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Fluoride Toxicity
  Fluorosis
 Signs, symptoms, indicators
 Conditions that suggest it
 Contributing risk factors
 It could instead be...
 Treatment recommendations
 


"After a handshake, a friendly smile is one of the most important elements in creating a good first impression. However, it's hard to smile if you're self-conscious about teeth that are yellow or stained." [University of New York, School of Dental Medicine, Oral Health Letter] According to the U.S. Public Health Service, fluoride makes dental enamel more porous, and makes bones more brittle.

The toxic effects of fluorosis take three forms: skeletal, clinical (non-skeletal) and dental (enamel). Dental fluorosis is extensively described by toxicologists as the first visible sign of chronic fluoride poisoning [Taber, CW. Taber's Cyclopedic Medical Dictionary, F.A. Davis Co., Philadelphia, PA, 1994]. Research thus far indicates that the manifestations of fluorosis are irreversible.

Dental Fluorosis
A 1998 survey by the American Academy of Cosmetic Dentistry showed that:

  • More than 92% of adults agree that an attractive smile is an important social asset
  • 85% believe that an unattractive smile makes a person less appealing to the opposite sex
  • 75% believe that an unattractive smile can be detrimental to a person's chances of career success
  • Half of the respondents see unattractive teeth as a sign of poor personal hygiene.
Skeletal Fluorosis
The disease known as crippling skeletal fluorosis develops in stages, with phase two described as chronic joint pain, dose-related calcification of ligaments, osteosclerosis, and possible osteoporosis. Phase three includes "crippling deformities of the spine and major joints."

According to the U.S. government experts, most people currently ingest about four times as much fluoride as they did during the early days of water fluoridation - approximately equally divided between drinking water, food, other beverages, and dental products.

Incidence; Causes & Development
According to the UK Government's systematic scientific review on water fluoridation, carried out at York University, some 48% of people living in areas with fluoridated water are affected by dental fluorosis. In England, this translates to nearly three million individuals who have fluorosed teeth to some degree. For three quarters of a million people, dental fluorosis is of the "moderate to severe" degree. [McDonagh MS, Whiting PF, Wilson PM, Sutton AJ, Chestnutt I, Cooper J, Misso K, Bradley M, Treasure E, Kleijnen J. Systematic review of water fluoridation. BMJ 2000; 321: pp.855-9]

Fluorosis is increasing significantly in areas with and without artificially fluoridated water and is caused by over-exposure to fluorides from all sources, e.g. fluoridated water, fluoride toothpaste, mouth rinses, drops, tablets, gels, sealants and fluoridated school milk programmes. Fluorides are also found in foodstuffs, beverages, (particularly tea), medicines, anesthetics, pesticides, herbicides and in the polluted air we breathe.

Fluoride wastes are created through the production of aluminum, steel, cement, glass, fertilizer, fuels, refrigerants, rat poison, pesticides, uranium and many other items. They are released into the air, water and soil, constantly increasing our exposure to this bioaccumulative substance which is more toxic than lead.

Diagnosis & Tests
The diagnosis of skeletal fluorosis, until recent years, was made with the help of radiographs which reveal interosseous membrane calcification, enhanced bone density, and bone mass. These are, however, late characteristics of the disease. Recognizing the disease at such late stages does not help prevention. The disease is usually irreversible by then.

Complications
In 1985, following a review commissioned by the United States Environmental Protection Agency (EPA), an independent panel of behavioral scientists found that people with moderate to severe fluorosis are at increased risk of experiencing psychological and behavioral problems. [Drinking Water Regulations; Fluoride. 50 Fed. Reg. 220, 47144 (1985), Welbury, P, Shaw, L. A simple technique for removal of mottling, opacities and pigmentation. Dental Update 1990; 17: 161-3]

Major Related Diagnoses:
Alzheimer's disease/demyelinizing diseases, anemia, arthritis, breast cancer, carpal tunnel syndrome, decrease in testosterone/spermatogenesis, altered vas deferens/testicular growth, decreased dental arch, dental crowding, delayed tooth eruption, diabetes insipidus, diarrhea, Down syndrome, early onset of puberty, eosinophilia, eye/ear/nose disorders, fever, gastro-intestinal disturbances, gingivitis, heart disorders, hypertension, hypoplasia, hypothyroidism/thyroid cancer, kidney dysfunction, osteosarcoma, low birth weight, candidiasis, multiple sclerosis, oral squamous cell carcinoma, Parkinson's disease, seizures, slurred speech, skin irritations, ankylosing spondylitis, telangiectasia, thrombosis, ulcerative colitis, uterine cancer, vaginal bleeding, weak pulse.





