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| Version | User | Scope of changes |
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| May 25 2008, 2:50 PM EDT (current) | 1candidate | 987 words added |
| May 25 2008, 2:42 PM EDT | 1candidate |
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What are normal Fluoride concentrations in body tissues and fluids?
What are the clinical signs of Fluorosis?
The effects of excessive Fluoride intake on the human body are not limited to bones and teeth. Therefore, having observed clinical signs of any one of Dental, Skeletal, or Systemic Fluorosis, the physician or dentist should be on the look-out for other manifestations of Fluoride toxicity in their patients.
Clinical Signs of Fluorosis;
1. Mottled Dentition:
Click here to see pictures of Dental Fluorosis associated with different concentrations of Fluoride in drinking water.
2. Abnormal Tissue Mineralization:
Click here to view a diagnostic protocol for Skeletal Fluorosis developed by Indian healthcare providers.
3. Elevated Body Fluid Fluoride Concentrations:
What are the symptoms of Fluorosis?
Though apparently vague and non-specific, most of the symptoms of Fluoride toxicity point towards some kind of profound metabolic dysfunction, and are strikingly similar to the symptoms of Hypothyroidism.
Symptoms of Fluorosis
What other diseases are related to Fluorosis?
In answer to the question, "So what brings you into the clinic today?", you are not likely to hear the answer "Fluorosis" from many of your patients or their guardians, even though further investigation may reveal that Fluoride toxicity is indeed the reason for their visit. Fluorosis is notoriously difficult to nail down with a diagnosis; however, it is a helpful practice to consider it a Fluorosis Purple Flag (as opposed to a red flag) in cases where;
| Body Tissue or Fluid | Normal Fluoride Concentration | Comments/Reference |
| Tooth Enamel | 900-1000 mg/kg |
|
| Tooth Dentin | 1800-3000 mg/kg |
|
| Bone | 200-800 mg/kg (ashed wt.) in 20-30 year-olds and 1000-2500 mg/kg (ashed wt.) in 70-80 year-olds consuming 0.5 mg/l Fluoride in drinking water |
|
| Muscle | 0.05 mg/kg | (Pais, 1997) |
| Other Soft Tissues | >1.0 mg/kg (wet wt.) |
|
| Blood (plasma) | 10-15 µg/l |
|
| Urine | >1.0 mg/l |
|
| Saliva | 6.5-9.8 µg/l | (Ekstrand et al., 1977a) |
| Sweat | only a few % of total Fluoride intake |
|
| Faeces | >0.2 mg/day |
|
| Breast Milk | 0.01 mg/l or 10 µg/l |
|
What are the clinical signs of Fluorosis?
The effects of excessive Fluoride intake on the human body are not limited to bones and teeth. Therefore, having observed clinical signs of any one of Dental, Skeletal, or Systemic Fluorosis, the physician or dentist should be on the look-out for other manifestations of Fluoride toxicity in their patients.
Clinical Signs of Fluorosis;
1. Mottled Dentition:
| Clinical Observation | The most "tell-tale" sign of chronic Fluorosis. Bilateral patches of white-yellow-brown mottling are caused by Fluoride mineralization (i.e. replacement of hydroxyl ion) of tooth enamel, typically during early childhood. |
| Diagnostic Methods | Degree of severity of Dental Fluorosis determined by the TF or Dean's Index, which ranges from 1 Mild (overall blanching) to 10 Severe (dark staining, pitting, and breakage). Direct visual appraisal, computer-aided evaluation of a digital or film photograph of the dentition taken under standardized conditions (i.e. using additional lighting and cheek spreaders), chemical analysis of available tooth material |
| Differential Diagnosis | Blunt trauma to the tooth surface, childhood episodes of malnutrition, gestational anitibiotic exposure, high altitude-induced amelogenesis. |
Click here to see pictures of Dental Fluorosis associated with different concentrations of Fluoride in drinking water.
2. Abnormal Tissue Mineralization:
| Clinical Observation | Not as obvious as dental mottling, but the conversion of hydroxyapatite (i.e. the mineral constituent of hard tissues) to fluorapatite in bone involves essentially the same process. Soft tissues and articular surfaces may also be abnormally mineralized; however, loss of function may not be limited to joints that are typically susceptible to "wear and tear" injury. Whereas fluorosed soft tissues lose elasticity and take on a "thickened" appearance radiographically, hard tissues become brittle and degenerative, with X-rays showing overgrowth or decalcification of bone. |
| Diagnostic Methods | Range of motion testing, radiography, tissue biopsy for chemical analysis. |
| Differential Diagnosis | Osteoarthritis, osteoporosis, calcific tendinitis, calcinosis. |
Click here to view a diagnostic protocol for Skeletal Fluorosis developed by Indian healthcare providers.
3. Elevated Body Fluid Fluoride Concentrations:
| Clinical Observation | The only truly definitive signs of Systemic Fluorosis, which is a syndrome which may be linked with nearly every major multi-causal affliction of the 21st Century. Typically, death by acute Fluoride Poisoning is the result of cardiac failure, due to extreme blood chemistry imbalance. |
| Analytical Methods | Fluoride ion specific electrode (F ISE), ion chromatography (IC). |
What are the symptoms of Fluorosis?
Though apparently vague and non-specific, most of the symptoms of Fluoride toxicity point towards some kind of profound metabolic dysfunction, and are strikingly similar to the symptoms of Hypothyroidism.
Symptoms of Fluorosis
- Learning Disorders/Difficulty Concentrating/Incoherence/Memory Loss/Confusion
- Body Temperature Disturbances/Cold Shivers
- Chest Pains
- Heart Palpitations
- Depression
- Dizziness/Vertigo
- Dyspepsia
- Excessive Sleepiness/Fatigue
- Headaches/Migraines
- Joint Pains
- Nausea
- Restlessness
- Sensitivity to Light
- Shortness of Breath
- Difficulties Swallowing
- Thirst
- Tinnitus
- Visual Disturbances
What other diseases are related to Fluorosis?
In answer to the question, "So what brings you into the clinic today?", you are not likely to hear the answer "Fluorosis" from many of your patients or their guardians, even though further investigation may reveal that Fluoride toxicity is indeed the reason for their visit. Fluorosis is notoriously difficult to nail down with a diagnosis; however, it is a helpful practice to consider it a Fluorosis Purple Flag (as opposed to a red flag) in cases where;
- the patient has consumed drinking water containing more than 1.5 mg/l over an extended period (especially during early childhood),
- the patient has resided close to a possible point source of natural or anthropogenic F pollution during their lifetime (including in utero), and
- the patient is currently complaining of, or there is a documented medical history of any combination of,
| Complaint | Diagnosis |
| Tooth discolouration, pitting and/or breakage | Dental Fluorosis |
| Bone pain and/or fracture | Osteoporosis |
| Joint pain and/or loss of range of motion | Osteoarthritis |
| Nerve and/or low back pain | Neural and/or spinal degeneration |
| Fatigue, with or without weight gain | Hypothyroidism |
| Infertility | Male reproductive dysfunction |
| Behavioural problems | Attention Deficit Hyperactivity Disorder |
| Memory loss | Alzheimer's Disease |
| Recurrent illness | General immune dysfunction |
| Digestive problems, diarrhea, weight loss | Gastrointestinal disturbances |
| Skin irritations | Eczema, dermatitis, acne |
| Heart palpitations, chest pain | Non-specific cardiovascular dysfunction |
| Frequent headaches | Migraines |
| Urinary problems | Kidney dysfunction |
