Skip to main content

Fluorides

Stannous fluoride

Also listed as SnF2, tin fluoride, stabilised stannous fluoride

A fluoride that also fights gum inflammation, sensitivity and acid erosion, thanks to the tin. Can stain teeth brown in some people.

Strong evidenceTypical strength: 0.454% (about 1,100 ppm fluoride)

What it is

Stannous fluoride delivers the same anti-decay fluoride as sodium fluoride (about 1,100 ppm at the usual 0.454%), but the stannous (tin) ion adds three extras: it is antibacterial, it plugs the open tubules in exposed dentine that cause sensitivity, and it forms an acid-resistant layer that slows erosion from acidic drinks.

Older formulas stained teeth and tasted metallic; modern 'stabilised' versions reduce but do not always eliminate this.

How strong is the evidence?

Strong evidence

As a fluoride it prevents decay at least as well as other fluorides. Meta-analyses of six-month trials show a clinically meaningful reduction in gingivitis versus ordinary toothpaste, and network meta-analyses rank it among the most effective toothpaste ingredients for sensitivity. Many trials were run or funded by manufacturers, and results vary widely between studies.

What it's used for, checked

Prevents tooth decay

Holds up

Similar or slightly better than other fluoride toothpastes.

Reduces gingivitis (bleeding gums)

Holds up

Consistent but modest benefit over regular fluoride paste.

Relieves tooth sensitivity

Holds up

Moderate-to-high certainty in network meta-analyses; relief builds over 2-8 weeks of twice-daily use.

Protects against acid erosion

Holds up

Better than other fluorides in 7 of 8 studies, though most were at high risk of bias.

Works well with

  • potassium-nitrate
  • sodium-fluoride

Who should be careful

  • Can cause brown surface staining on teeth or tongue coating in some users; it polishes off at a cleaning and is less common with stabilised formulas.
  • 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.
  • Persistent sensitivity or bleeding gums need a dental check: they can signal decay, cracks or gum disease.

The studies

Every citation is checked against its PubMed record.

  1. A review of the effects of stannous fluoride on gingivitis.
    Paraskevas S, van der Weijden GA · J Clin Periodontol · 2006 · Systematic review / meta-analysis

    15 studies: stannous fluoride toothpastes reduced gingivitis compared with regular toothpaste, with less consistent effects on plaque; the size of the benefit was hard to pin down because results varied widely between studies.

  2. Stabilized stannous fluoride dentifrice in relation to dental caries, dental erosion and dentin hypersensitivity: A systematic review.
    Konradsson K, Lingstrom P, Emilson CG, et al. · Am J Dent · 2020 · Systematic review / meta-analysis

    Stabilised stannous fluoride paste gave similar or slightly better caries protection than other fluoride pastes (few, high-bias studies), better protection against acid erosion in 7 of 8 studies, and less sensitivity in a meta-analysis of six 8-week trials.

  3. A meta-analysis of six-month studies of antiplaque and antigingivitis agents.
    Gunsolley JC · J Am Dent Assoc · 2006 · Systematic review / meta-analysis

    Six-month trials showed a clinically meaningful anti-gingivitis effect for stannous fluoride pastes, the largest body of support (21 studies) for essential-oil rinses, and variable results for cetylpyridinium chloride rinses depending on the formula. Unpublished manufacturer studies were included.

  4. Desensitizing Toothpastes for Dentin Hypersensitivity: A Network Meta-analysis.
    Martins CC, Firmino RT, Riva JJ, et al. · J Dent Res · 2020 · Network meta-analysis

    125 RCTs (12,541 patients). Compared with ordinary fluoride paste, stannous fluoride, potassium salts (alone or combined with stannous fluoride), calcium sodium phosphosilicate, arginine and strontium reduced sensitivity to at least one stimulus, with moderate-to-high certainty.