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The curious history of NovaMin toothpaste (2018) (medium.com/ravenstine)
129 points by miles on April 2, 2021 | hide | past | favorite | 37 comments



'Why do I have a tab with a search about NovaMin open already?'

NovaMin was mentioned in a comment by @dannyw two days ago: https://news.ycombinator.com/item?id=26642987

The author of this Medium post mentioned this link in a comment ~10 months ago: https://news.ycombinator.com/item?id=23345716

Some comments mentioning NovaMin over the years: https://hn.algolia.com/?dateEnd=1609372800&dateRange=custom&...


It looks to be decent at helping sensitive teeth, but not so much for cavities: https://aap.onlinelibrary.wiley.com/doi/abs/10.1902/jop.2010...

https://www.karger.com/Article/Abstract/453622


This article covers the older NovaMin which is used in the commonly available Sensodyne toothpaste, NovaMin is an older formula, BioMin is the newer replacement.

https://www.biomin.co.uk/science-information/bioactive-glass...

https://www.biomin.co.uk/professional-information/clinical-s...


"First fluoride-containing bioglass toothpaste cleared for sale in the US" - Dec 2020

https://www.dental-tribune.com/news/first-fluoride-containin...


Last I checked, there isn't clear evidence that Biomin F is superior to Novamin. Some studies show Biomin F is better, but some studies show they have the same effect.


There is also Nano-Hydroxyapatite toothpastes, from Japan. From my naive understanding, it is better than NovaMin and Flouride generally - there has been a lot of research on it.


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5121804/ An In-vitro Comparison of Nano Hydroxyapatite, Novamin and Proargin Desensitizing Toothpastes - A SEM Study

Results

The qualitative analysis showed no occlusion of the dentinal tubules in Group A (control group) and Group B (nano-hydroxyapatite) showed 98.1% tubule occlusion. Group C (Novamin) and D (Proargin) showed 83.1% and 69.1% tubule occlusion respectively. Quantitative analysis showed a statistical significant difference between Group B and D (p< 0.005) and no statistical significant difference between group B and C (p= 0.235). Similarly, there was no significant difference between Group C and D as (p=0.235).

Conclusion

It was concluded that all the three desensiting agents were effective in the dentine tubule occlusion. In addition efficacy of nano-hydroxyapatite toothpaste was greater compared to the other desensiting agents.


Is that the same as zinc hydroxyapatite? In Italy it's pretty well known under the brand name BioRepair (which is how I discovered about it, and personally I'm very satisfied with it)


Probably not. Though probably both are somehow effective.

In this https://www.sciencedirect.com/science/article/pii/S030057121... they study some difference between the Zinc-nano-Hydroxyapatite vs pure nano-Hydroxyapatite.

But zinc-hydroxyapatite in BioRepair may not be some Zinc-nano-Hydroxyapatite. They are the same compounds but the size of the crystals are not the same. BioRepair is advertised as "microRepair".

The size of the crystals seems to matter : smaller crystals are better as they allow to get inside smaller holes to fill them, but probably also more expensive to produce.

Source : https://www.hindawi.com/journals/jnm/2009/746383/ >"It can be supposed that the application of CHA nanocrystals 20 nm sized allows a better mineralization in the lower surface fissure, because the interprismatic and prismatic enamel structures appear totally hidden. Using an equal time of treatment, the application of CHA nanocrystals 100 nm sized produces the formation of a homogeneous coating which hides interprismatic and prismatic enamel structures when examined with SEM."

Toothpaste is kind of a complex mixture that also depends on the PH and the interaction with saliva to work. Therefore probably only specific studies between the full products using a microscope could tell the better products.

As a final note, the tooth mineralization is a tug-of-war (dynamic equilibrium) between demineralization and remineralization, this means that using more effective products should be used carefully and not as an excuse to compensate for bad behavior like excessive soda consumption throughout the day.


Study that comparey biorepair and sensodyne https://onlinelibrary.wiley.com/doi/full/10.1002/sca.21105


so they tested 2 Biorepair products, but only one was effective


I bought a tube of this ("Boka" brand). I can't personally vouch for its efficacy (not a dentist), but I find it extremely pleasant to use.

