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Fluorides

Sodium monofluorophosphate

Also listed as SMFP, MFP, monofluorophosphate

A fluoride source that works in chalk-based toothpastes where sodium fluoride would be neutralised. Protects against decay about as well as sodium fluoride.

Strong evidenceTypical strength: 0.76-1.14% (1,000-1,500 ppm fluoride)

What it is

Sodium monofluorophosphate holds its fluoride in a phosphate group that saliva enzymes release in the mouth. That lets it coexist with calcium-based abrasives such as calcium carbonate (chalk), which would lock up free sodium fluoride inside the tube.

A 0.76% concentration gives 1,000 ppm fluoride; 1.14% gives 1,500 ppm.

How strong is the evidence?

Strong evidence

Numerous clinical trials show SMFP toothpastes prevent decay. Head-to-head comparisons with sodium fluoride were long argued over; pooled analyses found no clinically meaningful difference. Those analyses were written largely by industry scientists, but the broader Cochrane evidence on fluoride toothpaste includes both.

What it's used for, checked

Prevents tooth decay

Holds up

Equivalent to sodium fluoride at matched fluoride levels in pooled trials.

Better than sodium fluoride

False

No meaningful difference; the choice is driven by which abrasive the paste uses.

Works well with

  • calcium-carbonate

Who should be careful

  • Children under 3: a smear the size of a grain of rice; ages 3-6: a pea-sized amount, with an adult supervising so they spit rather than swallow.
  • Same fluorosis and swallowing cautions as any fluoride toothpaste.

The studies

Every citation is checked against its PubMed record.

  1. The anti-caries efficacy of calcium carbonate-based fluoride toothpastes.
    Lynch RJ, ten Cate JM · Int Dent J · 2005 · Narrative review (industry author)

    Sodium monofluorophosphate in calcium carbonate toothpastes is an effective anti-caries combination in numerous clinical trials; the authors propose that calcium carbonate may add benefit by raising plaque calcium and neutralising acid, which is mechanistic and not separately proven.

  2. Clinical anticaries efficacy of NaF and SMFP dentifrices: overview and resolution of the scientific controversy.
    Volpe AR, Petrone ME, Davies R, Proskin HM · J Clin Dent · 1995 · Review / pooled analysis (industry authors)

    Re-analysing the head-to-head clinical trials, the authors found no statistically significant or clinically meaningful difference in caries prevention between sodium fluoride and sodium monofluorophosphate toothpastes.