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12.4: Fluoride

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    21041
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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 (\(\ce{OH}\)) ions in hydroxyapatite (\(\ce{Ca10(PO4)6(OH)2}\)), forming fluorohydroxyapatite. Fluorohydroxyapatite is more resistant to acid degradation than hydroxyapatite, leading to fewer cavities2.

    Before and after images of a smile showing noticeable dental improvement and whitening.
    Figure \(\PageIndex{1}\): Fluorosis3

    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.

    Dental x-ray showing a close-up view of upper teeth with visible cavities and decay.
    Figure \(\PageIndex{2}\): 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.

    Bar chart showing percentages of dental floss usage among different age groups in the U.S. from 1999 to 2004.
    Figure \(\PageIndex{3}\): 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.

    Bar chart comparing changes in preferred energy sources among adults aged 18-64 from 1992-1997 and 1998-2014.
    Figure \(\PageIndex{4}\): Change in dental fluorosis in 12-15 year-old US children5

    There is debate as to whether water should be fluoridated. The following link describes the history in Portland, the largest city in the country to not fluoridate its water. The second link is a CDC resource which allows you to learn more about water fluoridation in different geographic areas in the US.

    ADAPT \(\PageIndex{1}\)
    ADAPT \(\PageIndex{2}\)

    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.