Signs, symptoms & indicators of Fluoride Toxicity:
Symptoms - Cardiovascular  Heart racing/palpitations

Symptoms - Food - Beverages

  Constant/frequent thirst
 Excessive thirst (and resultant frequent urination) can be early warning signs of fluorosis.

Symptoms - Food - General

  Weak appetite
 Loss of appetite is an early sign of fluorosis.

Symptoms - Gas-Int - General

  Difficulty swallowing
  Frequent/regular unexplained nausea
 Nausea is an early sign of fluoride toxicity.

Symptoms - General

  Constant fatigue
 Unusual and excessive sleepiness/fatigue is a symptom.

  General dizziness
 Dizziness and vertigo are signs of fluorosis.

Symptoms - Head - Eyes/Ocular

  Vision disturbances
  (High) sensitivity to bright light

Symptoms - Head - Mouth/Oral

  Having signs of fluorosis

Symptoms - Metabolic

  Frequent/occassional 'chills'
 Symptoms include body temperature disturbances and cold shivers.

  Hyperactivity
 Restlessness is one symptom of fluorosis.

Symptoms - Mind - General

  Having trouble concentrating
 Learning disorders, difficulty concentrating, incoherence, memory loss and confusion are all signs of fluorosis.

  Poor/reduced mental clarity
  Frequent/occasional confusion/disorientation
  Having a learning disability

Symptoms - Muscular

  Individual weak muscles
 Early warning signs of fluorosis include loss of muscle power, weakness and pain.

Symptoms - Nervous

  Numb/tingling/burning extremities

Symptoms - Respiratory

  Deep chest pain
  Shortness of breath

Symptoms - Skeletal

  Joint pain/swelling/stiffness

Conditions that suggest Fluoride Toxicity:
Digestion  Dyspepsia / Poor Digestion
 Studies have shown that ingested fluoride damages gastroduodenal mucosa. Gastrointestinal discomfort can be an early warning sign of fluorosis, so fluoride toxicity should be considered a possible reason for non-ulcer dyspepsia and gastrointestinal discomfort in the form of dyspeptic symptoms should be an important diagnostic feature when identifying fluorosis patients and should not be dismissed as non-specific. [Susheela AK, Das TK, Gupta IP, Tandon RK, Kacker SK, Ghosh P, and Deka, Fluoride ingestion and its correlation with gastrointestinal discomfort, Fluoride, 1992, 25:l, pp.5-22]

The gastro-intestinal system is one of the most sensitive systems in the body to react adversely to fluoride toxicity. There are now many case histories available to establish the correlation of fluoride toxicity to gastro-intestinal problems.

  Constipation
 Chronic constipation is an early sign of fluorosis.

  Diarrhea
 Chronic diarrhoea is an early sign of fluorosis.

Mental

  Poor Memory
  Depression

Metabolic

  Tinnitus
  Migraine/Tension Headaches
 Persistent headaches are one sign of fluorosis.

Musculo-Skeletal

  Osteoporosis - Osteopenia
 Fluorides destroy collagen, which is the glue that adds strength to the bones.

  Muscle Pains (Myalgia)

Organ Health

  Vertigo

Risk factors for Fluoride Toxicity:
Symptoms - Metabolic  History of migraine headaches
 Persistent headaches are one sign of fluorosis.

Fluoride Toxicity could instead be:
Hormones  Hypothyroidism
 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.

Recommendations and treatments for Fluoride Toxicity:
Mineral  Calcium
 It has been observed that the ingestion of calcium, vitamin C or vitamin D, individually, is effective in protection from fluoride toxicity to a certain extent.