It has a much milder, non-minty flavor (I picked the ginger); the instructions indicate that you use it at night, and don't rinse, just spit. It doesn't taste "toothpastey" at all, actually quite nice, I don't mind leaving on my teeth overnight at all. I use a normal fluoride in the morning.


On the toothpaste technology front I’ve been using Livionex[1] for years now and I can’t believe it hasn’t caught a larger following, especially with the HN crowd. You can feel the plaque reduction. Occasionally I’ve had to use traditional paste while traveling and it’s really quite a gross sensation now that I’m accustomed to the gel.

I have no affiliation with the company other than being a very satisfied customer.

[1]https://getlivfresh.com/how-it-works/


Interesting. Here [1] is a study that tests the efficacy this product. No idea if this open access journal is reputable or even peer-reviewed.

Looks like the active ingredient, edathamil, is another name for EDTA, a chelating agent which is also used as a preservative, so it should be safe.

I wish these newer toothpaste were cheaper, though:

• Livionex — $14.26/fl oz ($20 for 1.75 fl oz)

• Boka — $3/fl oz ($12 for 4 fl oz)

• Dr. Collins Biomin — $2.39/fl oz ($8 for 3.5 fl oz)

• Sensodyne with Novamin — $4.95/fl oz ($13.40 for 2.70 fl oz)

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4454341/


If they add some stannous fluoride and make it foamy I'd probably try it.

The Verdict: The gel, called Livionex, removed plaque better than Colgate Total—a popular product used as a comparison—in a study at the University of California, Irvine. The results look promising, but longer studies with more subjects are needed, particularly since the new gel doesn’t contain fluoride, dentists say.

“Fluoride has 150 years of solid research proving that it does prevent cavities and tooth decay,” says Sally Cram, a Washington, D.C., periodontist and a spokeswoman for the American Dental Association. If you’re thinking about trying the new gel, Dr. Cram suggests talking to your dentist about your risk for tooth decay and considering using fluoride mouthwash along with it. [0]

[0]https://www.wsj.com/articles/anti-plaque-dental-gel-excels-1...


I'll wait for more and longer term studies before I try it. Maybe it slowly erodes teeth, or destroys amalgam fillings since it's EDTA.


I was going to say... EDTA is also suspected to be the primary active ingredient in Evapo-Rust: https://www.youtube.com/watch?v=xf3ma1XFt9Y


So? That doesn't mean anything. Water is an ingredient in both, too.

EDTA is used in food, medicine, and dentistry. It's ingested, inhaled, and injected into people every day.[1]

In the video you linked Adam Savage reads out the safety warnings from the Evapo-Rust bottle ("non-toxic, biodegradable, safe on the skin and eyes") and from the Evapo-Rust SDS[2] it seems like a pretty darn safe product.

[1]https://en.wikipedia.org/wiki/Ethylenediaminetetraacetic_aci...

[2]https://evapo-rust.com/wp-content/uploads/2018/08/Evapo-Rust...


Acids such as citric acid are also very safe, but definitely not in the context of brushing teeth as they dissolve enamel. There simply isn't enough safety data _in that context_ for dentists to start recommending EDTA vs regular fluoride toothpaste. In one in vitro study I found, EDTA is shown to cause erosion https://www.medigraphic.com/pdfs/odon/uo-2012/uoi121b.pdf so I'd say more studies are required.


Another interesting teeth restoring substance I just discovered:

Oligopeptide P11-4 [1]

[1]https://en.wikipedia.org/wiki/Oligopeptide_P11-4


Came here to post the same thing. This is actually the state of the art [1]. A peptide that helps creating a scaffold to rebuild little enamel cracks.

If you apply some P11-4 varnish and you use a regular toothpaste results are quite good. Something to keep in mind is that fluoride might interfere with newer enamel repair technologies, but not with NovaMin.

Fluoride is nice, although I have some little concerns about swallowing it and getting some accumulation in soft tissue which alter calcium pathways. The Japanese strongly prefer HPA, which is safer and more effective. It's funny it has not become popular in the West.

