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.
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Revisiting Fluoride in the Twenty-First Century: Safety and Efficacy Considerations.
Over 100 years of scientific literature is available which describes the long relationship between dentistry and the many possible applications of fluoride anion (F-) as successful therapeutic strategies. To date, systemic introduction of fluoride via water, milk and salt fluoridation, and fluoride-containing tablets, has been employed. Post-eruption topical fluoride products
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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
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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
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Fluoride intoxication from drinking water (a report of 52 cases)
In previous publications, cases of incipient fluorine 1) poisoning from drinking artificially fluoridated water at the 1 ppm concentration were reported. A specific disease pattern could be discerned closely tallying with what has b??n observed in industrial poisoning from fluorine intake at higher levels. There are three groups of symptoms: 1. Those
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Early diagnosis and classification of professional fluorosis
On the basis of evaluating the clinical course and supplementary method of examination carried out in 132 patients suffering of professional fluorosis and in 200 workers in the premorbid state the author proposes criteria of early diagnosis. Considering Zislin's classification of professional fluorosis, literature data and own findings the author
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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
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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
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Fluoride & Gastrointestinal System: The Importance of Fluoride Concentration in Stomach
The following is an excerpt from the National Research Council's (2006) review of fluoride toxicity: "It is important to realize that GI effects depend more on the net concentration of the aqueous solution of fluoride in the stomach than on the total fluoride dose in the fluid or solid ingested. The
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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.
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Skeletal Fluorosis: The Misdiagnosis Problem
It is a virtual certainty that there are individuals in the general population unknowingly suffering from some form of skeletal fluorosis as a result of a doctor's failure to consider fluoride as a cause of their symptoms. Proof that this is the case can be found in the following case reports of skeletal fluorosis written by doctors in the U.S. and other western countries. As can be seen, a consistent feature of these reports is that fluorosis patients--even those with crippling skeletal fluorosis--are misdiagnosed for years by multiple teams of doctors who routinely fail to consider fluoride as a possible cause of their disease.
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