May 6, 2026
2025 was the year oral care stepped out of the bathroom and into the headlines. Two major themes fueled consumer interest in toothpaste and other oral health products – fluoride safety and the interconnections between oral and systemic health.
Part 1: Fluoride Safety & Alternative Ingredients for Dental Care
Fluoride Makes Headlines
A September 2024 federal court ruling that mandated the EPA review fluoride safety in drinking water ushered fluoride into the spotlight, and it stayed there throughout most of 2025.1 Utah became the first state to ban the addition of fluoride to public water systems, followed by Florida and Oklahoma.2-4 Another 6 states have active legislation aimed at banning the practice, and more are expected to be added to that list this year.5
Government scrutiny of fluoride was not limited to the public water fluoridation. In May 2025, the US FDA announced they would initiate actions against prescription fluoride supplements citing that these products have never been reviewed or approved by the FDA.6 Ultimately, the FDA stopped short of a full ban but did restrict the use of these products by children under 3 years of age or not at high risk for dental caries.7
Why it matters: Despite government scrutiny being limited to fluoride ingestion, there has been a clear halo effect on topical fluoride products. Dental professionals are facing increased hesitancy from patients and parents, and more consumers are actively seeking fluoride-free dental care. This is driving interest in alternative technologies, such as hydroxyapatite, theobromine, xylitol, and herbal ingredients.
Hydroxyapatite Goes Mainstream
Hydroxyapatite toothpastes have been available in the US for at least a decade, but prior to 2025 they were primarily found online or at specialty retailers. Boka ELA Mint has been the “#1 Best Seller in Toothpaste” on Amazon for the past several years, and in March 2025 they announced their expansion into physical Target stores nationwide. This may have been the most highly publicized hydroxyapatite toothpaste debut in mass market, but it is far from the only one. Other brands featuring hydroxyapatite, including GuruNanda, Made by Dentists, Coco Floss, Davids, and others, have also become easy to find at national brick and mortar retailers such as Walmart, Target, CVS and Walgreens.
Why it matters: Toothpaste is a multibillion-dollar business in the US, dominated by just a few multinational brands. The growth of hydroxyapatite toothpaste in mass market is a clear signal that many consumers are interested in alternative oral health technologies, creating a niche where boutique brands can prosper in a historically difficult and highly competitive segment.
Claims Under the Microscope
Amidst the excitement of nationwide roll-out in Target stores, the Boka brand was also faced with a challenge to their product claims by industry giant Procter & Gamble. For those that are unaware, the personal care industry self-polices advertising claims through the National Advertising Division (NAD) of the Better Business Bureau (BBB). In this case, the NAD recommended that Boka discontinue all their performance claims, i.e., remineralization, tooth whitening, and maintaining a healthy microbiome.8 Furthermore, following Boka’s appeal, the National Advertising Review Board (NARB) agreed with the NAD ruling, citing that Boka lacked sufficient evidence for its product efficacy claims.9
Why it matters: Boka provided evidence for their tooth remineralization and whitening claims based on the ingredient hydroxyapatite, and evidence for their healthy microbiome claims based on the prebiotic ingredient preBIULIN. These rulings send a clear message that ingredient-based evidence alone is not enough, and that brands must provide evidence that demonstrates the claimed benefit is provided by the marketed product. As brands succeed and grow in popularity, it is imperative to adequately substantiate claims to protect brand equity.
Part 2: A Shift in Approach to Oral Health
Inflammation & the Oral Microbiome
The complex relationship between oral health and overall health has been well established over the past decade, with mounting evidence supporting links between oral health and cardiovascular disease, diabetes, pregnancy complications, respiratory diseases, rheumatoid arthritis, Alzheimer’s disease, and even certain cancers.10-15 Although the mechanisms aren’t all well understood, they predominantly involve inflammation and the oral microbiome.
Why it matters: This is fundamentally impacting the entire landscape of oral health. The impact of toothpaste and other oral hygiene products on the oral microbiome is being scrutinized, the focus on oral health is expanding outside of toiletries into food and nutritional products, and healthcare systems are exploring new models integrating dental care with traditional medical care. These changes create countless opportunities for new product formats, usage occasions, and technologies to be integrated as part of an expanding oral wellness routine.