A double blind control trial was conducted to examine the effect of a combination of calcium, vitamin D3 and ascorbic acid supplementation in fluorosis-affected children. 25 children were selected from an area consuming water containing 4.5ppm of fluoride. All the children were in the age group 6-12 years and weighed 18-30kg. They were graded for clinical, radiological and dental fluorosis and relevant biochemical parameters. Grade I skeletal fluorosis and all grades of the manifestation of dental and clinical fluorosis were observed. The children were given ascorbic acid, calcium and vitamin D3 well below the toxic dosages in a double blind manner using lactose as a placebo. Follow up revealed a significant improvement in dental, clinical and skeletal fluorosis and relevant biochemical parameters in these children. Thus, the study indicated that fluorosis can be reversed, at least in children, by a therapeutic regimen that is fairly cheap, simple and easily available and without any side-effects.

Vitamins

  Vitamin D
 See link between Fluorosis and Calcium.

  Vitamin C (Ascorbic Acid)
 See link between Fluorosis and Calcium.


KEY
Weak or unproven link
Proven definite or direct link
May do some good


GLOSSARY

Alzheimer's Disease (Alzheimer's)
A progressive disease of the middle-aged and elderly, characterized by loss of function and death of nerve cells in several areas of the brain, leading to loss of mental functions such as memory and learning. Alzheimer's disease is the most common cause of dementia.

Anemia (Anaemia, Anemias)
A condition resulting from an unusually low number of red blood cells or too little hemoglobin in the red blood cells. The most common type is iron-deficiency anemia in which the red blood cells are reduced in size and number, and hemoglobin levels are low. Clinical symptoms include shortness of breath, lethargy and heart palpitations.

Arthritis (Arthritic)
Inflammation of a joint, usually accompanied by pain, swelling, and stiffness, and resulting from infection, trauma, degenerative changes, metabolic disturbances, or other causes. It occurs in various forms, such as bacterial arthritis, osteoarthritis, or rheumatoid arthritis. Osteoarthritis, the most common form, is characterized by a gradual loss of cartilage and often an overgrowth of bone at the joints.

Calcium
The body's most abundant mineral. Its primary function is to help build and maintain bones and teeth. The body also needs calcium to carry nerve signals, keep the heart functioning, contract muscles, clot blood and maintain healthy skin. Calcium helps control blood acid-alkaline balance, plays a role in cell division, muscle growth and iron utilization, activates certain enzymes, and helps transport nutrients through cell membranes. Calcium also forms a cellular cement called ground substance that helps hold cells and tissues together.

Cancer
Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.

Candidiasis (Candida)
Infection of the skin or mucous membrane with any species of candida, usually Candida albicans. The infection is usually localized to the skin, nails, mouth, vagina, bronchi, or lungs, but may invade the bloodstream. It is a common inhabitant of the GI tract, only becoming a problem when it multiplies excessively and invades local tissues. Growth is encouraged by a weakened immune system, as in AIDS, or with the prolonged administration of antibiotics. Vaginal symptoms include itching in the genital area, pain when urinating, and a thick odorless vaginal discharge. Candidiasis is also known as: Candida; Candida albicans; Candida Related Complex; Chronic Candida Syndrome; (Chronic) Systemic Candidiasis; Monilia; Candidiasis Hypersensitivity Syndrome; Candidosis; (Chronic) Mucocutaneous Candidosis; Thrush (oral or vaginal); Moniliasis; Polysystematic Candidiasis.

Carcinoma
Malignant growth of epithelial cells tending to infiltrate the surrounding tissue and giving rise to metastasis: An invasive malignant tumor derived from epithelial tissue that tends to metastasize to other areas of the body.

Carpal Tunnel Syndrome
A common, painful defect of the wrist and hand. It is caused by pressure on the middle nerve in the carpal tunnel. The syndrome is seen more often in women, especially in pregnant and in menopausal women. Symptoms may result from a blow, swelling, a tumor, rheumatoid arthritis, or a small carpal tunnel that squeezes the nerve. Pain may be infrequent or constant and is often most intense at night.