I have tried basically all different technologies, and the only one that has made (a small) difference has been P11-4 plus a calcium salt toothpaste.

[1] https://sci-hub.st/https://link.springer.com/article/10.1007...


If there are regulatory issues selling it in the US, why can anyone in the US buy it on Amazon direct from the manufacturer?


On Amazon are many counterfeited products: there is no quality check, it is just a marketplace.

An expensive toothpaste sounds perfect to scam: ordinary white toothpaste can be very cheap and just by putting some text on the outside it becomes very valuable. One would need a lab to check if its true.


Novamin is very different from other toothpastes. I can feel it with my tongue - my teeth become glassy/hard in like 10 min, and the effect persists to the next day. I can’t speak to anyone else’s experience, but I can detect a scam toothpaste pretty quickly & send it back.


I tried the sensodyne version once, after buying from Amazon. That's not how I would describe it, instead the paste had an unusual warmth to it. Does that sound familiar to you? I'm just asking because I'm curious if I got the real stuff or not, no real way to know.


I've used retail Sensodyne with NovaMin. I second the feeling of warmth after brushing.


It doesn’t, but there might be variation between people? For me the toothpaste (sensodyne novamin) has a slightly crunchy feel, and yeah, the smooth glassy coating.

https://www.amazon.com/Sensodyne-Repair-Protect-Whitening-To...

I also use an electric toothbrush, so that might make a difference.


Probably because our regulatory agencies are reactive and spend their time on things other than taking down Novamin international toothpaste imports from Amazon, especially when it's probably the only "restricted" toothpaste in the USA.


I would have liked this to be a conspiracy for true crime fun but I appreciate the authors post script explaining the reasoning why it's not available.


It appears to be available in France: https://www.sensodyne.fr/produits/dentifrices/repare-et-prot...

EDIT: BioMin as well: https://biomin.fr/


Am I the only one getting a weird conspiracy vibe when reading the article?


There has been a similar story from last year when FDA red tape prevented certain types of pasta from being imported into the US.

https://www.grubstreet.com/2020/12/2020-bucatini-shortage-in...

To be fair this is not just limited to the US. In a theoretically free trade world, food safety regulation remains one of the few ways that states could still practice mercantilism.

https://www.livescience.com/47032-time-for-us-to-ban-ractopa...

https://www.bigissue.com/latest/the-truth-behind-the-chlorin...


Yeah, but it seems to be mostly because the change has been silent and under the covers. But what I gathered are two basic things:

One, GSK bought up the brand name NovaMin, possibly related patents. GSK took competitors (or their own product?) off the market, and pushed their premium and strongest brand Sensodyne to the front.

Two, toothpaste is considered a drug in the US and falls under strict rules. They can still use NovaMin / the chemical compound, it's still there, they're just not allowed to advertise with it.


Another tooth restorative product that is hard to find in the USA is CPP-ACP (Recaldent). Apparently there are some regulatory issues with this product as well. It's available in the USA as MI Paste, and in other countries as Recaldent gum. I was interested in this for a while as it seems promising and you can feel the anti-plaque slickness effect, but on the other hand, the research tends to be in lesser-known journals, which is suspicious to me.


Recaldent gum used to be widely available in the US. I was a big fan of the trident gum variety, which had recaldent and was sweetened with xylitol.

It was a solid product but it just disappeared one day. And unfortunately the shelf life for that gum was a bit worse than usual, so hoarding isn’t a great strategy.

I think last time I was able to get it was around 2010.

Edit: something is going wrong in American regulation of dental products. I should not have to illegally buy smuggled toothpaste and gum from Europe and Canada in order to maintain my dental health. I don’t understand how that makes anyone safer and regulators haven’t said why Americans are at risk in a way that Europeans aren’t.


I wonder how it compares to Elmex Gelee which is only sold in pharmacies and also recommended by dentists. It can also remove initial caries.


Back in 2012-14 I similarly found that Burt's Bee's was the only toothpaste with it locally, and went to eBay for more when it was discontinued.

I had a couple chips on my teeth I hoped would improve, but there was no change.

After my last tube ran out I realized that Colgate/Crest clean better anyway.




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