Can fluoride make you sick

Contents

9 Things to Know About Topical Fluoride Treatment

You’ve probably heard of fluoride. Dentists recommend using a toothpaste with fluoride in it. Over-the-counter mouth-rinses are available with fluoride as an active ingredient.

This article will focus on a type of fluoride, which is not available for purchase at your drug or grocery store: a professional fluoride treatment.

Professional fluoride treatments are prescription strength and topically applied. They are only administered by a dental professional and provide many great benefits for the teeth.

1. Fluoride is a natural mineral.

Fluoride is a mineral found in rocks, soil and water. It is the 13th most abundant element in the earth’s crust. Fluoride appears in natural ground water in varying levels, which is why some places have too much fluoride in their drinking water, and others have none.

2. Professional fluoride treatments are worth the cost.

No matter how much you pay for a topical fluoride treatment, the cost is worth it. It is significantly less expensive than the cost of repairing the tooth decay it can prevent. Professional fluoride treatment is a preventive therapy, which helps your body naturally fight cavities. By preventing tooth decay, you are lowering the amount of money you spend on dental care over your lifetime.

3. Fluoride fights cavities by strengthening enamel.

Our teeth are in a constant battle between demineralization and remineralization.

Demineralization

The bacteria in our mouths eat carbohydrates to produce acid. The acid weakens the surface of enamel, making it softer and more likely to decay. This process is demineralization.

Remineralization

The minerals in our saliva work to remineralize or harden and strengthen the enamel. The naturally occurring minerals in our saliva are calcium and phosphate. They are constantly working to remineralize enamel.

Fluoride amps up the remineralization process.

Cavities occur when there is more demineralization than remineralization. Fluoride increases the remineralization process, which prevents cavities from occurring.

4. Fluoride treatments are not just for kids!

Fluoride improves the remineralization process on any tooth surface. People of all ages are prone to cavities, not just children. Anyone with a high risk for cavities should receive professional fluoride treatments regularly.

Elderly patients who struggle with oral hygiene benefit from professional fluoride treatments. Because they are not able to effectively remove plaque from the teeth, elderly patients have an inherently higher risk for cavities. This risk is reduced by applying a professional fluoride treatment to the teeth every three or six months.

Patients with special needs who are not able to keep their teeth clean also experience a greater likelihood of cavities. To lower this risk, professional fluoride treatments offer a considerable advantage.

In addition to fighting cavities, fluoride also reduces tooth sensitivity. Many adults opt for professional fluoride treatments to alleviate the discomfort of sensitive teeth. Professional fluoride treatments can make dental cleaning much more comfortable for people who suffer from tooth sensitivity.

5. Professional fluoride treatments can reverse small cavities!

When demineralization outpaces remineralization, a cavity starts. In its earliest stages, a cavity is called an incipient lesion. These early cavities can be arrested or stopped by professional fluoride treatments and excellent oral hygiene at home.

Who would not want to stop a cavity in its tracks? Preventing a cavity is so much better than allowing it to progress to a stage that requires dental work.

6. Professional fluoride treatments are safe.

Professional fluoride treatments are prescription strength. The dosage of fluoride in a professional treatment is supported by scientific studies, proving its effectiveness and safety. This dosage would not be safe if used at home on a daily basis.Research has shown that professional fluoride treatments are safe and effective at intervals as close as every 3 months.

There is a controversy about the safety of fluoride. Its opponents claim that it is poisonous and causes an increased risk for bone fractures, cancer, and brain toxicity. A systematic review of all the published literature on the safety of fluoride found no correlation between fluoridation of water, milk or salt and topical fluoride treatments with an increase in bone fractures or cancer.

There is risk associated with fluoride intake. If too much fluoride is ingested (like a child swallowing a tube of prescription strength fluoride toothpaste), nausea, vomiting and diarrhea are likely to occur. As long as fluoride is used as directed by your dental and medical professionals, the risk is minimal.

7. Professional fluoride treatments do not stain teeth.

The stains associated with too much fluoride (called fluorosis) occur during tooth formation. Fluorosis can happen when a pregnant mother drinks water with too much fluoride. The baby’s teeth will be affected and have dark brown or splotchy stains on his or her teeth.

This cannot occur after teeth are formed, which means teeth treated with professional fluoride are not at risk for staining.

8. Professional fluoride treatments do not hurt.

A professional fluoride treatment might be the simplest treatment you will ever get in a dental office. A fluoride varnish is painted onto the teeth with a small brush. Sometimes a tray filled with fluoride gel or foam applies fluoride to the teeth for 1-2 minutes.

There is nothing invasive and no pain.

9. You can eat and drink after a fluoride varnish treatment.

Some professional fluoride treatments require a waiting period of 30 minutes before eating or drinking anything. Fluoride varnishes adhere to the teeth for hours, and no waiting period is required. You may eat or drink immediately following its application.

