text: I would say fluoride toothpaste is much more effective in the long run than bicarbonate. Fluoride has the ability to be incorporated into your enamel to make it even harder and less prone to caries. It also has the ability to help remineralize incipient caries. Another factor that makes fluoride a good choice is its antiseptic properties vs. bacteria. Fluoride will diffuse into bacterial cells and inhibit enolase, a protein used by bacteria to breakdown glucose into energy. Without a way to metabolize fuel, the bacteria will die.\n\nFluorinated water is usually in concentrations of about 1 part per million (ppm), which is great for children who still have developing teeth. Children can drink this low level of fluoride and some will be used to help form teeth. Studies have shown however that systemic fluoride does very little to prevent tooth decay in adults because our teeth have stopped developing. Topical fluoride treatment is much more effective for adult teeth and a typical fluoride toothpaste has about 1000 ppm.\n\nBicarbonate toothpastes are great for neutralizing the decay-causing acid secreted by the bacteria in your mouth. The problem is they only work while the toothpaste is in your mouth. There are no lasting effects and as soon you eat again, just as much acid will form. Unless you are willing to brush immediately after every time you eat, it won't likely serve as a great a benefit as fluoride.