Chronic (Chronicity)
Usually referring to chronic illness: Illness extending over a long period of time.

Collagen
The primary protein within white fibers of connective tissue and the organic substance found in tendons, ligaments, cartilage, skin, teeth and bone.

Constipation (Constipated)
Difficult, incomplete, or infrequent evacuation of dry, hardened feces from the bowels.

Diabetes Insipidus
Excessive production of urine, usually due to insufficient production of antidiuretic hormone.

Diarrhea
Excessive discharge of contents of bowel.

Dyspepsia
Indigestion / poor digestion, usually with heartburn and/or regurgitation of stomach acids.

Eosinophil (Eosinophilia, Eosinophils)
The eosinophils, ordinarily about 2% of the granulocyte count (60 to 75% of the white blood cells), increase in number in the presence of allergic disorders and parasitic infestations.

EPA
Environmental Protection Agency. Also: Eicosapentanoic Acid. A metabolite of the omega-3 fatty acid alpha-linolenic acid.

Gastrointestinal (GI, GI Tract)
Pertaining to the stomach, small and large intestines, colon, rectum, liver, pancreas, and gallbladder.

Gingivitis
Inflammation of the fibrous tissues that surround the teeth.

Hypertension
High blood pressure. Hypertension increases the risk of heart attack, stroke, and kidney failure because it adds to the workload of the heart, causing it to enlarge and, over time, to weaken; in addition, it may damage the walls of the arteries.

Hypothyroidism (Hypothyroid)
Diminished production of thyroid hormone, leading to low metabolic rate, tendency to gain weight, and sleepiness.

Kidneys (Kidney, Renal)
Bean-shaped organs, each about the size of a fist. They are located near the middle of the back, just below the rib cage. The kidneys are sophisticated reprocessing machines, each day handling about 50 gallons of blood to sift out about half a gallon of waste products and extra water. The waste and extra water become urine, which flows to the bladder through tubes called ureters. The actual filtering occurs in tiny units inside the kidneys called nephrons. Every kidney has about a million nephrons. In a nephron, a glomerulus -- which is a tiny blood vessel, or capillary -- intertwines with a tiny urine-collecting tube called a tubule. A complicated chemical exchange takes place, as waste materials and water leave your blood and enter your urinary system. The kidneys recycle chemicals such as sodium, phosphorus, and potassium and thus regulate their levels. Renal: Pertaining to the kidneys.

Kilogram (kg, kgs, Kilogramme, Kilogrammes, Kilograms)
1000 grams, 2.2lbs.

Learning Disorder (Learning Disabilities, Learning Disability, Learning Disorders)
A generic term that refers to a group of disorders manifested by significant difficulties in the acquisition and use of listening, speaking, reading, writing, reasoning or mathematical abilities. These disorders are intrinsic to the individual and presumed to be due to central nervous system dysfunction. Even though a learning disability may occur along with other handicapping conditions (e.g. sensory impairment, mental retardation, social and emotional disturbance) or environmental influences (e.g. cultural differences, insufficient/inappropriate instruction, psychogenic factors) it is not the direct result of those condition or influences.

Metabolism (Metabolic, Metabolize, Metabolizes, Metabolizing)
The chemical processes of living cells in which energy is produced in order to replace and repair tissues and maintain a healthy body. Responsible for the production of energy, biosynthesis of important substances, and degradation of various compounds. Also defined as the sum total of changes in an organism in order to achieve a balance (homeostasis): Catabolic burns up, anabolic stores and builds up; the sum of their work is metabolism.

Mucous Membranes (Mucosa, Mucous Membrane, Mucus Membranes)
The membranes, such as the mouth, nose, anus, and vagina, that line the cavities and canals of the body which communicate with the air.

Multiple Sclerosis (MS)
Demyelinating disorder of the central nervous system, causing patches of sclerosis (plaques) in the brain and spinal cord, manifested by loss of normal neurological functions, e.g. muscle weakness, loss of vision, and mood alterations.

