Toxicity

Chronic intakes of up to 5mg fluoride/day in healthy adults appear to be safe. As intakes rise above this level, toxicity occurs. The first sign is dental fluorosis, in which the excess fluoride interferes with mineralization of the enamel and produces weakened, stained, and pitted enamel. Ingestion of more than 8-10 mg fluoride/day may produce skeletal deformities, osteoporosis, and osteomalacia, along with secondary hyperparathyroidism and calcification of soft tissues.2 3

References

  1. Burt BA. The changing patterns of systemic fluoride intake. J Dent Res. 1992;71:1228.
  2. National Research Council. Health effects of ingested fluoride. Washington, DC: National Academy Press; 1993.
  3. Whitford GM. The metabolism and toxicity of fluoride. Monographs in Oral Science. Vol. 16. Basel: Karger; 1996.
  4. Richmond VL. Thirty years of fluoridation: A review. Am J Clin Nutr. 1985;41:129.
  5. Horowitz HS. Commentary on and recommendations for the proper uses of fluoride. J Public Health. 1995;55:57.
  6. Kleerekorper M. Fluoride and the skeleton. Crit Rev Clin Lab Sci. 1996;33:139.
  7. Phipps KR. Fluoride. In: Ziegler EE, Filer LJ, eds. Present Knowledge in Nutrition. Washington DC: ILSI Press; 1996.
  8. Levy SM. Sources of fluoride intake in children. J Public Health Dent. 1995;55:39.
  9. Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D and Fluoride. Washington DC: National Academy Press; 1997.
  10. American Academy of Pediatrics. Fluoride supplementation for children. Pediatrics. 1995;95:777.
  11. Ismail AI. Fluoride supplements: current effectiveness, side effects and recommendations. Comm Dent Oral Epidemiol. 1994;22:164.
  12. Riggs BL, et al. Effect of fluoride treatment on the fracture rate in postmenopausal women with osteoporosis. N Engl J Med. 1990;322:802.
  13. Pak CYC, et al. Treatment of postmenopausal osteoporosis with slow release sodium fluoride: Final report of a randomized controlled trial. Ann Intern Med. 1995;123:401.
  14. Eastell R. Treatment of postmenopausal osteoporosis. N Engl J Med. 1998;338:736.

As sodium fluoride At bedtime, after brushing teeth11

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