Abstract
Fluoride (F) is added to many dental care products as well as in drinking water to prevent dental decay. However, recent data associating exposure to F with some developmental defects with consequences in many organs raise concerns about its daily use for dental care. This systematic review aimed to evaluate the contribution of dental care products with regard to overall F intake through drinking water and diet with measurements of F excretion in urine used as a suitable biomarker. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using keywords related to chronic exposure to F in the human population with measurements of F levels in body fluids, 1,273 papers published between 1995 and 2021 were screened, and 28 papers were finally included for data extraction concerning daily F intake. The contribution of dental care products, essentially by toothbrushing with kinds of toothpaste containing F, was 38% in the mean regardless of the F concentrations in drinking water. There was no correlation between F intake through toothpaste and age, nor with F levels in water ranging from 0.3 to 1.5 mg/L. There was no correlation between F intake and urinary F excretion levels despite an increase in its content in urine within hours following exposure to dental care products (toothpastes, varnishes, or other dental care products). The consequences of exposure to F on health are discussed in the recent context of its suspected toxicity reported in the literature. The conclusions of the review aim to provide objective messages to patients and dental professionals worried about the use of F-containing materials or products to prevent initial caries or hypomineralized enamel lesions, especially for young children.
*Read full study online at https://www.frontiersin.org/articles/10.3389/froh.2022.916372/full
Excerpt:
Discussion
The present systematic review showed that the mean contribution of F-containing dental care products, mainly toothpastes, is 38% regardless of the age of children or F concentration in drinking water. These data are slightly lower than those published earlier by Paiva et al. [26], reporting a 65% contribution. The difference may be either due to the method of collecting data or to evolution of the use of less fluoridated toothpastes.
The contribution of F intake was not correlated with the age of children. However, children under 4 years old presented a very high TDFI as well as some adults who did not respect the good practice of dental care uses. Those two cases highlight the importance of: (i) dental products on the exposome, (ii) the types of F, bio-assimilation, and concentrations in the dental care products, and (iii) the importance of dental care products adapted to age, but more importantly, the results show the importance of good dental care habits (no swallowing, rinsing with water after toothbrushing, exposure to F after meals, and use of appropriate amount of toothpaste). The variation of F intake from the diet seemed to be less sensitive to the water concentration than the variation due to the concentration and good use of dental care products in the different areas. Therefore, despite the fact that studies in this field are lacking especially for adults, impact of dental care products on TDFI for adults should not be negligible. This requests to be further investigated in the case of misconducted use as it can increase the risk of excessive F intake.
The increase in F intake, especially due to dental care products did not necessarily correlate with the amount of F excretion. This result can be explained by the fact that we were looking at the reported means, which smoothed the values. The lack of correlation between DUFE and TDFI can also be due to (i) poor estimation of F inputs (additional sources and under or overestimation), and/or (ii) bias of the methodological and/or analytical quantification of urinary excretion (data were reported in means for each publication, choice of collection, and measure of the F into the urine), and/or (iii) variability of excretion capacity for each organism. In addition, these data were based on nine publications which could be a limitation of the study.
Urine is the only biomarker capable of measuring F excretion. However, urine may not be the most pertinent biomarker for the estimation of TDFI especially in children due to F accumulation during bone growth and mineralization. Children can retain more F in their skeleton (~50%) than adults (approximately 36%), with inverse retention in bone with age of the children and with the excess of F excreted in urine [67]. The absence of correlation between DUFE and TDFI suggests that there is a variability but a non-negligible amount of F was not eliminated from the organism. Our data showed a variation of DUFE between 65.2 and 691 ?g/day that may have informed on the F bioavailability, its residence time (clearance), and its interactions with different tissues. The majority of body F is bound in hard tissues, such as bones and teeth, and <1% can be found in soft tissues [17].
