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 :

  • 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

  • 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

  • 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

  • Induction of apoptosis in rabbit oral mucosa by 1.23% acidulated phosphate fluoride gel

    Applying of 1.23% acidulated phosphate fluoride (APF) gel to prevent caries in children has become very popular among dental practitioners. When applied to dental surfaces, however, APF often comes into contact with the oral mucosa. Due to the possibility of local toxic effect, we aimed to investigate the effects of APF on

  • 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

• 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-Induced Gastric Symptoms in Human Clinical Trials

    In studies where fluoride has been used (at doses of 18-34 mg/day) as an experimental drug for the treatment of osteoporosis, gastrointestinal disturbances are one of the two main side effects consistently encountered. The following are some of the accounts from the published literature: "The use of fluoride in the prophylaxis or

  • 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

  • "Pre-Skeletal" Fluorosis

    As demonstrated by the studies below, skeletal fluorosis may produce adverse symptoms, including arthritic pains, clinical osteoarthritis, gastrointestinal disturbances, and bone fragility, before the classic bone change of fluorosis (i.e., osteosclerosis in the spine and pelvis) is detectable by x-ray. Relying on x-rays, therefore, to diagnosis skeletal fluorosis will invariably fail to protect those individuals who are suffering from the pre-skeletal phase of the disease. Moreover, some individuals with clinical skeletal fluorosis will not develop an increase in bone density, let alone osteosclerosis, of the spine. Thus, relying on unusual increases in spinal bone density will under-detect the rate of skeletal fluoride poisoning in a population.