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
exposed and easily accessible to
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%).
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
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
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
people have become so concerned about the risks of fluoride
ingestion toxicity that
set up groups
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.