|
Sign In to gain access to subscriptions and/or personal tools.
|
Fluoride in Dental Products: Safety Considerations
G.M. Whitford
Department of Oral Biology-Physiology, Medical College of Georgia, Augusta, Georgia 30912
This review summarizes the nature of acute fluoride toxicity, its time-course, and the fluoride doses that are involved. The generally accepted "certainly lethal dose" range for 70 kg adults, i.e., from 5 to 10 g of sodium fluoride or from 32 to 64 mg fluoride/kg, is discussed. Based on recent case reports of fluoride-induced fatalities, it is concluded that this dose range has little utility in cases involving young children. The concept of a "probably toxic dose" (PTD) is advanced. The PTD, 5.0 mg Flkg, is defined as the dose of ingested fluoride that should trigger immediate therapeutic intervention and hospitalization because of the likelihood of serious toxic consequences. The concentrations and quantities of fluoride in selected dental products are discussed in relation to the PTD. It is concluded that, as these products are currently packaged, most of them contain quantities of fluoride sufficient to exceed the PTD for young children. Recommendations are made to reduce the risk of toxicity associated with their use.
REFERENCES
- American Dental Association (1982): Fluoride Compounds. In: Accepted Dental Therapeutics, Chicago, IL: American Dental Association, 39th ed., pp. 344-368.
- Bayless, J.M. and Tinanoff, N. (1985): Diagnosis and Treatment of Acute Fluoride Toxicity, J Am Dent Assoc 110:209-211.[Abstract]
- Birdsong-Whitford, N.L.; Whitford, G.M.; Pashley, D.H.; and El Moslemany, I. (1987): Fluoride-induced Changes in Canine Gastric Mucosal Ion Fluxes, J Dent Res 66 (Spec Iss): 341, Abst. No. 1879.
- Black, M.M.; Kleiner, I.S.; and Bolker, H. (1949): The Toxicity of Sodium Fluoride in Man, NY State J Med 49:1187-1188.
- Church, L.E. (1976): Fluorides - Use With Caution, Maryland Dent Assoc J 19:106.
- Dean, H.T. (1942): The Investigation of Physiologic Effects by the Epidemiologic Method. In: Fluorine and Dental Health, F.R. Moulton, Ed., Washington, D.C.: Am Assoc Adv Sci, pp. 23-31.
- Dreisbach, R.H. (1980): Fluorine, Hydrogen Fluoride and Derivatives. In: Handbook of Poisoning, Los Altos, CA: Lange Medical Publishers, pp. 210-213.
- Dukes, M.N.G. (1980): Fluoride. In: Side Effects of Drugs, Annual 4, Oxford: Excerpta Medica, p. 354.
- Easmann, R.P.; Steflik, D.E.; Pashley, D.H.; McKinney, R.V.; and Whitford, G.M. (1984): Surface Changes in Rat Gastric Mucosa Induced by Sodium Fluoride: A Scanning Electron Microscopic Study, J Oral Pathol 13:255-264.[CrossRef][Medline]
[Order article via Infotrieve]
- Easmann, R.P.; Pashley, D.H.; Birdsong, N.L.; McKinney, R.V., Jr.; and Whitford, G.M. (1985): Recovery of Rat Gastric Mucosa Following Single Fluoride Dosing, J Oral Pathol 14:779-792.[CrossRef][Medline]
[Order article via Infotrieve]
- Eichler, H.G.; Lenz, K.; Fuhrmann, M.; and Hruby, K. (1982): Accidental Ingestion of NaF Tablets by Children: Report of a Poison Control Center and One Case, Int J Clin Pharmacol Ther Toxicol 20:334-338.[Medline]
[Order article via Infotrieve]
- Heifetz, S.B. and Horowitz, H.S. (1986): Amounts of Fluoride in Self-administered Dental Products: Safety Considerations for Children, Pediatrics 77:876-882.[Abstract/Free Full Text]
- Hodge, H.C. and Smith, F.A. (1965): Biological Properties of Inorganic Fluorides. In: Fluorine Chemistry, J.H. Simons, Ed., New York: Academic Press, pp. 1-42.
- Horowitz, H.S. (1978): Abusive Use of Fluoride, J CO Dent Assoc, Jan: 15-16.
- Horowitz, H.S. (1983): Safety First, J Pub Health Dent 43:194-195.
