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I have read many opinions from dentists, educated by the latest research, who claim otherwise.
Hydroxyapatite toothpaste has been on the market for a long time in Japan, and their statistics do not suggest that there is rampant decay in their population.
Topically applied fluoride only remineralizes the surface enamel, however, it is more resistant to acid-attack. The typical American diet and oral care habits make this a more desirable choice for those who are unwilling to commit to a consistent oral hygeine routine (and changing their diet + snacking/drinking habits).
Nano-Hydroxyapatite is similar to actual tooth structure and occludes dentinal tubules. This means it has superior remineralization capabilities, as it penetrates deeper into the tooth structure. For me, this has greatly reduced the sensitivity I have experienced (which is why I switched).
While the research has not quite caught up, it seems ideal that one ceases using fluoride toothpaste for a period of a few weeks to a few months and uses only nano-hydroxyapatite toothpaste to remineralize the parts that fluoride doesn't, and if their oral care routine isn't sufficient or they are showing signs of decay (due to e.g. acid attack or improper flossing/etc.), they then should use fluoride toothpaste exclusively after that point in time (until sensitivity occurs), or a mixture of the two toothpastes (such as using a product like CariFree, which contains both), as this will make the surfaces of their teeth more resistant to acid.
Now, as for fluoride added to the water supply, it's mostly useless to your teeth. Fluoride's benefits are topical, and most people do not give it a sufficient time to work (by leaving it on the teeth for 30 minutes). The fluoridated water doesn't stay on your teeth long enough to outweigh the benefits of proper toothpaste usage/application.
Even if studies in third world countries or other countries (like Canada) suggest there is a benefit to fluoridating the water supply, an increase in dental education (especially in parents with children) would be sufficient to outweigh the supposed negatives of ceasing a largely ineffective practice. Or through the regulation of foods and drinks that are known to directly contribute to the development of caries (especially in products targeting children).
Tooth decay doesn't magically happen, there are specific causes for it. Like repeatedly applying acids to the teeth (e.g. soda) without rinsing it off with water or leaving plaque on the teeth (which produces acid) - which inevitably hardens to tartar and leads to a cascade of effects on oral and gum health, including more acid production. Dry mouth is another big reason for decay, as saliva plays a big role in remineralization.
If dental care and education were more accessible, more people would know about fluoride/nano-hydroxyapatite varnishes or would have trays made that they use overnight to remineralize their teeth. The benefits of water fluoridation are nil compared to the effectiveness of prescription (or regular) fluoride toothpastes and a proper oral care routine/diet interventions. Regular interventions from hygienists and licensed dentists - like dental cleanings/check-ups every 6 months are also imperative for oral health.
According to case studies, 1-3% (of nanoXIM) is optimal for safety, sensitivity, remineralization, and whitening.