From Fluoride-free to Probiotic-infused, Oral Care Is Getting a Refresh
Oral care has gone in for a deep cleaning.
The category, once primarily about cleaning teeth and freshening breath, has taken some twists and turns over the past few years. With an emphasis on whitening and overall appearance, oral care, expected to reach $10.8 billion in sales in the U.S. this year according to Mintel, dove deep into beauty a few years ago with brands like Moon developing “oral beauty” as an adjacent category. Now, the pendulum has swung to oral wellness as consumers and brands focus on inflammation, clean ingredients, the oral microbiome and the mouth’s impact on one’s overall health.
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“The angle in the category was all about the ‘skinification,’ making a different category more beauty-like, and in the past few years, we’ve seen a big swing to the wellness space,” said Sarah Mountcastle Mitchell, vice president of beauty and wellness at Essor, which owns oral care brand Boka.
As the wellness category continues to grow, consumers are seeking a more holistic approach to health. For example, rather than focusing on just whitening, they are now seeking ingredients that could strengthen enamel, in turn resulting in brighter teeth. With this, the category has also gone beyond topical products into devices and supplements.
While many dread going to the dentist, there is a growing interest in the category — “81 percent of adults are interested in learning more about their specific oral health needs,” according to Mintel. The firm reports that products that market additional health benefits is an area of opportunity going forward.
How Oral Care Evolved to Oral Wellness
This evolution of the oral care category starts with the conversation around the oral microbiome, as consumers and brands are approaching health more holistically rather than reactively trying to treat one symptom at a time. Experts agree that oral health has a major impact on other bodily functions.
“If you don’t have good oral health, you can have periodontal disease, cavities, premature tooth loss, and that can actually affect your ability to eat,” said Dr. Jaskaren Randhawa, dentist and founder of holistic dental wellness practice Sama. “Not having good nutrition and having inflammation in the mouth can affect a variety of autoimmune conditions and other comorbidities.”
Dentist and Made by Dentists cofounder Dr. Lisa Creaven added: “Oral health can impact your heart health… If you have a physical issue with your heart, [bad] bacteria can travel from your mouth, from something as simple as a teeth cleaning, and get to your heart and create a significant infection.”
She pointed to many other issues caused by poor oral health, such as gut dysbiosis and orthopedic procedure complications.
Biohacking for the Mouth
As oral microbiome health has become a concern for consumers, testing is gaining traction. For example, Randhawa offers an in-office test at Sama that shows the good and bad bacteria present in the mouth. From there, Randhawa provides patients with customized routines to achieve their healthiest oral microbiome.
“This is shifting oral care towards more biohacking,” she said. “By doing this customized diagnosis and customized treatment plans, we can cater it so that every single patient actually is getting the care that they need.”
There are also several at-home options on the market from brands like Viome and Bristle Health, which can then provide personalized routines and supplements. However, to create a more seamless approach Boka has created Boka Well, a line of oral microbiome-boosting supplements including Pro Stix Pre + Probiotic Powder, $29, and Vital Bite Pre + Probiotic Tablets, $29. Both are formulated with pre- and probiotics and vitamins D3, K and E.
“All support beneficial bacteria in the mouth, so it makes for healthy teeth, gums and oral microbiome,” said Mountcastle Mitchell. “We’ve always said as a brand that health starts with the mouth, and oral care is more than what’s going on in your mouth. This is the first franchise that brings us beyond the oral care space.”
Tackling Ingredient Lists
In addition to microbiome-boosting formulas, brands are also looking at clean alternatives to some ingredients. One of the most controversial conversations dominating the category right now is around fluoride.
“There are concerns about fluoride intake and the development of children’s brain development… Fluoride is a neurotoxin, so it’s good for your teeth. It’s not necessarily good for your body [if ingested,]” said dentist and Cocofloss cofounder Chrystle Cu. “It’s a real murky area [in the dental community.]”
As a result, many brands are removing the ingredient from formulas, opting instead for nano-hydroxyapatite or n-Ha. Many experts in the space compare this change to the shift from aluminum-filled antiperspirants to clean deodorants.
“Hydroxyapatite is the natural crystal that our tooth is actually made out of, and this nano form is synthesized in a lab, so it’s a very clean form,” said Cu. “N-ha is a small crystal that can get incorporated into one’s tooth structure to help strengthen one’s teeth and help improve the luster of enamel.”
