Plastic-free toothpaste: tablets, jars, metal tubes and the fluoride question

Toothpaste is the bathroom’s most stubborn plastic habit. You can swap a toothbrush handle for bamboo in an afternoon (here’s our guide to toothbrushes), but the paste comes in a squeezy tube that, until recently, almost nobody could recycle. The plastic-free answers are real: tablets, jars, metal tubes. The catch is that some of them quietly drop the one ingredient with decades of evidence that it prevents cavities.

So here’s our rule for this article, and for what Less Plastic Please will list: fluoride first. A toothpaste that saves a tube but costs you a filling isn’t a win. We cover hydroxyapatite, the fashionable fluoride alternative, and grade its evidence honestly, but we won’t list it as a swap.

The tube problem

The classic toothpaste tube is a laminate: thin layers of different materials bonded together. A 2023 review of plastic packaging design describes the traditional tube as a combination of low-density polyethylene and aluminium, and notes that multilayer packaging like this is very hard to separate and recycle. A tube that’s part plastic, part metal, all glued together, fits no recycling stream at all.

What “recyclable” tubes do and don’t mean

Since 2019, the big brands have been switching to tubes made from one plastic: high-density polyethylene (HDPE, resin code #2), the same plastic as milk jugs. A 2023 review, citing Colgate, says Colgate’s was the first to be recognised by the Association of Plastic Recyclers (APR), a US trade group that tests whether packaging works in existing recycling systems. Tom’s of Maine says its full-size toothpastes are now in a recyclable #2 HDPE tube with the same recognition.

That recognition means a tube of the right design can be sorted and processed with HDPE bottles. It doesn’t mean your local programme takes it. Tom’s own page says some communities may not yet accept tubes, tells you to “check locally”, and notes that its caps are a different plastic from the tube. Its advice if you’re unsure: “When in doubt, throw it out!”

In the US, the Federal Trade Commission’s Green Guides say a product can be called recyclable without qualification only if recycling is available to a “substantial majority” of the people where it’s sold, defined as at least 60%. And even a recycled tube is still a plastic tube: recycling slows the flow of new plastic; it doesn’t stop it. For how recycling claims hold up generally, see our explainer on recycling labels.

Aluminium tubes aren’t quite metal-only

Metal tubes are the old-school fix, and several plastic-free brands use them. Look closer, though. Davids, a US brand, says its aluminium tubes are lined with a “food grade non-BPA liner” so the paste never touches the metal, and that its cap is HDPE. Georganics lists an HDPE lid on its aluminium tube. That’s a lot less plastic than a laminate tube, but it isn’t none, and none of the makers we checked said what the liner is made of.

Tablets, powders and jars: where the plastic goes instead

Changing the format moves the plastic around; it rarely makes it vanish.

• Tablets. Dry, pressed tablets you chew, then brush. Without water they don’t need an airtight squeeze tube, so they’re sold in glass jars, metal tins or bags. Bite, a US brand, ships its first order in glass bottles or jars with aluminium lids and its refills in pouches it calls “100% home compostable”. Denttabs, a German brand, sells its 125-tablet packs in a bag without saying what it’s made of, and its bigger packs and a 1 kg refill in bags it calls industrially compostable.
• Paste in a jar. You scoop it out with a spatula. Ben & Anna sells a fluoride paste in a glass jar. Truthpaste, a UK brand, uses glass jars with aluminium lids and takes jars back for refilling.
• Powders. You dip a wet brush in. US rules do allow a fluoride powder, but only one specific sodium fluoride formula, so check any powder’s label for a named fluoride compound before assuming it has one.

Two things to watch. First, lids: glass jars almost always close with a lid, and the seal has to come from somewhere. None of the jar makers we checked said whether their lids have a sealing liner or what it’s made of. Second, refill pouches: “compostable” film is usually a bioplastic, and whether it composts depends on where it ends up. Home-compostable and industrially compostable are different claims. We’ve covered what compostable plastics actually do.