Further investigation combining measures of F in plasma and urine could be informative on the bioavailability of F and its interactions with different organs. Once absorbed, F reaches peak serum concentrations after 20–60 min, and then returns to the baseline after approximately 15 h suggesting that part of the oral F passes through systemic route [56, 57, 68, 69]. This is probably the reason why a relation has been reported between supplement use or the amount of toothpaste used for brushing and child’s fluorosis scores [65]. Most pharmacokinetic analyses showed a transient increase in the urinary F excretion approximately 1–3 h after topical application of fluoridated varnishes in adults and in children, after the use of a fluoridated mouthrinse solution, or after brushing with F-containing toothpastes [42, 56–58, 60, 64, 66]. A return to baseline is reported by all the studies 24–72 h after the end of the exposure, irrespective of the source. The minimal recommended period of urine collection is 24 h to obtain good estimations of the daily amount of F excretion. The DUFE is the variable generally recommended for the estimation of the daily F exposure. The amount of excreted F is obtained by multiplying the 24-h urinary volume by its F concentration [18].
As a consequence, we have proposed an experimental model of cumulative F exposure following the age of the individuals considering three different thresholds of 30, 300, and 1,300 ug F/day (Supplementary Figure 3) and a model of mixed exposures (1,300 ug F/day until 4 years, then 300 ug F/day until 8 years, and 30 ug F/day until 16 years). The thresholds have been defined based on the estimated F retention. Those values were obtained by subtracting the DUFE from the TDFI and were estimated between a few ug and 1,890 ug/day. Thus, this model is a cumulative representation, which includes daily F bone retention to estimate the trapped F into the body over a span of several years. According to this model, early age exposure could drastically affect the total F retention into the organism. Even though the residence time (i.e., half-life) of F into the different organs remains not well known, the exposure to a high absorption of dental care products may print a high F content over the years. In addition, bad habits of dental care products may impact F exposure for the adults. Therefore, these data showing a non-negligible contribution to daily F intake through toothbrushing using F-containing toothpastes may be discussed in the light of the literature as F was reported to pass through the blood-placental barrier and the blood-brain barrier thus subsequently cause learning problems [70]. In fact, most of studies on the safety of toothpastes and dental care products are short-term pharmacokinetics studies that do not consider long-term effects, whereas F accumulated in bone may be released in specific situations associated to skeletal loss, such as lactation [71]. However, we found no study that has explored the contribution of dental care products to total F exposure in pregnant and lactating women nor studies taking into account the gender, especially in young children. This concern is even more important considering that recent studies reported a relation between prenatal F exposure and lower performance intelligence quotient (IQ) in boys, but not in girls [72]. An increase of 0.5 mg/L of F concentration in the water (approximately equal to the difference between fluoridated and non-fluoridated regions) was associated with a 7.9-point lower IQ score in formula-fed infants and 6.3-point lower IQ score in breastfed children in both boys and girls, suggesting that postnatal exposure to F may affect both sexes [73]. Sex-dependent susceptibility to F may be due to multiple biological and behavioral reasons, they have also been reported in several experimental studies in rodents, and more recently in zebrafish [12, 13].
In conclusion, our review highlights the major F contribution from dental care products regardless of the area or F concentration in drinking water. This additional source presents a large variability depending on the concentration, chemical forms, and amount of the dental product used. However, the good usage of these products also seems to be determinant for the contribution to TDFI. Therefore, the contribution of F intake through toothpaste can be easily controlled and adapted to the patient. Consequently, the future studies on F exposure and toxicity need to take into consideration exposure to F-containing dental care products, habits of use, and individual features (gender, age, diet, caries, etc.). Furthermore, considering the contribution of dental care products to the TDFI, the “optimal daily F intake” estimated approximately 50–70 ug/kg bw/day by EFSA could be reevaluated to determinate the optimal DDFI depending on each individual. The contribution of ~39–51% due to dental care products suggests that the optimal daily dietary F may be half of the EFSA values.
