Fluoride in toothpaste does help as well but it only does so much, and yes some toothpaste brands also don’t include fluoride. To get the most out of fluoridated toothpaste you need to pair it with a better diet. Most Americans eat a diet that’s incredibly heavy in sugars and carbs as compared to Europe. That’s part of the reason why many European countries found little benefit to adding fluoride to their drinking water, their rates of tooth decay were already significantly less than in the US due mostly to dietary differences.