Meta-analysis shows: HAP is as effective as fluoride in caries prophylaxis


Numerous scientific publications confirm the effect of hydroxyapatite (HAP) in oral care. However, a systematic literature review and meta-analysis of the study data are always necessary to verify the evidence of efficacy of an application. This Canadian-German collaboration is the first scientific evaluation of all studies on HAP of this kind with respect to caries prophylaxis.

Research question

How effective is hydroxyapatite in caries prophylaxis?

Material and Methods

A systematic literaturereview in 5 databases, as well as their structured analysis – based on the highest scientific standards, was performed. The clinical studies available were examined for bias. Subsequently, the data were summarized in a meta-analysis.


A total of 291 studies were identified that investigated HAP in the context of oral care. Three recent clinical trials were used for the meta-analysis from this selection. Here it was found that HAP reduces caries by 17%. Since HAP was compared to fluoride in terms of caries-protective effect in a majority of the studies, a key message of this scientific review is: HAP is (at least) as effective as fluoride in caries prophylaxis.


HAP is effective in caries prophylaxis. Oral care products containing HAP provide an effective alternative to products containing fluoride – especially for children and all those who do not want fluoride in their oral care products.

The publication of the study can be found here.

Source:  Limeback, H., Enax, J. & Meyer, F. Biomimetic hydroxyapatite and caries prevention: a systematic review and meta-analysis. Can J Dent Hyg 55, 148-159 (2021).