Curse of Fluorosis

Abstract

Fluoride was identified to have caries preventive properties and was widely used for fluoridation of water since 1940, especially in developed countries. After this there was sudden increase in the use of fluorides in food items and in oral medicinal products like toothpastes and mouth washes. Inadvertent use of above has lead to increase in fluorosis as a public health problem. In many places high fluorides are naturally present in earth crust leading to high water fluoride content increasing the risk of fluorosis. Maintaining a fine balance of fluorides in the body is mandatory for exploiting its advantages. World Health Organization (WHO) has fixed permissible limit of fluorides in water to 1.5 mg/L as a preventive step to contain fluorosis. Fluorosis has three clinical components: Dental, Skeletal and Non-Skeletal Fluorosis. It occurs with increasing level of fluorides in the body. Acute toxicity due to fluorides is also known and occurs as a result of sudden exposure to high levels of fluorides, usually by ingestion. Once fluorosis occurs it is irreversible without any cure. Only symptomatic and supportive management is possible. Hence prevention is the mainstay of management. Prevention is by using alternative sources of water or its de-fluoridation. National Program for Prevention and Control of Fluorosis (NPPCF) was launched in 2008-9 to identify areas with high fluoride content of water, manage the water bodies, screen schools and community for fluorosis and comprehensive management of cases. Improving quality of drinking water as per standards and improving nutritional status of children are also important components of prevention of fluorosis.

Pathophysiology of Demineralization, Part I: Attrition, Erosion, Abfraction, and Noncarious Cervical Lesions

“…Despite broad-based opposition to fluoridation for many years, there are no scientific risks with F − use as promoted in dentistry [104,105]. However, the accumulative dose of F − including absorption spikes in ECF should not exceed 1part per million (ppm) to avoid fluorosis [106]. With respect to noncavitated white spot lesions (WSLs), F − is a double-edged sword.…”

“…The problem with optimal fluoridation of teeth and bones is the precise control of F − levels in saliva and ECF. If they are too low, inadequate FA is formed, but excessive F − levels, even if only transient, are toxic to mineralized tissue forming cells: osteoblasts (bone), ameloblasts (enamel), odontoblasts (dentin) [99,106]. Optimal F − in the public water supply is more effective than oral administration for an optimal F − effect in all age groups [89,99,100].…”

“…Optimal F − in the public water supply is more effective than oral administration for an optimal F − effect in all age groups [89,99,100]. For young children still forming teeth, fluoridated tooth paste must be carefully administered to avoid fluorosis particularly if the water supply is also fluoridated [103][104][105][106]. Adolescents and adults achieve FA protection on the outer surface and within the enamel rods via cyclic remineralization of enamel.…”

Fluoride and Pineal Gland

“…Significantly, the deposition of fluoride in hard tissues may have its own adverse effects. The symptoms of excessive fluoride accumulation in bones and teeth are known and well documented, classified as skeletal fluorosis and dental fluorosis, respectively [19][20][21][22][23][24]. In addition to deposition in hard tissues, fluoride may also be found in calcification areas in soft tissues such as the aorta [25][26][27][28][29], coronary arteries [30,31], placenta [32][33][34][35][36][37][38][39][40][41], tendons [42][43][44], or cartilage [42,45,46].…”

Infiltrants for Aesthetic Treatment of White Spots Lesions by Fluorosis: Case Report

“…Cuando el grado es leve, las lesiones ocasionadas por la fluorosis dental se caracterizan por presentarse como áreas opacas y blanquecinas. En casos moderados y graves las lesiones pueden adquirir una tonalidad marrón y volver el esmalte frágil y susceptible a la fractura (1,2).…”