Nausea
Symptoms resulting from an inclination to vomit.

Osteoporosis
A disease in which bone tissue becomes porous and brittle. The disease primarily affects postmenopausal women.

Parkinson's Disease (Parkinson's)
A chronic, slowly-progressing disease of the nervous system characterized clinically by the combination of tremor, rigidity, extreme slowness of movement, and stooped posture. It is characterized pathologically by loss of dopamine in the substantia nigra.

Placebo (Placebos)
A pharmacologically inactive substance. Often used to compare clinical responses against the effects of pharmacologically active substances in experiments.

ppm
Parts Per Million. A measure of the concentration of a substance, usually in air or water.

Seizure (Seizures)
While there are over 40 types of seizure, most are classed as either partial seizures which occur when the excessive electrical activity in the brain is limited to one area or generalized seizures which occur when the excessive electrical activity in the brain encompasses the entire organ. Although there is a wide range of signs, they mainly include such things as falling to the ground; muscle stiffening; jerking and twitching; loss of consciousness; an empty stare; rapid chewing/blinking/breathing. Usually lasting from between a couple of seconds and several minutes, recovery may be immediate or take up to several days.

Spondylitis
Inflammation of one or more vertebrae.

Syndrome
A medical condition characterized by a collection of related symptoms (what the patient feels) and signs (what a doctor can observe or measure).

Telangiectasia
Small, unsightly red, purple or blue blood vessels found along the surface on the face, upper chest, neck and rarely on other parts of the body. Similar veins are found on the legs but called spider veins.

Testicles (Testicle, Testicular)
Egg-shaped sex glands in the scrotum that secrete male hormones such as testosterone, and produce sperm.

Testosterone
The principal male sex hormone that induces and maintains the changes that take place in males at puberty. In men, the testicles continue to produce testosterone throughout life, though there is some decline with age. A naturally occurring androgenic hormone.

Thrombosis
Formation of blood clots causing vascular obstruction.

Thyroid (Thyroid Gland)
The thyroid gland is an organ with many veins, anchored around the front of the throat near the voice box. It is essential to normal body growth in infancy and childhood. It absorbs iodine from the diet and releases thyroid hormones - iodine-containing compounds that help govern the rate of the body's metabolism (its total life processes), affecting body temperature, and regulating protein, fat and carbohydrate catabolism in all cells. They keep up growth hormone release, skeletal maturation, and heart rate, force, and output. They promote central nervous system growth, stimulate the making of many enzymes, and are necessary for muscle tone and vigor. To a high degree, metabolism is regulated by the hormone thyroxine, which can be made by the thyroid if enough organic iodine is available. An enlarged thyroid gland that is not cancer is sometimes called goitre.

Ulcerative Colitis (Colitis Ulcerosa)
Ulceration of the colon and rectum, usually long-term and characterized by rectal bleeding or blood in the stool, frequent urgent diarrhea/bowel movements each day, abdominal pain.

Uterus (Uterine)
The part of the female reproductive system specialized to allow the implantation, growth and nourishment of a fetus during pregnancy.

Vertigo
The sensation of spinning or whirling; a state in which you or your surroundings seem to whirl dizzily.

Vitamin C (Ascorbic Acid)
A water-soluble antioxidant vitamin essential to the body's health. When bound to other nutrients, for example calcium, it would be referred to as "calcium ascorbate". As an antioxidant, it inhibits the formation of nitrosamines (a suspected carcinogen). Vitamin C is important for maintenance of bones, teeth, collagen and blood vessels (capillaries), enhances iron absorption and red blood cell formation, helps in the utilization of carbohydrates and synthesis of fats and proteins, aids in fighting bacterial infections, and interacts with other nutrients. It is present in citrus fruits, tomatoes, berries, potatoes and fresh, green leafy vegetables.

Vitamin D
A fat-soluble vitamin essential to one's health. Regulates the amount of calcium and phosphorus in the blood by improving their absorption and utilization. Necessary for normal growth and formation of bones and teeth. For Vitamin D only, 1mcg translates to 40 IU.




Last updated: Jun 22, 2009


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