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Fluoride Ingestion and Toxicity


In 1974, a 3 year-old child died after swallowing a large amount of 2% stannous fluoride during his visit to the dentist. Since then, there have been apprehensions regarding the safety of fluoride applications for dental health.

Fluoride in dental treatments

Fluoride application, be it in toothpaste or gel, foam, or varnish forms, must be carefully monitored because there is a high likelihood of ingestion and toxicity, especially among toddlers. Fluoride, when ingested, is absorbed in the gastrointestinal tract, causing systemic effects of toxicity.

Hence, patients should not be left unattended by the dentist or nurse before or after fluoride varnish applications in the dental office. This is especially so when the materials are exposed and easily accessible to children.

Fluoride varnishes used in dental clinics contain higher fluoride concentration (2.26% up to 5%) compared to gels and foams (0.15% up to 1.23%). This compensates for the smaller amount of varnish applied for complete dentition. They are faster and easier to apply, which is its advantage over gels and foams, especially when used in children. However, because it has a higher fluoride content, fluoride varnish poses a greater risk of toxicity if taken internally in large amounts.

Like any other PATF, fluoride varnish application entails minimal risk as long as proper preventive measures are taken to minimize ingestion. Fluoride varnish can be applied twice- to four-times- a year, depending on the risk stratification, without adverse effects.

Fluoride in drinking water

Around 40% of the water supply in North America and Western Europe has fluoride added to it as a preventative measure against tooth decay. A few sources of drinking water actually have a natural fluoride content in it. It is estimated that the addition of fluoride to drinking water reduces problems of tooth decay by 20-30%.

However, some people have become so concerned about the risks of fluoride ingestion toxicity that they have set up groups to lobby for a reduction or removal of fluoride from drinking water. For the most part they have been unsuccessful in their attempts to have fluoride removed from drinking water.

Authorities claim that fluoride ingestion in the very low amounts that are present in drinking water is not a significant toxicity issue. Authorities suggest that the benefits of fluoride in drinking water to dental health outweigh any potential problems from drinking water with low fluoride content.

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