Funding
The study was funded by the French National Institute of Health and Medical Research (INSERM), the Université Paris Cité (Idex Project FLUOREMAIL), and the National Agency for Safety of Food and Environment (ANSES) (Grant 2019/1/230).
Supplementary Material
The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/froh.2022.916372/full#supplementary-material
References
1. Kumar S, Tadakamadla J, Johnson NW. Effect of Toothbrushing Frequency on incidence and increment of dental caries: a systematic review and meta-analysis. J Dent Res. (2016) 95:1230–6. doi: 10.1177/0022034516655315
2. Moreno EC, Kresak M, Zahradnik RT. Fluoridated hydroxyapatite solubility and caries formation. Nature. (1974) 247:64–5. doi: 10.1038/247064a0
3. Hamilton IR. Biochemical effects of fluoride on oral bacteria. J Dent Res. (1990) 69:682–3. doi: 10.1177/00220345900690S128
4. Fejerskov O, Larsen MJ, Richards A, Baelum V. Dental tissue effects of fluoride. Adv Dent Res. (1994) 8:15–31. doi: 10.1177/08959374940080010601
5. Satou R, Oka S, Sugihara N. Risk assessment of fluoride daily intake from preference beverage. J Dent Sci. (2021) 16:220–8. doi: 10.1016/j.jds.2020.05.023
6. Aoba T. The effect of fluoride on apatite structure and growth. Crit Rev Oral Biol Med Off Publ Am Assoc Oral Biol. (1997) 8:136–53. doi: 10.1177/10454411970080020301
7. Aoba T, Fejerskov O. Dental fluorosis: chemistry and biology. Crit Rev Oral Biol Med Off Publ Am Assoc Oral Biol. (2002) 13:155–70. doi: 10.1177/154411130201300206
8. Johnston NR, Strobel SA. Principles of fluoride toxicity and the cellular response: a review. Arch Toxicol. (2020) 94:1051–69. doi: 10.1007/s00204-020-02687-5
9. Chachra D, Vieira APGF, Grynpas MD. Fluoride and mineralized tissues. Crit Rev Biomed Eng. (2008) 36:183–223. doi: 10.1615/CritRevBiomedEng.v36.i2-3.40
10. Barbier O, Arreola-Mendoza L, Del Razo LM. Molecular mechanisms of fluoride toxicity. Chem Biol Interact. (2010) 188:319–33. doi: 10.1016/j.cbi.2010.07.011
11. Wei Q, Deng H, Cui H, Fang J, Zuo Z, Deng J, et al. A mini review of fluoride-induced apoptotic pathways. Environ Sci Pollut Res Int. (2018) 25:33926–35. doi: 10.1007/s11356-018-3406-z
12. Mullenix PJ, Denbesten PK, Schunior A, Kernan WJ. Neurotoxicity of sodium fluoride in rats. Neurotoxicol Teratol. (1995) 17:169–77. doi: 10.1016/0892-0362(94)00070-T
13. Wang G, Wang T, Zhang X, Chen J, Feng C, Yun S, et al. Sex-specific effects of fluoride and lead exposures on histology, antioxidant physiology, and immune system in the liver of zebrafish (Danio rerio). Ecotoxicol Lond Engl. (2022) 31:396–414. doi: 10.1007/s10646-022-02519-5
14. Everett ET, McHenry M a. K, Reynolds N, Eggertsson H, Sullivan J, Kantmann C, et al. Dental fluorosis: variability among different inbred mouse strains. J Dent Res. (2002) 81:794–8. doi: 10.1177/0810794
15. Huang H, Ba Y, Cui L, Cheng X, Zhu J, Zhang Y, et al. COL1A2 gene polymorphisms (Pvu II and Rsa I), serum calciotropic hormone levels, and dental fluorosis. Community Dent Oral Epidemiol. (2008) 36:517–22. doi: 10.1111/j.1600-0528.2007.00424.x