Oral Microbiome Diagnostics
Salivary diagnostic testing isn’t new by any means. Saliva testing for the identification of periodontal diseases has been available to the dental professional for over 20 years.16 However, the first at-home salivary diagnostic test kits only became available in mid-2022 and primarily focused on breath/halitosis. They have expanded and evolved over the past few years, becoming mainstream in 2025. Depending on the kit, they offer insight into the users’ oral microbiome and other biomarker analyses related to oral and systemic health outcomes. They score the health of the microbiome in ways that are easy to understand, and may even provide customized hygiene, product, or nutritional recommendations to achieve desired oral health outcomes.
Why it matters: At-home salivary diagnostic test kits may be a double-edge sword for brands. This is ultimately a tool for consumers, and one of the potential use cases is to determine if a new oral care product regimen is delivering the desired results. This could be bad news for brands trying to capitalize on the oral-systemic health trend without appropriate scientific rigor behind their claims. On the other hand, these kits also offer brands with a relatively inexpensive means to investigate clinical outcomes. Furthermore, partnering with the companies behind these tests may offer an opportunity to market your brand directly to your target consumer.
Functional Gums & Mints
Functional gums are predicted to grow at 9.7% CAGR despite decline in the traditional gum market.18 These products range from energy and focus for gamers to mental health and immune support for overall wellness.17, 18 The new generation of functional gums and mints for oral health go far beyond simply being a sugar-free way to freshen up midday. They incorporate ingredients like hydroxyapatite, arginine, and xylitol to promote oral health. Some of these products have been clinically validated to neutralize acids and promote a healthy plaque pH, reduce hypersensitivity, reduce gingival inflammation and bleeding, alter the oral microbiome, or increase nitric oxide generation.
Why it matters: Oral health is no longer just about cavities, it’s about longevity, and people realize they need to spend more than two minutes twice a day to take care of their mouths. Functional gums and mints offer consumers an easy way to do something good for their mouth, and their health, throughout the day. For brands focused on oral health and wellness specifically, these formats create an opportunity for expansion and the creation of unique personalized regimens addressing the specific needs of their users.
Medical-Dental Integration
As researchers continue to uncover links between oral health and systemic health, and learn more about the mechanisms driving these relationships, there is growing sentiment that dental care needs to be better integrated with traditional medical care.19, 20 Today, there are both structural and technical barriers making it very difficult to weave these together. Dentists and medical doctors are trained at distinctly separate institutions. It is uncommon for medical and dental practices to be collocated. The electronic systems (EHRs) used by medical and dental practitioners to record patient information don’t speak to each other, adding another layer of difficulty in sharing information between providers. While some dental procedures may be covered by medical insurance, routine preventative dental care must be paid out-of-pocket or requires supplemental insurance.21, 22 This is just a brief overview of some of the hurdles that must be overcome to integrate dental and medical care.
Despite the longstanding barriers, there is growing support for medical-dental integration. One of the main drivers is reduced costs for patients, providers, and the healthcare system. Preventative care is less expensive than treating chronic and acute conditions. Integrated care enhances chronic disease management through early detection and intervention, improving health outcomes while reducing reliance on high-cost emergency services. According to several case studies, integrating routine dental care into the management of cardiovascular disease and diabetes has been shown to reduce overall annual healthcare costs.
Why it matters: Interest in medical-dental integration isn’t just a passing fad. It’s a signal that our perspectives about oral health are set to change, and it’s a strategic opportunity for oral care brands. There is going to be a shift in demand from cosmetics to clinical benefits. While tooth whitening and breath freshening products may continue to be of interest, they will be outshined by clinically validated benefits for gum health and oral microbiome support. Brands with robust scientific support behind their claims and positioning will become the go-to recommendations of physicians and dentists.
Conclusion
For decades, oral care existed as a relatively niche category dominated by relatively few multinational brands. Despite technically sophisticated formulations, innovations often went unnoticed or unappreciated by consumers. While the category has been evolving over the past decade, most movement in the category reflected broader beauty, wellness, or food trend. In 2025, that dynamic shifted dramatically. This was the year oral care generated its own momentum, driven by science, policy, consumer curiosity, and a growing recognition of oral health’s impact on whole‑body wellbeing. Fluoride scrutiny, the rise of hydroxyapatite, new diagnostic tools, functional formats, and an accelerating move toward medical‑dental integration signaled that oral care is no longer following trends from adjacent categories—it is now setting them.