If you have received an application of fluoride varnish to your teeth, wait until bedtime to brush your teeth. You do not want to brush the varnish off!

Are you interested in a professional fluoride treatment?

Whether you have a high risk for cavities or sensitive teeth, a professional fluoride treatment may be just what you need. Call your local Premier Dental office today to schedule a consultation with one of our doctors to discuss the specific benefits a fluoride treatment would provide for you.

ACT Fluoride Rinse

Generic Name: fluoride topical (FLOR ide TOP i kal)
Brand Name: ACT Fluoride Rinse, Biotene, Clinpro 5000, Control Rx, Denta 5000 Plus, Dentagel, Fluoridex, Fluorigard, Fluorinse, Gel-Kam, NaFrinse Daily/Acidulated, Nafrinse Solution, Neutracare Gel, Neutragard, Neutral Sodium Fluoride Rinse, Omnii Gel Just For Kids, Oral B Anti-Cavity, OrthoWash, Perfect Choice, Perio Med, Prevident, Prevident Dental Rinse, SF

Medically reviewed by Drugs.com on Feb 4, 2019 – Written by Cerner Multum

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What is ACT Fluoride Rinse?

Fluoride is a substance that strengthens tooth enamel. This helps to prevent dental cavities.

ACT Fluoride Rinse is used as a medication to prevent tooth decay in patients that have a low level of fluoride topical in their drinking water. This medicine is also used to prevent tooth decay in patients who undergo radiation of the head and/or neck, which may cause dryness of the mouth and an increased incidence of tooth decay.

Fluoride may also be used for purposes not listed in this medication guide.

Important Information

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

ACT Fluoride Rinse should not be used if the level of fluoride in the drinking water is greater than 0.7 parts per million (ppm).

Before taking this medicine

ACT Fluoride Rinse should not be used if the level of fluoride in the drinking water is greater than 0.7 parts per million (ppm).

To make sure ACT Fluoride Rinse is safe for you, tell your doctor if you are on a low salt or a salt free diet

If you have gum disease, some forms of fluoride topical may be irritating to your gums. Talk to your dentist or doctor if you have bothersome mouth irritation while using ACT Fluoride Rinse.

Talk to your doctor and dentist before using ACT Fluoride Rinse if you are pregnant.

Talk to your doctor and dentist before using ACT Fluoride Rinse if you are breast-feeding.

The use of fluoride is particularly important in children to protect against tooth decay. The American Dental Association’s Council on Dental Therapeutics recommends the use of fluoride by children up to 13 years of age. The American Academy of Pediatrics recommends fluoride supplementation in children until the age of 16 years old.

Do not allow a child to swallow ACT Fluoride Rinse or serious overdose symptoms could result.

How should I use ACT Fluoride Rinse?

Use this medication exactly as directed on the label, or as it was prescribed by your dentist or doctor. Do not use it in larger amounts or for longer than recommended. Follow the directions on your prescription label.

ACT Fluoride Rinse should be used immediately after brushing or flossing your teeth. For best results, use the medication just before bedtime, unless your doctor tells you otherwise.

Swish this medication in your mouth without swallowing. Then spit it out.

Do not eat, drink, or rinse your mouth for 30 minutes after using ACT Fluoride Rinse.

Store ACT Fluoride Rinse at room temperature away from moisture and heat.

What happens if I miss a dose?

Use the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may result if you swallow large amounts of fluoride while using it.

Overdose symptoms may include nausea, vomiting, stomach pain, diarrhea, drooling, numbness or tingling, loss of feeling anywhere in your body, muscle stiffness, or seizure (convulsions).

What should I avoid while using ACT Fluoride Rinse?

Do not swallow ACT Fluoride Rinse. Spit it out after use.

ACT Fluoride Rinse side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor if you have any of the following side effects:

  • discolored teeth;

  • weakened tooth enamel; or

  • any changes in the appearance of your teeth.

Common side effects may include:

  • stomach upset;

  • headache; or

  • weakness.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect ACT Fluoride Rinse?

It is not likely that other drugs you take orally or inject will have an effect on topically applied fluoride. But many drugs can interact with each other. Tell each of your health care providers about all medicines you use, including prescription and over-the-counter medicines, vitamins, and herbal products.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2018 Cerner Multum, Inc. Version: 3.07.

Medical Disclaimer

More about ACT Fluoride Rinse (fluoride topical)

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  • Drug class: mouth and throat products

Consumer resources

Other brands: Prevident, Biotene, Denta 5000 Plus, Ethedent, … +23 more

Professional resources

  • Stannous Fluoride Oral Rinse (FDA)

Related treatment guides

  • Prevention of Dental Caries

Dental Products

Overview

Many dental products contain dangerously high levels of fluoride. For years, manufacturers and dentists failed to warn consumers about the risks from ingesting these products. Although the FDA now requires manufacturers to warn consumers that fluoride products are poisonous when swallowed, manufacturers and dentists are still using these products in ways that expose consumers and patients to potentially toxic levels of fluoride.

