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Medicine LibreTexts

12.4: Fluoride

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Fluoride is a nonessential mineral. It is not required by the body and it is not widely found in the food supply. The majority of what we consume comes from fluoridated water. Other good non-dietary sources are fluoridated toothpaste and dental rinses1. Absorption of fluoride is near 100% for both dietary and non-dietary forms and it is rapidly excreted in the urine2.

Fluoride alters the mineralization of bones and teeth. It does this by replacing hydroxyl (OH) ions in hydroxyapatite (Ca10(PO4)6(OH)2), forming fluorohydroxyapatite. Fluorohydroxyapatite is more resistant to acid degradation than hydroxyapatite, leading to fewer cavities2.

Since it is a nonessential mineral, there is no fluoride deficiency, but lower levels are associated with higher dental cavity rates. This connection is why so many water supplies are fluoridated. However, fluoride can be quite toxic. Acute toxicity symptoms from large intakes of fluoride include1:

  • Nausea
  • Vomiting
  • Diarrhea
  • Convulsions

Chronic toxicity results in an irreversible condition known as fluorosis, characterized by the mottling and pitting of teeth as shown below.

clipboard_e53e85e138beccafae07bf20450ddfc21.png
Figure 12.4.1: Fluorosis3
clipboard_e38cc33a548e2ed35d9daa8cae15b32d8.png
Figure 12.4.2: Severe case of fluorosis4

As you can see from the figure below, fluorosis is more prevalent in the United States than most people would probably believe.

clipboard_e6b1b3f06e5bf5674abcc66981b16f69f.png
Figure 12.4.3: Fluorosis prevalence by age in the United States5

A comparison of the prevalence of fluorosis in US children, ages 12-15, indicates an increase from the late 1980s to the early 2000s5.

clipboard_e9d6f2ee2abd373a5d765df603db72e93.png
Figure 12.4.4: Change in dental fluorosis in 12-15 year-old US children5

There is debate as to whether water should be fluoridated. The following links are examples of just how conflicted the U.S. is. The first is a New York Times article on this topic. There is also an article about Portland’s decision to begin fluoridating its water in 2014. The third article is about a bill introduced by a Kansas lawmaker concerned about the effects of water fluoridation. Salina, Kansas, which is home to one of Kansas State University’s campuses, voted last November to not rescind its policy of fluoridating its water, as described in the fourth link.

Web Links

Query 12.4.1

Query 12.4.2

References

  1. Byrd-Bredbenner C, Moe G, Beshgetoor D, Berning J. (2009) Wardlaw's perspectives in nutrition. New York, NY: McGraw-Hill.
  2. Gropper SS, Smith JL, Groff JL. (2008) Advanced nutrition and human metabolism. Belmont, CA: Wadsworth Publishing.
  3. https://s3-us-west-2.amazonaws.com/c...E8266316CD.jpg
  4. https://s3-us-west-2.amazonaws.com/c...2CB324935B.jpg
  5. Beltran-Aguilar, ED, Barker, L, Dye, BA. (2010) Prevalence and Severity of Dental Fluorosis in the United States, 1999-2004. https://www.cdc.gov/nchs/products/databriefs/db53.htm

This page titled 12.4: Fluoride is shared under a CC BY-NC-SA 4.0 license and was authored, remixed, and/or curated by Brian Lindshield via source content that was edited to the style and standards of the LibreTexts platform.

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