References
- Food & Water Watch, Inc. v. EPA, No. 17‑cv‑02162‑EMC, 2024 WL 4291497 (N.D. Cal. Sept 24, 2024).
- Utah Legislature. B. 81 Fluoride Amendments. https://le.utah.gov/~2025/bills/static/HB0081.html (accessed March 2, 2026).
- ABC News. Florida Becomes 2nd State to Ban Fluoride in Public Drinking Water.
https://abcnews.com/Health/florida-2nd-state-ban-fluoride-public-drinking-water/story?id=121852274 (accessed March 2, 2026). - RFK Jr., Stitt Announce Fluoridation Review and SNAP Waiver in “Make Oklahoma Healthy Again” Campaign.
https://www.kosu.org/local-news/2025-06-26/rfk-jr-stitt-announce-fluoridation-review-and-snap-waiver-in-make-oklahoma-healthy-again-campaign (accessed March 2, 2026). - CareQuest Institute for Oral Health. 2026 Community Water Fluoridation Policy: State Legislative Activity.
https://carequest.org/2026-community-water-fluoridation-policy-state-legislative-activity/ (accessed March 2, 2026). - S. Food and Drug Administration. FDA Begins Action to Remove Ingestible Fluoride Prescription Drug Products for Children from the Market.
https://www.fda.gov/news-events/press-announcements/fda-begins-action-remove-ingestible-fluoride-prescription-drug-products-children-market (accessed March 2, 2026). - S. Food and Drug Administration. FDA Acts To Protect Children from Unapproved Fluoride Drug Products.
https://www.fda.gov/news-events/press-announcements/fda-acts-protect-children-unapproved-fluoride-drug-products (accessed March 2, 2026). - BBB National Programs. NAD Case Decision: Essor Group, Inc. (Boka Oral Care Products).
https://bbbprograms.org/media/newsroom/decisions/essor (accessed March 2, 2026). - BBB National Programs. NARB Case Decision: Essor Group, Inc. (Boka Oral Care Products Appeal).
https://bbbprograms.org/media/newsroom/decisions/essor-group (accessed March 2, 2026). - Hopkins, S.; et al. Oral Health and Cardiovascular Disease. J. Med. 2024, 137 (4), 304–307.
- Arbildo‑Vega, H. I.; Cruzado‑Oliva, F. H.; Infantes‑Ruíz, E. D.; Coronel‑Zubiate, F. T.; Becerra‑Atoche, E. G.; Terrones‑Campos, W.; Herrera‑Plasencia, P. M.; Seminario‑Trelles, O. A.; Ortega‑Gallegos, R. E.
An Umbrella Review of the Association Between Periodontal Disease and Diabetes Mellitus. Healthcare 2024, 12, 2311. - Choi, S. E.; Choudhary, A.; Ahern, J. M.; Palmer, N.; Barrow, J. R.
Association Between Maternal Periodontal Disease and Adverse Pregnancy Outcomes: An Analysis of Claims Data. Pract. 2021, 38 (6), 718–723. - Zygmunt, Ł.; Kiryk, S.; Wesołek, K.; Kiryk, J.; Nawrot‑Hadzik, I.; Rybak, Z.; Sztyler, K.; Małyszek, A.; Matys, J.; Dobrzyński, M.
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https://www.vitafoodsinsights.com/functional-food-beverages/chewing-with-a-purpose-the-rise-of-functional-gums (accessed March 2, 2026). - FoodBev Media. Chew on This: Why Functional Gum Is the Next Big Wellness Trend.
https://www.foodbev.com/news/chew-on-this-why-functional-gum-is-the-next-big-wellness-trend (accessed March 2, 2026). - Blue Cross Blue Shield of Michigan. The Value of Integrating Dental Benefits.
https://www.bcbsm.com/amslibs/content/dam/public/providers/documents/value-of-integrating-dental-benefits.pdf (accessed March 2, 2026). - 2025 Dental Trends Report.
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