The fluoride in toothpaste reacts with the enamel – which has a substance called hydroxyapatite one the surface. This substance is covered in OH groups that can react with acids to make water and slowly dissolve away. Acids are formed when bacteria metabolize sugars. The fluoride reacts with the hydroxyapatite and converts it to fluoroapatite, which is resistant to reaction with acids, slowing decay of the enamel.
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