Content Dam Diq En Articles 2017 12 Hygiene Message In A Bottle Mailbag Fluoride Free Product Recommendations For Patients Who Refuse To Use Fluoride Leftcolumn Article Thumbnailimage File

Hygiene Message in a Bottle Mailbag: Fluoride-free product recommendations for patients who refuse to use fluoride

Dec. 8, 2017
Colleen Olson, RDH, BBA, discusses fluoride-free product recommendations for patients who refuse to use fluoride.
Colleen Olson, RDH, BBA, Editorial Director
THE HYGIENE MESSAGE IN A BOTTLE MAILBAG is a monthly feature of the e-newsletter, Pearls for Your Practice: The Product Navigator. Each month, Colleen Olson, RDH, BBA, the editorial director of the Hygiene Product Navigator, will answer reader-submitted questions to help you navigate your dental hygiene product decisions (and more!).

This month, she discusses fluoride-free product recommendations for patients who refuse to use fluoride.


What do you recommend to your patients who refuse to use anything with fluoride in it? What about xylitol?


Great question! I’m lucky that in our practice most patients trust our judgment and recommendations, but I know that antifluoride people exist. Although xylitol doesn’t work via the same mechanism as fluoride, it can be helpful in preventing decay in patients who flat out refuse to use fluoridated products.

As far as in-office products go, I keep a tube of Ivoclar’s Proxyt medium-grit prophy paste (RDA 36) on hand, just in case any patients specify they are avoiding fluoride products. This paste contains xylitol like the other prophy pastes in the Proxyt line, but unlike the others, it's free of fluoride and flavor additives.

If a patient is not using fluoride toothpaste and can’t be convinced that doing so is safe and valuable, I would recommend the patient find xylitol products that fit his or her needs. Tom’s of Maine has many fluoride-free products that contain xylitol. Spry has a xylitol oral rinse available in four different flavors. One product we often recommend, even for patients who use fluoridated products but who may have high caries risk, is Ice Breakers Ice Cubes chewing gum. This gum comes in cubes that contain more xylitol per piece than competitors, and it comes in a wide assortment of flavors from minty to fruity. The gum has a long-lasting flavor and a pleasant texture, and it's available in most grocery and drug store checkout aisles, so it is easy for patients to get.

MI Paste is also a fantastic option for these patients because it combines the bacteria-fighting power of xylitol with Recaldent, the MI Paste family’s milk-derived protein that releases calcium and phosphate back into the oral cavity. MI Paste is brushed on after regular toothpaste, and it comes in five flavors. As with all MI Paste products, patients with confirmed or suspected milk protein allergies should avoid using this product. MI Paste is a particularly beneficial addition to the home care regimen for patients who are experiencing dry mouth or dentin hypersensitivity.

While fluoridated products are ideal, there are options available for patients who choose to go fluoride-free. It is always good to have a few of these products in mind, should you need to offer recommendations to this type of patient.

More reading

November 2017 | Should pregnant dental hygienists continue to take x-rays?
October 2017 | Posttreatment mouth rinses for periodontal patients

September 2017 | Should you be using fluoride varnish, foam, or gel?

Editor's note: Do you have a question for Colleen? Is there a product you'd like to see her review? Or would you like to submit your own hygiene product article? Send an email to [email protected]. You might just see it in the Hygiene Product Navigator! If you're not a Product Navigator subscriber, click here to sign up.

Colleen Olson, RDH,BBA, is an editorial director for the e-newsletter, Pearls for Your Practice: The Product Navigator. She earned a bachelor's degree in business administration from Texas A&M University in 2008 and worked in sales for five years. She graduated from the Blinn College Dental Hygiene program in 2013. She is a full-time mom to Bonnie Grace and is currently a part-time hygienist in private practice in San Antonio, Texas. She enjoys spending time outdoors with her husband, Zach, and their families.
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