Not all toothpastes contain fluoride. People do have this option, and it's very easy to find if you are looking for it.
Fluoride may or may not be necessary. Personally I try to avoid it when I can by using a toothpaste without, and drinking reverse osmosis water.
I am not an oral health professional, but as far as oral health goes, personally I'd say the bigger problem might be old dental amalgams. Take the following video click for example:
My dentist was careful to change our old amalgam to the new white ones years ago, and explained that they were healthier. And then I found the above video a few months ago.