FLUORINE

Fluorine (F) is a gaseous chemical and potentially a toxic element. But its ion, fluoride is composed of fluorine bound to a metal, non-metal, or organic compound. 

Fluoride predominates in nature and the human body. It is present in the bones and teeth. The hardness of the tooth enamel and resistance to tooth decay is increased markedly by the incorporation of this mineral. However, taking high amounts of fluoride can lead to fluorosis resulting in the hardening of bones.

Why is Fluoride essential for the human body? 

The only beneficial role demonstrated for fluoride is reducing the prevalence and severity of dental caries in children and adults.

There are three ways in which fluoride may act to prevent tooth decay.

• Firstly, when fluoride is incorporated into the tooth early in life at the time of tooth eruption, the enamel containing fluorapatite becomes more resistant to damage by acids.

• Secondly, the enamel gets demineralized regularly by contact with food acids and demineralization occurs to ensure that enamel structure is maintained. Topical application of fluoride enhances demineralization and maintains the integrity of the enamel. 

• Lastly, fluoride inhibits and reduces the formation of acid from sugars on the teeth. It helps to prevent enamel demineralization and tooth decay. 

Fluoride also inhibits dental caries by affecting the activity of cariogenic bacteria.

For these reasons, fluoride is considered a beneficial element for humans but it is not an essential element. 

Drinking water contains fluoride that is sufficient for the human body. Fluoride levels of 0.7 to 1.2 mg/L in drinking water are considered safe. Levels above this can cause several health risks and should be avoided.

What are the signs and symptoms of fluoride deficiency?

Fluoride deficiency can lead to weakened tooth enamel and tooth decay.

What are the food sources of Fluoride?

The prime source of fluoride in most diets is water. Fluoridated municipal drinking water—including water that people drink as well as foods and beverages prepared using municipal drinking water accounts for about 60% of fluoride intake in most countries.

Foods provide only about 25% of the total intake. These include tea and marine fish, ready-to-use infant formulas made with fluoridated water. Brewed tea typically contains higher levels of fluoride than most foods. Tea plants take up fluoride from soil and depending on the type of tea and its source, the fluoride amounts may vary. Other foods which significantly contribute to fluoride in our diet are:

• Cereal and cereal products
• Meat
• Fish
• Potatoes
• Dairy products
• Sugar

What are the signs of fluoride toxicity?

Fluoride is a cumulative toxin. Ingestion of fluoride 1.0-1.5 mg/L for several years may produce dental fluorosis –  browning and pitting of teeth known as mottling.

Chronic high levels of fluoride in the range of 2-5 mg/L can cause skeletal fluorosis.

Crippling skeletal fluorosis can occur where drinking water containing higher than 10 mg/L is consumed for several years. The severe forms of skeletal deformity in toxic fluorosis include kyphosis (abnormal curvature of the spine), fixed spine, and other joint deformities.

A form of severe skeletal fluorosis known as Genu valgum (knocked knees) has been reported from India, China, and Africa. The condition is characterized by severe skeletal fluorosis and osteoporosis of the limbs. 

– Most toothpaste contains fluoride in the form of sodium fluoride or monofluorophosphate. It is present in amounts of 1,000 to 1,100 mg/L. The amount of fluoride ingested from toothpaste depends on the quantity used, the swallowing control, and how often the person uses toothpaste. Fluoride in toothpaste, regardless of its form, is well absorbed in the human body.

– Fluoride toothpaste is considered one of the best ways to reduce the chances of dental caries. However, for children aged less than 6 years, there is an increased risk for enamel fluorosis because of inadequately developed control of the swallowing reflex. Parents or caregivers should avoid fluoridated toothpaste. In case of using a fluoridated toothpaste, limit the child’s toothbrushing to < 2 times a day and apply only a pea-sized amount. Supervise toothbrushing, and encourage the child to spit out excess toothpaste. (Source: CDC)

– There is a limited reduction in dental caries after using a fluoride mouth rinse. Therefore, children below 6 years of age should not use fluoride mouth wash without consultation with a dentist or other healthcare provider. There is an increased chance of enamel fluorosis if fluoridated mouthwash is swallowed repeatedly. (Source: CDC)