16. Zhou GY, Ren LJ, Hou JX, Cui LX, Ding Z, Cheng XM, et al. Endemic fluorosis in Henan province, China: ER? gene polymorphisms and reproductive hormones among women. Asia Pac J Clin Nutr. (2016) 25(4):911–9. doi: 10.6133/apjcn.062016.01
17. Buzalaf MAR, Whitford GM. Fluoride metabolism. Monogr Oral Sci. (2011) 22:20–36. doi: 10.1159/000325107
18. Villa A, Anabalon M, Zohouri V, Maguire A, Franco AM, Rugg-Gunn A. Relationships between fluoride intake, urinary fluoride excretion and fluoride retention in children and adults: an analysis of available data. Caries Res. (2010) 44:60–8. doi: 10.1159/000279325
19. Martins CC, Paiva SM, Lima-Arsati YB, Ramos-Jorge ML, Cury JA. Prospective study of the association between fluoride intake and dental fluorosis in permanent teeth. Caries Res. (2008) 42:125–33. doi: 10.1159/000119520
20. Levy SM, Kohout FJ, Kiritsy MC, Heilman JR, Wefel JS. Infants’ fluoride ingestion from water, supplements and dentifrice. J Am Dent Assoc 1939. (1995) 126:1625–32. doi: 10.14219/jada.archive.1995.0110
21. Rojas-Sanchez F, Kelly SA, Drake KM, Eckert GJ, Stookey GK, Dunipace AJ. Fluoride intake from foods, beverages and dentifrice by young children in communities with negligibly and optimally fluoridated water: a pilot study. Community Dent Oral Epidemiol. (1999) 27:288–97. doi: 10.1111/j.1600-0528.1998.tb02023.x
22. Levy SM, Warren JJ, Davis CS, Kirchner HL, Kanellis MJ, Wefel JS. Patterns of fluoride intake from birth to 36 months. J Public Health Dent. (2001) 61:70–7. doi: 10.1111/j.1752-7325.2001.tb03369.x
23. Murakami T, Narita N, Nakagaki H, Shibata T, Robinson C. Fluoride intake in Japanese children aged 3-5 years by the duplicate-diet technique. Caries Res. (2002) 36:386–90. doi: 10.1159/000066537
24. Levy SM, Warren JJ, Broffitt B. Patterns of fluoride intake from 36 to 72 months of age. J Public Health Dent. (2003) 63:211–20. doi: 10.1111/j.1752-7325.2003.tb03502.x
25. Martínez-Mier EA, Soto-Rojas AE, Ureña-Cirett JL, Stookey GK, Dunipace AJ. Fluoride intake from foods, beverages and dentifrice by children in Mexico. Community Dent Oral Epidemiol. (2003) 31:221–30. doi: 10.1034/j.1600-0528.2003.00043.x
26. Paiva SM, Lima YBO, Cury JA. Fluoride intake by Brazilian children from two communities with fluoridated water. Community Dent Oral Epidemiol. (2003) 31:184–91. doi: 10.1034/j.1600-0528.2003.00035.x
27. Pessan JP, Silva SMB da, Buzalaf MAR. Evaluation of the total fluoride intake of 4-7-year-old children from diet and dentifrice. J Appl Oral Sci Rev FOB. (2003) 11:150–6. doi: 10.1590/S1678-77572003000200012
28. Cardoso VES, Whitford GM, Buzalaf MAR. Relationship between daily fluoride intake from diet and the use of dentifrice and human plasma fluoride concentrations. Arch Oral Biol. (2006) 51:552–7. doi: 10.1016/j.archoralbio.2005.12.003
29. Omena LMF, Silva MF de A, Pinheiro CC, Cavalcante JC, Sampaio FC. Fluoride intake from drinking water and dentifrice by children living in a tropical area of Brazil. J Appl Oral Sci Rev FOB. (2006) 14:382–7. doi: 10.1590/S1678-77572006000500015