According to Cu, it is safe to ingest, which has become one of the largest complications around fluoride. It’s this information which lead Agent Nateur founder Jena Covello to launch her own clean version Agent Nateur Holi (Pearly) Whites, $27, which uses probiotics, pearl powder, clove, n-Ha, calcium carbonate and hydrated silica to clean the mouth and boost microbiome health.
“We add a probiotic to the toothpaste because of that link between the gut and oral health,” Covello said. “When you’re putting the probiotics into the toothpaste, you can help improve oral health by fighting that bacteria.”
Boka, Cocofloss and Bite have all also opted for n-Ha over fluoride in their toothpaste formulas. However, not all experts are anti-fluoride.
“As a dentist, fluoride is one of those key ingredients that has been proven for decades [that] this is how you’re going to clinically prevent cavities, reduce gum disease and reverse early cavities. If you want to use fluoride-free products, you just have to be aware that the risk of getting a cavity is increased,” said Creaven. “I’m more concerned about other [filler] ingredients in your toothpaste like sodium lauryl sulfate… It is an inflammatory ingredient that… causes your toothpaste to foam.”
According to Creaven, most toothpastes still contain fluoride, and there haven’t been enough studies to convince her it is dangerous in the amounts used in oral care. However, she also sees the benefits of hydroxyapatite and says it is most beneficial when used in combination with fluoride, which Made by Dentists Enamel Rebuilding Professional Toothpaste, $7, does. For Creaven, it’s all about combining clean and active ingredients, particularly because “the lining of your mouth is about 50 times more absorbent than your skin.”
Oral Innovations
N-Ha isn’t the only innovation the category has seen. For example, Cocofloss made a name for itself with its thick, woven fiber floss, and now has launched electric brush heads that use bristles of varied sizes meant to more effectively address plaque.
In addition, Moon, an early adopter of oral beauty, launched Platinum Pro Glow Teeth Whitening Device, $130, that also employs red and yellow light (similar to skin care LED masks) to support gum health and better breath.
Today’s oral care companies aren’t just trying to provide wellness — they’re trying to give users a more enjoyable, sensorial experience than in the past. Cu learned this in her dental practice prior to starting Cocofloss, she said.
“I had this menu… [of] 20 different toothpaste flavors for polishing after one’s teeth cleaning,” she said. “It was the moment that you saw the patient’s face light up… That’s such a rare emotion to have in the dental setting.”
She took this with her when creating Cocofloss. For example, the brand’s signature dental floss, $10, comes in unexpected flavors like Passion Fruit, Confetti Cake and Gelato Affogato. Other brands have taken a similar approach, such as Boka with its Apple Pomegranate n-Ha Toothpaste, $13.
Experts say the category will borrow other ingredients from skin care and wellness going forward — think niacinamide and probiotics.
“[We’ve] started to see this interesting dip into ingredients that you wouldn’t naturally associate with oral care,” said Mountcastle Mitchell. “Probiotics is one… and then things like amino acids and niacinamide… [It’s] definitely a space with a lot of innovation happening.”
New entrants to the oral care do face challenges — especially competing with large, heritage companies, and Mintel reports that 53 percent of consumers repurchase the same brand of oral care products.
“It’s hard to get people to convert, especially when they’ve been using a brand their entire life, but once they make the switch, they’ve made the switch for life,” Mountcastle Mitchell said.
Agent Nateur Holi (Pearly) Whites, $27
Agent Nateur’s Holi (Pearly) Whites employs pearl powder, n-Ha, calcium carbonate and hydrated silica meant to polish and brighten teeth and probiotic strain Lactobacillus salivarius that aims to support a healthy oral microbiome.
Boka Well Vital Bite Pre + Probiotic Tablets, $29, and Pro Stix Pre + Probiotic Powder, $29
Boka’s new Well line employs strains of pre- and probiotics that aim to support better breath and a healthy microbiome. Vitamins are combined for additional antioxidant and tooth-supporting benefits.
Cocofloss Electric Brush Refills, $24
While best known for its dental floss, $10, which employs thick woven fibers meant for a more effective cleaning, it recently launched its electric brush refills — to be used on a Sonicare brush — using thousands of dual-style bristles to target plaque.
Made by Dentists Enamel Rebuilding Professional Toothpaste, $7
Rather than choosing fluoride or hydroxyapatite, Made by Dentists has opted for both in its Enamel Rebuilding Professional Toothpaste, as Creaven says they are most impactful when used together.
Moon Platinum Pro Glow Teeth Whitening Device, $130
Rather than just employing blue light for whitening, Moon’s latest device also combines red and yellow light meant to give users healthy gums and better breath.
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