Prescription Fluoride Toothpaste: When It's Worth Asking For After 50

If your dentist has mentioned decay at the gumline or on exposed roots, you may hear about a prescription toothpaste with much more fluoride than the tube in your drawer. Here are answers to the questions that come up about it.

What is prescription fluoride toothpaste?

The American Dental Association (ADA)¹ describes prescription-strength fluoride toothpastes as containing 5,000 ppm fluoride, as sodium fluoride. They need a prescription from a dentist or physician for home use, and you follow the package insert or your dentist’s instructions.¹

Why might I need it after 50?

When gums recede, the softer root surface is exposed. Dry mouth adds to the risk. NIDCR notes that hundreds of medicines can reduce saliva, including some used for high blood pressure, depression and bladder control. Saliva helps keep harmful germs in check, so dry mouth raises the risk of tooth decay.²

What does the evidence say?

An ADA expert panel reviewed treatments that can stop or reverse early decay without drilling. For decay on root surfaces, the panel suggested prioritizing 5,000 ppm fluoride toothpaste or gel, used at least once a day, over options such as in-office fluoride varnish every few months.³

Is it right for everyone?

No. It’s meant for people at higher risk of decay, and your dentist decides whether you need it.¹ Ask if you have exposed roots, frequent new cavities, dry mouth, or a medicine list that includes several of the drug types above.

How do I use it?

Follow the package insert or your dentist’s directions exactly.¹ Ask your dentist:

• Should it replace my regular toothpaste, or be used once a day in addition?
• Should I spit without rinsing afterward?
• How long should I use it before we recheck?

Keep the tube out of reach of children and grandchildren, as you would any prescription.

What will it cost?

Ask your dentist whether a generic version is available, and check with your pharmacy and dental or medical plan about coverage. If you’re paying cash, ask the pharmacist to compare prices.

What about dry mouth itself?

NIDCR advises seeing your dentist or doctor to find the cause of ongoing dry mouth. Sometimes a medicine change helps.² Bring your full medicine list to the appointment.

Try: “My gums have pulled back and my mouth is often dry from my medicines. Would a prescription fluoride toothpaste help protect my roots?”

Is It My Breath? includes a visit script. Use it to bring your medicine list and questions about dry mouth and decay to your next dental visit.