RFK Jr.’s criticism of fluoride is good news for natural toothpaste brands

Fluoride-free toothpaste sales are jumping as Health and Human Services Secretary Robert F. Kennedy Jr. and other government officials openly question the safety of the mineral long hailed as a public-health miracle.

Since the beginning of last year, sales of tubes that eschew fluoride have grown around 16% on average each month through April, compared to an increase of just 2.4% for fluorinated options over that time, according NielsenIQ data. 

While Kennedy has said he supports fluoride in toothpaste and mouthwash, questioning its safety in drinking water has caused a small but growing group of consumers to adjust their oral care regimes, and rising prices for alternative toothpastes are doing little to slow growth.

“When someone at a high level in the government has an opinion about something, certain people are going to listen,” Catherine Hayes, chair of the department oral health policy and epidemiology at the Harvard School of Dental Medicine said in an interview.

“That probably has raised this issue more frequently and, perhaps, with more intensity than it has previously.”

Questioning the safety of fluoride has garnered widespread attention on popular podcasts including several episodes of Joe Rogan’s show, with the comedian and show host railing against fluoridated water and spotlighting fluoride-free toothpastes. 

That attention has been a boon for brands like Boka and Biöm, both of which sell fluoride-free toothpaste formulated with tooth-strengthening alternative nano-hydroxyapatite, a version of the naturally occurring mineral and primary inorganic component in teeth.

Boka’s share of Amazon.com Inc. toothpaste sales has grown to 8% as of April 1, up from 3% in 2023, according to Jungle Scout data, making it the fourth most popular brand on its US marketplace, overtaking Colgate-Palmolive Co.’s Tom’s of Maine brand and Church & Dwight Co.-owned Arm & Hammer.

For Biöm, that momentum should continue this year, according to co-founder and Chief Executive Officer Calvin Jacob.

“We will grow year-over-year, quite significantly,” he said in an interview, though tighter consumer spending could slow the business in the remainder of the year. 

Overall, fluoride-free toothpaste sales make up 5.4% of all toothpaste sales in the US, NielsenIQ show. That’s up from 3.9% at the beginning of the decade.

In the absence of any “well-conducted studies” on nano-hydroxyapatite, Hayes is skeptical of its efficacy relative to fluoride. “I don’t think we’re there yet with the science,” she said.

While there appears to be some positive evidence for the new compound, its relative obscurity could be part of the draw. 

Now, three of the top 10 toothpaste brands on Amazon are fluoride-free, with the sub-category growing its market share to 29% as of April 1, up from 18% two years ago, Jungle Scout data shows. 

Biöm has grown into the ninth most popular toothpaste on Amazon, up from 20th in March 2024, by selling a monthly supply of fluoride-free toothpaste tablets for $15.

Part of his company’s rise comes down to US consumers seeking fluoride alternatives that may offer similar oral health outcomes, Jacob said.

Meanwhile, internet search volumes for nano-hydroxyapatite, alongside fluoride-free and other natural toothpaste options, have soared in recent months, according to Google Trends data analyzed by Bloomberg News.

Fluoride, a naturally occurring mineral and byproduct from some industrial activities, has been shown to strengthen bone and teeth enamel, helping prevent cavities, Yale Associate Professor of Epidemiology Nicole Deziel wrote on the university’s webpage. Its addition to US public water systems, which began in the 1940s, has been hailed as one of the most efficacious, and cost effective, public health measures of the 20th century.

Drinking water

That hasn’t kept a faction of lawmakers — mostly Republicans — from trying to ban supplemental fluoride in drinking water. 

Utah Governor Spencer Cox made his state the first to ban supplementary fluoride in public drinking water earlier this year. Florida quickly followed suit.

More than 50 communities across the US have put forth similar proposals, according to Stuart Cooper, executive director for Fluoride Action Network, a lobbying group that seeks to end water fluoridation across the globe. 

Kennedy vowed to advise all US water systems to remove fluoride, claiming it is “industrial waste associated with arthritis, bone fractures, bone cancer, IQ loss, neurodevelopmental disorders, and thyroid disease.”

Many of those concerns have been debunked in scientific research, Harvard’s Hayes said.

Anti-science movement

“There’s this movement to not trust science that has been happening over many years, and I think we might be at a peak here,” she added. 

Removing fluoride from public water systems nationwide would cost $9.8 billion over five years, according to JAMA Health Forum, with a disproportionate share of the burden falling on children lacking private dental insurance.

The study did not examine cognitive outcomes due to lack of relevant data. 

Efforts to ban water fluoridation have accelerated since a California federal court concluded in October that fluoride concentrations US health officials consider optimal pose “an unreasonable risk of reduced IQ in children,” ordering the Environmental Protection Agency to update its policies.

The US Centers for Disease Control and Prevention, approximately four months into Kennedy’s reign at DHHS, maintains its recommendation for low levels of fluoridation in community water sources.