Fluoride: the evidence is about as strong as dentistry gets

Fluoride toothpaste is one of the best-tested things in your bathroom. A Cochrane review pooled 70 trials involving 42,300 children and found fluoride toothpaste prevented about 24% of new decayed, missing and filled tooth surfaces compared with non-fluoride paste. The reviewers called the benefits “firmly established”. Cochrane reviews are systematic reviews that pool all the trials they can find on a question.

It works for adults too. In a 2019 update covering 96 studies, adults using 1,000 or 1,100 ppm fluoride paste developed fewer new cavities than with non-fluoride paste (moderate-certainty evidence, three trials, 2,162 adults).

How much fluoride: reading the ppm

Fluoride strength is given in parts per million (ppm). The same 2019 review found:

• Pastes with 1,000 to 1,250 ppm and 1,450 to 1,500 ppm both reduce cavities in children and teenagers compared with non-fluoride paste, with high- to moderate-certainty evidence.
• 1,450 to 1,500 ppm does slightly better than 1,000 to 1,250 ppm.
• Going higher, to 1,700 to 2,800 ppm, didn’t clearly add more in the children studied.

The NHS tells adults to use toothpaste with at least 1,350 ppm. In the US, the FDA’s rules for over-the-counter anticavity toothpaste set regular strength at 850 to 1,150 ppm, and also allow one stronger paste, 1,500 ppm sodium monofluorophosphate, labelled for adults and children 6 and over. The American Dental Association’s Seal of Acceptance is a useful shortcut: every toothpaste carrying it with a cavity-protection claim must contain fluoride.

So what does “fluoride-free” mean? Unless it contains something proven to replace fluoride (see hydroxyapatite, below), a fluoride-free toothpaste is a cleaning paste. It removes plaque while you brush, but it gives up the roughly one-quarter reduction in cavities that fluoride brings.

Children: a smear, then a pea

Young children swallow toothpaste, so the advice is about amount, not avoiding fluoride:

• From the first tooth to age 3: a smear, the size of a grain of rice, says the ADA. The NHS says a smear of paste with no less than 1,000 ppm.
• Ages 3 to 6: a pea-sized amount of paste with 1,000 to 1,500 ppm, spat out, not rinsed.
• Supervise brushing until at least age 7, says the NHS.

The ADA estimates a smear is about 0.1 g of toothpaste (0.1 mg fluoride) and a pea about 0.25 g. One practical problem with tablets for small children: a tablet is a fixed dose. You can’t make a rice-grain smear from it.

Is fluoride toothpaste safe?

Used as directed, yes. The known risk is dental fluorosis: white flecks or streaks on permanent teeth from swallowing too much fluoride while they’re forming. A 2024 Cochrane review found moderate-certainty evidence that children who brushed with 1,000 ppm or more from age one or two until five or six probably had a higher chance of fluorosis than children using 440 to 550 ppm paste; the fluorosis in the studies was mostly mild. Evidence on how much paste and what starting age matter was very uncertain. The ADA describes fluorosis as primarily a cosmetic concern, though severe cases can leave brown spots or pitting. The smear-and-pea amounts are there to keep the fluoride a child swallows low.

You may have seen headlines about fluoride and children’s IQ. They’re about drinking water, a separate debate: the US National Toxicology Program concluded with moderate confidence that water with more than 1.5 mg/L of fluoride, roughly twice the US recommended level, is associated with lower IQ, and said its review wasn’t designed to assess fluoridated tap water alone. It didn’t assess toothpaste on its own either, and the NHS and ADA, read for this article in November 2026, still advise brushing with fluoride toothpaste and spitting it out.

Hydroxyapatite: promising, mostly company-funded

Hydroxyapatite (HAP) is a calcium phosphate mineral, the same family of material your enamel is made of. It’s sold as the “natural” alternative to fluoride, in two sizes: nano (particles under 100 nanometres) and micro. The difference matters because the trials and the products don’t always match.

The trials

The headline studies come from a Polish university team:

• Children, 2021. In a one-year trial of 207 children, 72.7% in the HAP group and 74.2% in the fluoride group had early (enamel) cavities appear or get worse, counting the 177 who finished. The researchers concluded HAP was “not inferior” to fluoride.
• Adults, 2023. In an 18-month trial of 189 adults, 89.3% using HAP and 87.4% using 1,450 ppm fluoride had no increase in decayed, missing or filled surfaces, counting the 171 who finished. Again, “not inferior”.

