Abstract

BACKGROUND:  High-concentration topical fluorides are used commonly to with compromised salivary function due to irradiation and chemotherapy.

CASE DESCRIPTION:  The authors describe a 50-year-old man with previously treated cancer who was using tray-applied topical fluoride gel. He complained of gastric symptoms, difficulty in swallowing, leg muscle soreness and knee joint soreness. A computed tomographic scan revealed thickening of the esophageal walls. An upper endoscopy revealed abnormal motility. The motility test indicated high-amplitude peristalsis and hypertensive lower esophageal sphincter, and urine testing indicated high levels of systemic fluoride. The patient’s fluoride regimen was altered, and within a short period his urinary fluoride levels returned to normal and his symptoms resolved.

CLINICAL IMPLICATIONS:  Clinicians prescribing home-applied high-concentration fluorides need to be cognizant of the symptoms of fluoride toxicity, carefully monitor the patient’s compliance with the treatment regimen, and adjust the dosage or mode of application to control the total ingested dose of fluoride.

• Related Studies :

  • Topical fluorides: effects on physiologic and biochemical processes

    The ingestion of fluoride from dentifrices or mouthrinses can contribute substantially to the total daily intake of the ion, even in communities that provide optimally fluoridated drinking water. It is concluded that the frequent and unsupervised use of these products by children six years of age or younger, especially those living in

  • Recovery from skeletal fluorosis (an enigmatic, American case)

    A 52-year-old man presented with severe neck immobility and radiographic osteosclerosis. Elevated fluoride levels in serum, urine, and iliac crest bone revealed skeletal fluorosis. Nearly a decade of detailed follow-up documented considerable correction of the disorder after removal of the putative source of fluoride (toothpaste). INTRODUCTION: Skeletal fluorosis, a crippling bone

  • Painful periostitis in the setting of chronic voriconazole therapy

    A 72-year-old woman on chronic voriconazole therapy for recurrent histoplasmosis developed a painful forearm mass. Laboratory and imaging findings were consistent with a diffuse periostitis. Her symptoms resolved after discontinuation of voriconazole. To our knowledge, this is the first case of voriconazole-induced periostitis to be reported in a patient with

  • Elevated fluoride levels and periostitis in pediatric hematopoietic stem cell transplant recipients receiving long-term voriconazole

    Azole therapy is widely utilized in hematopoietic stem cell transplant (HCT) recipients for the treatment of aspergillus. Complications of voriconazole treatment related to its elevated fluoride content have been described in adults, including reports of symptomatic skeletal fluorosis. We review fluoride levels, clinical, and laboratory data in five pediatric HCT recipients

  • Fluoride ingestion in children: a review of 87 cases.

    All cases of fluoride ingestion in children younger than 12 years old reported to the Rocky Mountain Poison Center between January 1 and December 31, 1986, were retrospectively reviewed. Eighty-seven cases were identified. Eighty-four cases involved accidental ingestion of dental fluoride products in the home (tablets, drops, rinses) in children

• Related FAN Content :

  • Fluoride-Induced Damage to Gastric Mucosa in Human Clinical Trials

    When fluoride has been used (at doses of 18-34 mg/day) as an experimental treatment for osteoporosis, gastric pain is one of the two main side effects consistently encountered. To better understand how fluoride causes this effect, researchers have sought to determine how fluoride affects the tissue that lines the gastrointestinal tract. In a

  • Side Effects from Fluoride Gels: Gastric Distress

    Gastric distress -- including nausea, pain, and vomiting -- is one the most common side effects from professional application of "fluoride gels" at the dentist. Patients receiving fluoride gels can swallow more than 20 mg of fluoride from a single treatment -- doses that far exceed the doses that can

  • Fluoride Gels & Kidney Function

    Scientists have found that the application of "Fluoride Gels" at the dental office causes very high spikes in the blood fluoride level. The high spikes in blood fluoride levels are a result of three factors: the high concentration of fluoride in the gel (= 12.3 mg of fluoride in each

  • Fluoride & Osteoarthritis

    While the osteoarthritic effects that occurred from fluoride exposure were once considered to be limited to those with skeletal fluorosis, recent research shows that fluoride can cause osteoarthritis in the absence of traditionally defined fluorosis. Conventional methods used for detecting skeletal fluorosis, therefore, will fail to detect the full range of people suffering from fluoride-induced osteoarthritis.

  • Acute Fluoride Exposure from Fluoride Gels

    Fluoride gel (i.e., 1.23% APF) is an acidic, highly concentrated fluoride treatment that dentists apply to patients teeth about two times a year. The gel contains 1.23% fluoride, which equates to 12.3 mg of fluoride for every 1 mL. Since dentists apply anywhere from 4 to 8 mL of gel