Is a toothpaste with 927 parts per million (ppm) available fluoride effective for dental health?

Effectiveness of 927 ppm Fluoride Toothpaste for Dental Health

A toothpaste containing 927 ppm available fluoride is less effective for dental health than the standard concentration (1000-1100 ppm) recommended for optimal caries prevention. 1

Fluoride Concentration in Toothpaste and Caries Prevention

Optimal Fluoride Concentration

• The standard concentration of fluoride in toothpaste in the United States is 1,000-1,100 ppm 1
• This concentration has been extensively studied and shown to reduce caries experience among children by 15%-30% in studies of 2-3 years duration 1
• Higher concentrations (1,500 ppm) have been reported to be slightly more efficacious in reducing dental caries 1

Effectiveness of Lower Fluoride Concentrations

• Clinical trials have demonstrated that toothpaste containing 250 ppm fluoride is less effective than toothpaste containing 1,000 ppm fluoride in preventing dental caries 1
• Toothpaste containing 500-550 ppm fluoride might be almost as efficacious as that containing 1,000 ppm fluoride, but still provides less protection 1
• At 927 ppm, the fluoride concentration falls below the standard recommended range, potentially compromising its caries-preventive effect

Evidence from Research Studies

A 2019 Cochrane systematic review found evidence of a dose-response effect for fluoride concentration in toothpaste:

• There was moderate-certainty evidence that 1450-1500 ppm fluoride toothpaste slightly reduces caries increments compared to 1000-1250 ppm 2
• Lower fluoride concentrations (<600 ppm) provide less caries protection than standard (1,000 ppm) or high (1,500 ppm) concentration formulations 3

Special Considerations for Different Age Groups

Adults and Adolescents

• For adults and adolescents, toothpaste with 1,000-1,100 ppm fluoride is recommended for optimal caries prevention 1, 4
• The 927 ppm concentration would provide less protection than the standard recommendation

Children

• For children under 6 years at low risk for caries (particularly in fluoridated areas), lower fluoride concentrations may be appropriate to minimize fluorosis risk 3
• However, even for children, the evidence suggests that 500-550 ppm is the minimum effective concentration 1, 5
• A study examining acidified toothpaste found that only the 550 ppm acidified paste had comparable anticariogenic action to the 1,100 ppm neutral paste 5

Practical Recommendations for Fluoride Toothpaste Use

To maximize benefits of fluoride toothpaste:

• Brush twice daily with a fluoride toothpaste containing at least 1,000 ppm fluoride 1, 4
• Minimize rinsing after brushing to retain more fluoride in the mouth 1
• For children under 6 years, use only a pea-sized amount (approximately 0.25g) of toothpaste to reduce fluorosis risk 1

Important Caveats

• The effectiveness of fluoride toothpaste depends not only on concentration but also on frequency of use and post-brushing rinsing behavior 3
• Combined use of fluoride toothpaste and fluoridated water offers protection above either used alone 1
• The risk of fluorosis is primarily associated with young children swallowing toothpaste during tooth development 1, 3

While a 927 ppm fluoride toothpaste would provide some caries protection, it falls below the standard recommended concentration for optimal effectiveness in preventing dental caries.