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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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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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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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 studies in a patient with arthritis
SIR, A high intake of fluoride (F-) is known to cause severe skeletal fluorosis, but the actual fluoride intake required to produce fluorosis is unknown. I have shown that tea-drinking in Britain causes a high intake in both children and adults, maximum intakes in children surveyed reaching nearly 6 mg
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Correlation of pain and fluoride concentration in allogeneic hematopoietic stem cell transplant recipients on voriconazole
Supportive care guidelines recommend anti-mold prophylaxis in hematopoietic stem cell transplant (HSCT) recipients deemed high-risk for invasive fungal infection, leading to long-term use of voriconazole following allogeneic HSCT in patients that remain immunocompromised. Voriconazole has been associated with periostitis, exostoses, and fluoride excess in patients following solid organ transplant, HSCT
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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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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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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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"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.
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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
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