a day with floss, a water flosser or interdental brushes.
- Spit, don’t rinse, after brushing at night.
- Choose sugar-free gum and limit sugary snacks and drinks between meals.
- See your dentist for cleanings and checkups — usually every six months.
Frequently asked questions
Is hydroxyapatite toothpaste as good as fluoride?
A 2024 systematic review of clinical studies found hydroxyapatite toothpaste effective at helping prevent cavities, and some studies found it similar to fluoride. Fluoride remains the most thoroughly studied option, so many dentists recommend it for most patients and hydroxyapatite as a fluoride-free alternative.
Is a water flosser better than string floss?
Both clean between teeth. String floss is better for very tight spaces, while a water flosser is easier for people with braces, implants, bridges or limited dexterity. The best choice is the one you will use every day.
Is mouthwash necessary for an oral care routine?
Not if you brush twice a day and clean between your teeth daily. Fluoride or antimicrobial rinses can help people with a higher risk of cavities or gum problems, but mouthwash does not replace brushing and flossing.
Is chewing gum bad for your teeth?
Sugary gum can contribute to cavities. Chewing sugar-free gum for about 20 minutes after a meal increases saliva, which helps protect your teeth, but it does not replace brushing and flossing.
What are signs of healthy gums?
Healthy gums are pink, firm and do not bleed when you brush or floss. Bleeding, swelling, receding gums or persistent bad breath can be early signs of gum disease and are worth a dental checkup.
Advanced Dental Center has five Louisville-area offices: Preston Highway (Okolona), St. Matthews, Middletown, Brooks Hill and Jeffersontown. Evening hours and Saturday mornings are available at select offices, and our phones and chat are answered 24/7. Schedule online.