Now the fine print. Both trials were funded by Dr. Kurt Wolff GmbH, the German company behind Karex HAP toothpaste, and the HAP paste tested was identical or comparable to Karex. In the adult trial, three of the authors were company employees. Company funding doesn’t make a result wrong, but it’s exactly the situation where you want independent replication, and there isn’t much.

Three more things weaken the case:

• A wide margin. Both trials counted HAP as “not inferior” as long as it was no more than 20 percentage points worse than fluoride. The observed gaps were much smaller (in the children’s trial, the worst case allowed by the statistics was about 10 points), but a margin that wide is a generous allowance for a cavity-prevention product.
• A weak comparison in the children’s trial. The fluoride paste was a 500 ppm children’s paste, and kids brushed three times a day. NHS guidance for young children is at least 1,000 ppm.
• Micro vs nano. Those trials tested microcrystalline HAP. Several popular products, including Bite and Davids, use nano-HAP. Results from one don’t automatically transfer to the other.

The reviews disagree, and so do their authors

A 2024 meta-analysis concluded HAP is effective without fluoride, but two of its six authors are the same company employees disclosed in the adult trial. An independent 2022 review from the University of Bern, funded by the authors and their institution, looked at nano-HAP and rated the evidence very low: six of the studies had a high risk of bias, six were funded or published by the makers of the products tested, and in studies where volunteers wore enamel samples in their mouths under acid attack, sodium fluoride slowed enamel loss while nano-HAP did no better than a fluoride-free paste. A 2025 review from another group found only four eligible studies, with no significant differences between HAP and fluoride in new or worsening cavities.

Our grade: plausible and worth studying, but the clinical evidence is thin, short, mostly industry-funded and mostly about micro-HAP. Fluoride has 70 trials in one Cochrane review alone. That’s why LPP won’t list fluoride-free HAP toothpastes. If you want HAP anyway, some pastes combine it with fluoride; one is in our table.

Is nano-hydroxyapatite allowed?

In the EU, yes, with limits (as of November 2026). After an opinion from its Scientific Committee on Consumer Safety, the EU allows nano-HAP at up to 10% in toothpaste and 0.465% in mouthwash, only as rod-shaped, uncoated particles, and not in sprays. Non-compliant products couldn’t be newly placed on the EU market from 1 February 2025 and have had to be off shelves since 1 November 2025. In the US, hydroxyapatite isn’t one of the three fluoride compounds in the FDA’s anticavity toothpaste rules, so HAP pastes can’t be sold as anticavity drugs under them, and they can’t carry the ADA Seal for cavity protection.

Do toothpaste tablets work as well as paste?

Nobody has tested whether tablets prevent cavities as well as paste. There’s no long-term trial counting cavities in tablet users. What exists is shorter and narrower:

• Plaque and gums. In a two-week trial of 40 adults, Colgate fluoride tablets and Colgate paste controlled plaque and gingivitis equally, though people liked the tablets’ texture less. A four-week study of 100 children found a tablet and a paste equally effective at removing plaque. Both are small and short.
• Fluoride content. This is the worrying one. Dutch researchers bought 20 fluoride tablets in 2025 and measured them. Only 9 of 20 contained at least 80% of the fluoride they claimed and had at least 80% of it in a form available to teeth. Three had well under half the fluoride on the label. And 15 of the 20 tablets weighed less than the 0.6 to 1.2 g of paste recommended per brushing in the Netherlands, so even a good tablet may deliver less fluoride than a strip of paste. The authors found no studies comparing fluoride levels in the mouth after tablets and paste. Denttabs mint, which is in our table, met both criteria (90% of claim).
• Lab studies. A lab study found a 5% nano-HAP tablet as effective as 1,100 ppm fluoride paste at protecting cow enamel from bacteria for a week. It was funded by a company, BIOM LLC, and it’s cow teeth in a dish.

