Fluoride- Benefits, Uses, Safety & Fluoride Toxicity

Fluoride is a mineral that occurs naturally in many soil, rocks, some foods, and water; whose salts are typically white or colorless and odourless. Fluoride salts typically have distinctive bitter tastes. All tea leaves contain fluoride. Fluoride is an important mineral in your bones and teeth. Fluoride Toxicity is one of the most common Water-related diseases affecting the community. 

What are the benefits of fluoride?

• Protection from demineralization: It can prevent from tooth caries in greater extension.
• It can slow down the loss of minerals from tooth enamel (the hard outer crown surface of the tooth), fluoride helps rebuild (remineralize) weakened tooth enamel.
• It can prevent the growth of harmful oral bacteria in the mouth, which also may help to prevent from gingivitis (gum disease).
• It can help to maintain proper bone structure & strength; it prevents bone loss & Osteoporosis.

Tooth caries or Cavity prevention:

Fluoride-containing compounds, such as sodium fluoride orsodium monofluorophosphate are used in topical and systemic fluoride therapyfor preventing tooth decay. They are used for water fluoridation and in manyproducts associated with oral hygiene.

What is fluoride used for?

Fluoride is mainly used to improve dental health, sometime it is used to prevent or treat of osteoporosis & osteoarthritis. It is generally taken with water & foods. Other modes of fluoride:

• Toothpaste
• Mouth rinses
• Varnishes
• Cement and fillings
• Topical fluoride gel- mouthguard, which is applied to the teeth on dentist advice; gels can be painted on or applied via a mouthguard.
• Fluoride supplements- are also available as liquids and tablets and must be prescribed by your dentist, pediatrician, or family doctor.

Safety level of fluoride, recommended levels:

There are multiple controversies regarding the safety level of fluoride intake. The World Health Organization (WHO) notes that long-term exposure to drinking water that contains more than 1.5 ppm fluoride can lead to health problems. recommends a level of fluoride from 0.5 to 1.0 mg/L(milligrams per liter), depending on climate. Fluorosis becomes possible above this recommended dosage. As of 2015, the United States Health and Human Services Department recommends a maximum of 0.7 milligrams of fluoride per liter of water – updating and replacing the previous recommended range of 0.7 to 1.2milligrams issued in 1962. 

What are the risks of fluoride?

Excessive exposure to fluoride has been linked to multiple health issues.

• Dental fluorosis: Exposure to high concentrations of fluoride during teeth development can result in mild to moderate dental fluorosis. It can effect to milk tooth or permanent tooth. In mild condition there may be lacy white small, opaque, “paperwhite” areas markings that only dentists can detect. In more severe cases, however, the teeth may have yellow to dark brown Stains, Surface irregularities, Pits that are highly noticeable. People with fluorosis are relatively resistant to dental caries, although they may be of intrinsic tooth discoloration which affects the cosmetic. In moderate to severe fluorosis, teeth are physically damaged, Fluoride Toxicity became a problems in society.
• Skeletal fluorosis: Excess exposure to fluoride can lead to a bone disease known as skeletal fluorosis. Over many years, this can result in pain and damage to bones, ligaments and joints. The bones may become hardened and less elastic, increasing the risk of fractures. The early symptoms of skeletal fluorosis include stiffness and pain in the joints, with resulting impairment of muscles and pain. In severe cases, the bone structure may change and ligaments may calcify.
• Thyroid problems: In some cases, excess fluoride can damage the parathyroid gland. This can result in hyperparathyroidism, which involves uncontrolled secretion of parathyroid hormones.
• Neurological problems, report published on 19 September 2017, Research Open Access Prenatal Fluoride Exposure and Cognitive Outcomes in Children at 4 and 6–12Years of Age in Mexico.
• Sudden high-level exposure to fluoride causes immediate effects of abdominal pain, excessive saliva, nausea and vomiting. Seizures and muscle spasms may also occur.

Fluorosis is widely distributed in different countries, Fluoride contaminated groundwater is creating health problems in India. Nearly 90 million people including 6 million children in the country in 200 districts in 15 states are affected with dental, skeletal and/or non-skeletal fluorosis. The extent of fluoride contamination in groundwater varies from 1.0to 48 mg/l. The fluoride affected states are: Andhra Pradesh, Assam, Bihar, Delhi, Gujarat, Haryana, Jammu and Kashmir, Karnataka, Kerala, Madhya Pradesh, Maharashtra, Orissa, Punjab, Rajasthan, Tamil Nadu, and Uttar Pradesh. Rajasthan, Gujarat & Andhra Pradesh are the highly fluoride affected states, Fluoride Toxicity is became a major problem. 

What is Water fluoridation?

Adding fluoride to public water supplies is a safe and cost-effective way to prevent tooth decay and has played a major role in improving the public’s dental health; it can make teeth strong and reduces cavities. Water fluoridation is the controlled addition of fluoride to a public water supply. Community water fluoridation is the most effective way to deliver fluoride to people of all ages and income levels who live in a community. In 2011 the World HealthOrganization suggested the safe level of fluoride from 0.5 to 1 mg/L(milligrams per liter) or below 1.5mg/L; the fluoride level is also depending on climate, local environment, and other intake sources of fluoride. Indian Council of Medical Research(ICMR) is 1.0mg/L & Bureau of Indian Standards (BIS) is 0.6-1.2 mg/L. Public water fluoridation was first practiced in the U.S. Fluoridation does not affect the appearance, taste, or smell of drinking water. It is generally accomplished by adding sodium fluoride, fluorosilicic acid, or sodium fluorosilicate anyone out any of these three compounds to the water.

Written  by: Dr. Anuran Ghosh Mondal