30. de Almeida BS, da Silva Cardoso VE, Buzalaf MAR. Fluoride ingestion from toothpaste and diet in 1- to 3-year-old Brazilian children. Community Dent Oral Epidemiol. (2007) 35:53–63. doi: 10.1111/j.1600-0528.2007.00328.x
31. Miziara APB, Philippi ST, Levy FM, Buzalaf MAR. Fluoride ingestion from food items and dentifrice in 2-6-year-old Brazilian children living in a fluoridated area using a semiquantitative food frequency questionnaire. Community Dent Oral Epidemiol. (2009) 37:305–15. doi: 10.1111/j.1600-0528.2009.00477.x
32. Levy SM, Broffitt B, Marshall TA, Eichenberger-Gilmore JM, Warren JJ. Associations between fluorosis of permanent incisors and fluoride intake from infant formula, other dietary sources and dentifrice during early childhood. J Am Dent Assoc 1939. (2010) 141:1190–201. doi: 10.14219/jada.archive.2010.0046
33. Lima-Arsati YBO, Martins CC, Rocha LA, Cury JA. Fingernail may not be a reliable biomarker of fluoride body burden from dentifrice. Braz Dent J. (2010) 21:91–7. doi: 10.1590/S0103-64402010000200001
34. Amaral JG, Freire IR, Valle-Neto EFR, Cunha RF, Martinhon CCR, Delbem ACB. Longitudinal evaluation of fluoride levels in nails of 18-30-month-old children that were using toothpastes with 500 and 1100 ?g F/g. Community Dent Oral Epidemiol. (2014) 42:412–9. doi: 10.1111/cdoe.12103
35. Zohoori FV, Whaley G, Moynihan PJ, Maguire A. Fluoride intake of infants living in non-fluoridated and fluoridated areas. Br Dent J. (2014) 216:E3. doi: 10.1038/sj.bdj.2014.35
36. Abuhaloob L, Maguire A, Moynihan P. Total daily fluoride intake and the relative contributions of foods, drinks and toothpaste by 3- to 4-year-old children in the Gaza strip – palestine. Int J Paediatr Dent. (2015) 25:127–35. doi: 10.1111/ipd.12108
37. Lima CV, Cury JA, Vale GC, Lima MDM, Moura L de FAD, Moura MS de. Total fluoride intake by children from a tropical Brazilian city. Caries Res. (2015) 49:640–6. doi: 10.1159/000442029
38. Oliveira PFT de, Cury JA, Lima CV, Vale GC, Lima M de DM de, Moura L de FA de D, et al. Is the fluoride intake by diet and toothpaste in children living in tropical semi-arid city safe? Braz Oral Res. (2018) 32:e26. doi: 10.1590/1807-3107bor-2018.vol32.0026
39. Villa A, Anabalón M, Cabezas L. The fractional urinary fluoride excretion in young children under stable fluoride intake conditions. Community Dent Oral Epidemiol. (2000) 28:344–55. doi: 10.1034/j.1600-0528.2000.028005344.x
40. Zohouri FV, Rugg-Gunn AJ. Total fluoride intake and urinary excretion in 4-year-old Iranian children residing in low-fluoride areas. Br J Nutr. (2000) 83:15–25. doi: 10.1017/S0007114500000040
41. Haftenberger M, Viergutz G, Neumeister V, Hetzer G. Total fluoride intake and urinary excretion in German children aged 3-6 years. Caries Res. (2001) 35:451–7. doi: 10.1159/000047489
42. Pessan JP, Pin MLG, Martinhon CCR, de Silva SMB, Granjeiro JM, Buzalaf M a. R. Analysis of fingernails and urine as biomarkers of fluoride exposure from dentifrice and varnish in 4- to 7-year-old children. Caries Res. (2005) 39:363–70. doi: 10.1159/000086842
