Fluoride Toxicity

Fluoride Toxicity: Overview

"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]

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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 and 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 programs.  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 and 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.


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

Symptoms - Food - Beverages

Excessive/constant thirst

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

Symptoms - Food - General

Weak/loss of appetite

Loss of appetite is an early sign of fluorosis.

Symptoms - Gas-Int - General

Regular/frequent unexplained nausea

Nausea is an early sign of fluoride toxicity.

Symptoms - Head - Eyes/Ocular

Symptoms - Head - Mouth/Oral

Symptoms - Metabolic

Occasional/frequent 'chills'

Symptoms include body temperature disturbances and cold shivers.


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.

Symptoms - Muscular

Specific/severe muscle weakness

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

Symptoms - Nervous

Symptoms - Respiratory

Symptoms - Skeletal

Conditions that suggest Fluoride Toxicity:


Dyspepsia / Poor Digestion

Studies have shown that ingested fluoride damages gastroduodenal mucosaGastrointestinal 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.


Chronic constipation is an early sign of fluorosis.


Chronic diarrhoea is an early sign of fluorosis.


Migraine/Tension Headaches

Persistent headaches are one sign of fluorosis.


Osteoporosis - Osteopenia

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

Risk factors for Fluoride Toxicity:

Symptoms - Metabolic

History of migraine headaches

Persistent headaches are one sign of fluorosis.

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Fluoride Toxicity can lead to:


Excessive Fatigue

Unusual and excessive sleepiness/fatigue is a symptom.

Fluoride Toxicity could instead be:



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 for Fluoride Toxicity:



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.


Vitamin D

See link between Fluorosis and Calcium.

Vitamin C (Ascorbic Acid)

See link between Fluorosis and Calcium.

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