- Kempe, C.H.; Silver, H.K.; and O'Brien, D. (1974): Growth and Development. In: Current Pediatric Diagnosis and Treatment, 3rd ed., Los Altos, CA: Lange Medical Publishers, pp. 14-16.
- LeCompte, E.J. (1987): Clinical Application of Topical Fluoride Products: Risks, Benefits and Recommendations, J Dent Res 66:1066-1071.[Abstract/Free Full Text]
- Lidbeck, W.L. (1943): Acute Sodium Fluoride Poisoning, J Am Med Assoc 121:826-827.[Abstract/Free Full Text]
- Lim, J.K.; Renaldo, G.J.; and Chapman, P. (1978): LD50 of SnF2, NaF and Na2PO3F in the Mouse Compared to the Rat, Caries Res 12:177-179.[Medline]
[Order article via Infotrieve]
- Mornstad, H. (1975): Acute Sodium Fluoride Toxicity in Rats in Relation to Age and Sex, Acta Pharmacol Toxicol 37:425-428.[Medline]
[Order article via Infotrieve]
- Pashley, D.H.; Allison, N.B.; Easmann, R.P.; McKinney, R.V.; Horner, J.A.; and Whitford, G.M. (1984): The Effects of Fluoride on the Gastric Mucosa of the Rat, J Oral Pathol 13:535-545.[Medline]
[Order article via Infotrieve]
- Schrotenboer, G. (1981): Fluoride Benefits After 36 Years, J Am Dent Assoc 102:473-474.[Medline]
[Order article via Infotrieve]
- Shourie, K.L.; Hein, J.W.; and Hodge, H.C. (1950): Preliminary Studies of the Caries Inhibiting Potential and Acute Toxicity of Sodium Monofluorophosphate, J Dent Res 29:529-533.[Free Full Text]
- Whitford, G.M. and Ekstrand, J. (1980): Systemic Absorption of Fluoride from Alginate Impression Material in Humans, J Dent Res 59:782-785.[Abstract/Free Full Text]
- Whitford, G.M.; Finidori, C.; and Birdsong-Whitford, N.L. (1987): Acute LD50 Values of F Given as NaF and/or MFP in the Rat, Caries Res 21:166, Abst. No. 22.
- Whitford, G.M. and Pashley, D.H. (1984): Fluoride Absorption: The Influence of Gastric Acidity, Calcif Tissue Int 36:302-307.[CrossRef][Medline]
[Order article via Infotrieve]
Journal of Dental Research, Vol. 66, No. 5,
1056-1060 (1987)
DOI: 10.1177/00220345870660051501
 CiteULike  Complore  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter What's this?
This article has been cited by other articles:
|
|
|
|
 
S. Li, R. S. Hobson, Y. Bai, Z. Yan, T. E. Carrick, and J. F. McCabe
A method for producing controlled fluoride release from an orthodontic bracket
Eur J Orthod,
December 1, 2007;
29(6):
550 - 554.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. C. EICHMILLER, N. EIDELMAN, and C. M. CAREY
Controlling the fluoride dosage in a patient with compromised salivary function
J Am Dent Assoc,
January 1, 2005;
136(1):
67 - 70.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. Li
THE BIOCHEMISTRY AND PHYSIOLOGY OF METALLIC FLUORIDE: ACTION, MECHANISM, AND IMPLICATIONS
Critical Reviews in Oral Biology & Medicine,
March 1, 2003;
14(2):
100 - 114.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Topical fluoride for office use
J Am Dent Assoc,
April 1, 2002;
133(4):
502 - 503.
[Full Text]
[PDF]
|
|
|
|
|
|
|
V. Hind
Fluoride Mouthrinses
J. Orthod.,
September 1, 1999;
26(3):
242 - 243.
[Full Text]
[PDF]
|
|
|
|
|
|
|
G.M. Whitford
Acute and Chronic Fluoride Toxicity
Journal of Dental Research,
May 1, 1992;
71(5):
1249 - 1254.
[Abstract]
[PDF]
|
|
|
|
|
|
|
Public Health Service Report on Fluoride Benefits and Risks
JAMA,
August 28, 1991;
266(8):
1061 - 1067.
[PDF]
|
|
|
|
|
|
|
L. S. Kaminsky, M. C. Mahoney, J. Leach, J. Melius, and M. Jo Miller
Fluoride: Benefits And Risks of Exposure
Critical Reviews in Oral Biology & Medicine,
January 1, 1990;
1(4):
261 - 281.
[Full Text]
[PDF]
|
|
|
|
|