43. Maguire A, Zohouri FV, Hindmarch PN, Hatts J, Moynihan PJ. Fluoride intake and urinary excretion in 6- to 7-year-old children living in optimally, sub-optimally and non-fluoridated areas. Community Dent Oral Epidemiol. (2007) 35:479–88. doi: 10.1111/j.1600-0528.2006.00366.x
44. Zohoori FV, Buzalaf MaR, Cardoso CaB, Olympio KPK, Levy FM, Grizzo LT, et al. Total fluoride intake and excretion in children up to 4 years of age living in fluoridated and non-fluoridated areas. Eur J Oral Sci. (2013) 121:457–64. doi: 10.1111/eos.12070
45. Zohoori FV, Walls R, Teasdale L, Landes D, Steen IN, Moynihan P, et al. Fractional urinary fluoride excretion of 6-7-year-old children attending schools in low-fluoride and naturally fluoridated areas in the UK. Br J Nutr. (2013) 109:1903–9. doi: 10.1017/S0007114512003583
46. Idowu OS, Duckworth RM, Valentine RA, Zohoori FV. Biomarkers for the assessment of fluoride exposure in children. Caries Res. (2020) 54:134–43. doi: 10.1159/000504166
47. Idowu OS, Duckworth RM, Valentine RA, Zohoori FV. Biomarkers for the assessment of exposure to fluoride in adults. Caries Res. (2021) 55:292–300. doi: 10.1159/000516091
48. Fejerskov Ole, Ekstrand Jan, Burt Brian A. Fluoride in Dentistry. 2nd edition. Copenhagen: Munksgaard (1996). p. 363.
49. Alaçam A, Ulusu T, Bodur H, Ozta? N, Oren MC. Salivary and urinary fluoride levels after 1-month use of fluoride-releasing removable appliances. Caries Res. (1996) 30:200–3. doi: 10.1159/000262160
50. Altinova YB, Alaçam A, Aydin A, Sanisoglu SY. Evaluation of a new intraoral controlled fluoride release device. Caries Res. (2005) 39:191–4. doi: 10.1159/000084797
51. Caldas da. Rocha DR, Ricomini Filho AP, Cury JA. Soluble fluoride in Na2FPO3/CaCO3-based toothpaste as an indicator of systemically bioavailable fluoride. Caries Res. (2021) 56:55–63. doi: 10.1159/000521068
52. Chung CK, Millett DT, Creanor SL, Gilmour WH, Foye RH. Fluoride release and cariostatic ability of a compomer and a resin-modified glass ionomer cement used for orthodontic bonding. J Dent. (1998) 26:533–8. doi: 10.1016/S0300-5712(98)00017-7
53. Cury JA, Del Fiol FS, Tenuta LMA, Rosalen PL. Low-fluoride dentifrice and gastrointestinal fluoride absorption after meals. J Dent Res. (2005) 84:1133–7. doi: 10.1177/154405910508401208
54. Falcão A, Tenuta LMA, Cury JA. Fluoride gastrointestinal absorption from Na2FPO3/CaCO3- and NaF/SiO2-based toothpastes. Caries Res. (2013) 47:226–33. doi: 10.1159/000346006
55. Forte FDS, Moimaz SAS, Sampaio FC. Urinary fluoride excretion in children exposed to fluoride toothpaste and to different water fluoride levels in a tropical area of Brazil. Braz Dent J. (2008) 19:214–8. doi: 10.1590/S0103-64402008000300007
56. García-Hoyos F, Barbería E, García-Camba P, Varela M. Renal fluoride excretion in children following topical application of fluoride varnish. Eur J Paediatr Dent. (2012) 13:280–4.
57. García-Hoyos F, Cardososilva C, Barbería E. Renal excretion of fluoride after fluoride mouth rinses in children. Eur J Paediatr Dent. (2014) 15:35–8.