And tablets aren’t automatically greener. One life cycle assessment (Suppipat and colleagues, 2022), as summarised by the Dutch team, found tablets had a slightly higher six-month footprint than paste, mainly from the use phase and the tablet ingredients, partly offset when glass jars are recycled. That paper is paywalled and we couldn’t read it ourselves.

Bottom line: a fluoride tablet with the right ppm, from a brand whose fluoride claims hold up, is a reasonable plastic-cutting choice. The evidence it matches paste for cavities simply doesn’t exist yet.

Plastic in the formula itself

Packaging is the obvious plastic. Some is in the paste.

Microbeads were banned from US toothpaste years ago; the bans and their loopholes are in our bathroom plastics article, along with a lab study that still found polyethylene particles in toothpaste. We won’t repeat it here.

What’s still allowed is a family of synthetic polymers used as thickeners and binders: carbomer (an acrylic acid polymer), acrylates copolymers, PEG (polyethylene glycol) and PVP. They’re dissolved or gel-like rather than solid beads, so microplastic rules mostly miss them. The EU’s microplastics restriction, for example, excludes polymers that dissolve in water at more than 2 grams per litre. Whether these dissolved polymers do harm is genuinely unknown. They’re not the same as microplastics, and we’re not claiming they are.

Of the products in our table, one mainstream paste, Crest Cavity Protection, lists carbomer. None of the tablets we checked list a fully synthetic polymer: their binders were plant-derived or modified natural ones like microcrystalline cellulose, xanthan gum and guar gum.

Where the plastic is: 12 toothpastes compared

As of 12 November 2026, from each maker’s own product page or, for US drug products, the label filed with the US National Library of Medicine’s DailyMed. “Not stated” means we couldn’t find it on the maker’s page or label. We don’t lab-test products, and this isn’t a list of recommendations: three fluoride-free products are here for comparison only. For what LPP would require before vetting a product, see our standards.

Product	Format	Fluoride or hydroxyapatite	Container, lid, liner	Refills	Fully synthetic polymers in listed ingredients
Bite Toothpaste Bits with Fluoride (US)	Chewable tablet	Sodium monofluorophosphate 0.76%; maker’s page says 0.14% w/w fluoride ion (see note)	Glass jar or bottle; aluminium lid; liner not stated	Pouches the maker calls home compostable	None listed
Denttabs Mint mit Fluorid (Germany)	Chewable tablet	Sodium fluoride, 1,450 ppm	125-tab bag (material not stated)	Multi-packs and 1 kg bag the maker calls industrially compostable	None listed
Georganics Toothpaste with Hydroxyapatite, Fresh Mint, Fluoride (UK)	Paste	Sodium fluoride, 1,350 ppm, plus hydroxyapatite (type and amount not stated)	Aluminium tube (recycled); HDPE lid; lining not stated	None	None listed
Ben & Anna Zahnpasta White mit Fluorid (Germany)	Paste in jar	Sodium fluoride, 1,450 ppm	Glass jar; maker says the packaging contains no plastic; lid material not stated	Not stated	None listed
Ben & Anna Zahnpasta Tube Spearmint mit Fluorid (Germany)	Paste	Sodium fluoride, 1,450 ppm	Aluminium tube; cap and lining not stated	None	None listed
Tom’s of Maine Anticavity Freshmint (US)	Paste	Sodium fluoride 0.24% (0.15% w/v fluoride ion)	HDPE tube (maker says recyclable where accepted); cap a different plastic	None	None listed
Colgate Total Active Prevention Clean Mint (US)	Paste	Stannous fluoride 0.454% (0.15% w/v fluoride ion)	Tube; material not stated on label	None	None listed (cellulose gum is modified cellulose)
Crest Cavity Protection Regular (US)	Paste	Sodium fluoride 0.243% (0.15% w/v fluoride ion)	Not stated on label (carton panel only)	None	Carbomer
For comparison, fluoride-free: Bite Toothpaste Bits, Mint (US)	Chewable tablet	Nano-hydroxyapatite (amount not stated); no fluoride	Glass jar or bottle; aluminium lid; liner not stated	Pouches the maker calls home compostable	None listed
For comparison, fluoride-free: Davids Hydroxi Whitening + Enamel Health, Peppermint (US)	Paste	Nano-hydroxyapatite (amount not stated); no fluoride	Aluminium tube with “food grade non-BPA liner” (material not named); HDPE cap	None	None listed
For comparison, fluoride-free: Truthpaste Hydroxyapatite, Peppermint (UK)	Paste in jar	Micro-hydroxyapatite, 5%; no fluoride	Glass jar; aluminium lid; liner not stated	Jar return scheme (6 or more jars)	None listed
For comparison, fluoride-free: Georganics Mineral Toothpaste Tablets, Spearmint (UK)	Chewable tablet	Neither	Glass bottle; aluminium lid	720-tablet pouch the maker calls fully compostable	None listed