58. Lin YS, Rothen ML, Milgrom P. Pharmacokinetics of iodine and fluoride following application of an anticaries varnish in adults. JDR Clin Transl Res. (2018) 3:238–45. doi: 10.1177/2380084418771930
59. Lin YS, Rothen ML, Milgrom P. Pharmacokinetics of 38% topical silver diamine fluoride in healthy adult volunteers. J Am Dent Assoc 1939. (2019) 150:186–92. doi: 10.1016/j.adaj.2018.10.018
60. Lockner F, Twetman S, Stecksén-Blicks C. Urinary fluoride excretion after application of fluoride varnish and use of fluoride toothpaste in young children. Int J Paediatr Dent. (2017) 27:463–8. doi: 10.1111/ipd.12284
61. Martins CC, Paiva SM, Cury JA. Effect of discontinuation of fluoride intake from water and toothpaste on urinary excretion in young children. Int J Environ Res Public Health. (2011) 8:2132–41. doi: 10.3390/ijerph8062132
62. Milgrom P, Taves DM, Kim AS, Watson GE, Horst JA. Pharmacokinetics of fluoride in toddlers after application of 5% sodium fluoride dental varnish. Pediatrics. (2014) 134:e870–874. doi: 10.1542/peds.2013-3501
63. Opydo-Szymaczek J, Ogi?ska M, Wyrwas B. Fluoride exposure and factors affecting dental caries in preschool children living in two areas with different natural levels of fluorides. J Trace Elem Med Biol Organ Soc Miner Trace Elem GMS. (2021) 65:126726. doi: 10.1016/j.jtemb.2021.126726
64. Vale G, Simões N, Santana G, Mota B, Moura M. Gastrointestinal absorption and renal excretion of fluoride after ingestion of a high-fluoride dentifrice. Biol Trace Elem Res. (2019) 190:24–9. doi: 10.1007/s12011-018-1511-y
65. Martinez-Mier EA, Soto-Rojas AE. Differences in exposure and biological markers of fluoride among white and African American children. J Public Health Dent. (2010) 70:234–40. doi: 10.1111/j.1752-7325.2010.00173.x
66. Olympio KPK, Cardoso VE da S, Bijella MFB, Pessan JP, Delbem ACB, Buzalaf MAR. Urinary fluoride output in children following the use of a dual-fluoride varnish formulation. J Appl Oral Sci Rev FOB. (2009) 17:179–83. doi: 10.1590/S1678-77572009000300009
67. Buzalaf M a. R, Rodrigues MHC, Pessan JP, Leite AL, Arana A, Villena RS, et al. Biomarkers of fluoride in children exposed to different sources of systemic fluoride. J Dent Res. (2011) 90:215–9. doi: 10.1177/0022034510385937
68. Marthaler TM, Steiner M, Menghini G, De Crousaz P. Urinary fluoride excretion in children with low fluoride intake or consuming fluoridated salt. Caries Res. (1995) 29:26–34. doi: 10.1159/000262036
69. Villa A, Anabalón M, Cabezas L, Rugg-Gunn A. Fractional urinary fluoride excretion of young female adults during the diurnal and nocturnal periods. Caries Res. (2008) 42:275–81. doi: 10.1159/000135673
70. Choi AL, Sun G, Zhang Y, Grandjean P. Developmental fluoride neurotoxicity: a systematic review and meta-analysis. Environ Health Perspect. (2012) 120:1362–8. doi: 10.1289/ehp.1104912
71. Kovacs CS. Maternal mineral and bone metabolism during pregnancy, lactation, and post-weaning recovery. Physiol Rev. (2016) 96:449–547. doi: 10.1152/physrev.00027.2015
72. Green R, Rubenstein J, Popoli R, Capulong R, Till C. Sex-specific neurotoxic effects of early-life exposure to fluoride: a review of the epidemiologic and animal literature. Curr Epidemiol Rep. (2020) 7:263–73. doi: 10.1007/s40471-020-00246-1
Keywords: fluoride, drinking water, diet, toothpaste, dental products, urine
Citation: Saad H, Escoube R, Babajko S and Houari S (2022) Fluoride Intake Through Dental Care Products: A Systematic Review. Front. Oral. Health 3:916372. doi: 10.3389/froh.2022.916372
Received: 09 April 2022; Accepted: 04 May 2022;
Published: 10 June 2022.
Edited by:
Rogelio González-González, Juárez University of the State of Durango, Mexico
Reviewed by:
Jesus Lavalle-Carrasco, Juárez University of the State of Durango, Mexico
Omar Tremillo Maldonado, Juárez University of the State of Durango, Mexico
Copyright © 2022 Saad, Escoube, Babajko and Houari. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Sylvie Babajko, sylviebabajko@gmail.com
*Original full study online at https://www.frontiersin.org/articles/10.3389/froh.2022.916372/full
Print 
PDF-
-
Urinary fluoride excretion after application of fluoride varnish and use of fluoride toothpaste in young children.
BACKGROUND: The efficacy and safety of combined use of topical fluoride products are essential issues that must be monitored. AIM: To assess urinary excretion of fluoride after application of two different dental varnishes containing 2.26% fluoride in 3- to 4-year-old children and to compare the levels with and without parallel use
-
[Osteofluorosis caused by excess use of toothpaste].
BACKGROUND: Osteofluorosis is caused by chronic fluoride intoxication. Fluoride is used in toothpaste for the prevention of dental caries, and dental fluorosis has often been reported among children and attributed to ingestion of fluoride toothpaste. We report a case of chronic fluoride intoxication caused by excess use of toothpaste in
-
Fluorosis is linked to anaemia.
We report here a simple, easy-to-practice treatment procedure for anaemia, by focusing on withdrawal of fluoride consumption and promotion of nutrients through diet. The approach to improve nutrient intake as supplementation of iron and folic acid or iron tonic does not yield beneficial results. The reason being highly destructive F–
-
Urinary minerals excretion among primary schoolchildren in Dubai—United Arab Emirates.
Introduction Urinary excretion of calcium (Ca), magnesium (Mg), phosphorus (P), iodine and fluoride is used to assess their statuses and/or the existence of metabolic abnormalities. In the United Arab Emirates (UAE), the urinary concentration of these minerals among children have not been documented. Materials and methods A cross-sectional study, including 593 subjects (232
-
Fluoride balance in infants and young children in the UK and its clinical relevance for the dental team.
Key Points Provides an overview of the main sources of fluoride in children. Stresses the proportion of fluoride (F) intake from ingestion of toothpaste. Draws attention to the implications for oral health of the F balance in infants and young children. Illustrates the importance of assessing fluoride exposure at an
Related Studies :
-
-
-
Allergy to Fluoride
Six children and one adult exhibited various allergic reactions after the use of toothpaste and vitaimin preparations containing fluoride. The following conditions were encountered: Urticaria, exfoliative dermatitis, atopic dermatitis, stomatitis, gastro-intestinal and respiratory allergy.
-
Fluoride Dentrifice and Stomatitis
Statistical data of 133 patients who have been using fluoride dental cream or powder have been presented. Each has developed intraoral ulcerative lesions. Many have been treated for other complaints without clearance of the lesions. Age is not significant. Repeated insults with the fluoride dentrifices produced increasingly severe excoriations. There seems to be nothing specific about the lesions to differentiate them from other diseases of an oral nature.
-
Fluoride Toothpaste: A Cause of Perioral Dermatitis
We have gathered clinical and historical data implicating fluoride dentrifices as an important etiologic factor in this dermatosis. The following two cases support this observation.
-
Fluoride & Perioral Dermatitis
Perioral dermatitis (PD) is a common rosacea-like dermatitis that was never reported prior to the mid-fifties. Although it can affect both sexes and all ages, most patients are women ages 20-50 years. Patients with PD frequently report a pre-existing tendency to blush. This disease is most likely multifactorial in origin, and fluoride preparations in dentrifices probably have played a role as precipitator.
-
Fluoride Toothpaste: A Cause of Acne-like Eruptions
I feel that I should share with my colleagues in dermatology an observation relative to the treatment of problem acne.
Related FAN Content :
-