Sources for each row are listed at the end of this article. “Fully synthetic polymers” means ingredients such as carbomer, PEG, acrylates copolymers, polyethylene or PVP; plant-derived and modified natural gums (xanthan, guar, carrageenan, cellulose gum, microcrystalline cellulose) aren’t counted.

A note on Bite’s fluoride figure. Bite’s ingredients page lists sodium monofluorophosphate 0.76% (0.14% w/w fluoride ion). By our arithmetic they don’t match. Sodium monofluorophosphate (Na₂PO₃F) has a molecular weight of about 144, of which fluorine contributes 19, so it is about 13.2% fluorine by weight. 0.76% × 13.2% ≈ 0.10% fluoride, or about 1,000 ppm. That fits the FDA’s rules, which treat 0.654 to 0.884% of this compound as 850 to 1,150 ppm. A 0.14% figure would need about 1.06% of the compound. Either figure falls in the 1,000 to 1,500 ppm range that the 2019 Cochrane review found reduces cavities; they just don’t agree with each other. We’ll update this if Bite clarifies.

What to do, ranked by evidence

1. Use a fluoride toothpaste, twice a day. Strongest evidence by far: about a quarter fewer cavities in children, and fewer in adults too. Aim for at least 1,350 ppm as an adult, the NHS advice, or anything with the ADA Seal. Spit, don’t rinse.
2. Get the children’s amounts right. A rice-grain smear until 3, a pea from 3 to 6, and supervise. This is what keeps fluorosis risk low.
3. Cut the plastic without dropping the fluoride. A fluoride paste in a glass jar or aluminium tube is the closest thing to like-for-like. Expect a plastic cap or liner on most metal tubes.
4. If you choose fluoride tablets, pick ones that state ppm. Tablets have the thinnest evidence of the three: no cavity trials, and a lab test where 11 of 20 fell short on fluoride. Look for 1,000 to 1,500 ppm on the label, and prefer brands with independent test results.
5. If you stick with a plastic tube, choose an HDPE one and check whether your area takes it. Recognised as recyclable isn’t the same as recycled.
6. Skip synthetic polymers if you like. Carbomer, PEG and acrylates are easy to avoid. There’s no evidence they harm you; it’s a small plastic-free bonus, not a health move.
7. Don’t swap fluoride for hydroxyapatite on the strength of current evidence. The trials are company-funded and an independent review called the evidence very low. If you want HAP, use it alongside fluoride, and tell your dentist.

Where the evidence is weakest: we don’t know whether tablets prevent cavities as well as paste, whether nano-HAP works as well as the micro-HAP that was tested, or whether tablets are greener over their whole life. We do know fluoride works, and that’s the part not to give up.

Common questions

Should I rinse my mouth after brushing?

No. The NHS says to spit out the excess and not rinse, because rinsing washes away the concentrated fluoride left on your teeth and reduces its effect.

Why do US toothpaste labels show a percentage instead of ppm?

US drug labels state the fluoride compound and fluoride ion as percentages, often “0.15% w/v fluoride ion” for standard paste. The FDA’s rules define regular-strength paste as 850 to 1,150 ppm by weight. “W/v” means weight per volume, and toothpaste is denser than water, which is why 0.15% w/v doesn’t translate directly to 1,500 ppm. If you’re comparing a US paste with a European one, a US anticavity paste is roughly in the 1,000 ppm range unless its label says 1,500 ppm.