Fluoride Toothpastes

  • The vast majority of toothpastes now contain fluoride.
  • Although research suggests adult-strength fluoride toothpaste (1,100-1,450 ppm F) can reduce tooth decay, this potential benefit comes with the risk of disfigured teeth.
  • Use of fluoride toothpaste during childhood is a major risk factor for dental fluorosis, particularly for children who brush before the age of three and who live in areas with fluoridated water.
  • Children who swallow fluoride toothpaste can reach fluoride levels in their blood that exceed the levels that have been found to inhibit insulin secretion and increase blood glucose in animals and humans.
  • All fluoride toothpastes sold in the U.S. must now include a poison label that warns users to “contact a poison control center immediately” if they swallow more than used for brushing.
  • Just 1 gram of fluoride toothpaste (a full strip of paste on a regular-sized brush) is sufficient to cause acute fluoride toxicity in two-year old children (e.g., nausea, vomiting, headache, diarrhea).
  • In 2009, U.S. poison control centers received over 25,000 calls related to excessive ingestion of fluoride toothpaste, with over 378 users requiring emergency room treatment.
  • In adults, fluoride toothpaste can cause skin rashes around the mouth known as perioral dermatitis as well as canker sores.

For more discussion on fluoride toothpaste,

Fluoride “Supplements”

  • Fluoride “supplements” are tablets, drops, or lozenges that are designed to provide a substitute fluoride exposure for children living in areas where fluoride is not added to water. Unlike other dietary supplements, fluoride supplements cannot be purchased over the counter. They are only available by prescription.
  • Fluoride supplements were introduced in the 1950s on two incorrect assumptions: (1) fluoride is a nutrient and (2) fluoride is effective when swallowed.
  • Despite being prescribed by pediatricians and dentists for over 50 years, fluoride supplements have never been approved as either safe or effective by the FDA.
  • As conceded by a pro-fluoride researcher, “virtually none of the early fluoride supplement studies would be published today, because of methodological and other shortcomings.” (Riordan 1999).
  • Modern research has consistently shown that children who use fluoride supplements have a much higher rate of dental fluorosis than children who do not. By contrast, the evidence that supplements reduce tooth decay has recently been described by pro-fluoride researchers as “poor,” “inconsistent,” and “weak.”
  • Even the American Dental Association (ADA) and other pro-fluoride organizations no longer recommend fluoride supplements for most children. The ADA does not recommend fluoride supplements for infants under six months of age. After six months of age, the ADA only recommends supplements for children who are at “high risk” for cavities.
  • Some children who take fluoride supplements can develop allergic reactions, including skin rashes, gastric distress, vomiting, and headache.
  • Although fluoride supplements were only intended for children living in non-fluoridated areas, surveys have shown that some dentists prescribe supplements to children living in fluoridated areas as well. This places children at risk for the most severe forms of dental fluorosis.

For more discussion on fluoride supplements,

Fluoride Gels

“Fluoride Gels” are acidic, highly concentrated fluoride products that dentists topically apply to a patient’s teeth about two times a year. Of all the fluoride products currently used in dentistry, fluoride gels are – without question – the most hazardous. While fluoride gels are designed to be applied “topically” (i.e., directly to teeth), very large quantities of fluoride are absorbed into the body during the treatment. Due to this large systemic exposure, many patients – particularly children – experience symptoms of acute fluoride toxicity, including nausea, gastrointestinal pain, and/or vomiting within an hour of the treatment. Gastric distress is not the only side effect. Fluoride gels produce an enormous spike in blood fluoride levels for up to 14 hours, exposing every tissue in the body to fluoride concentrations that have been can damage, in short-term exposures, the kidney, the male reproductive system, and glucose metabolism. Although the dental community has taken steps to reduce the amount of fluoride that gets into the blood from fluoride gels, the extent of fluoride exposure from these gels continues to remain excessive and toxic. Due to the conspicuous absence of safety studies, however, the public health consequences from the dental community’s 40-year experiment with fluoride gels remains a disturbing mystery. Read More.

Other Fluoride Products

For information on other fluoridated products, including self-applied gels, fluoride varnishes, and fluoridated salt,

0 Shares Modified: 18 January 2020

Has your child’s dentist recommended that they have fluoride varnish applied to their teeth? Or perhaps you’re looking into the options for yourself as an adult and want to know more about the benefits and potential risks of fluoride varnish.

Fluoride varnish helps keep teeth healthy

This treatment is widely used as a preventative measure against dental caries (tooth decay). It’s highly encouraged that children routinely get it, but it can be used on adults as well. Although it has been proven to be very effective, it’s natural you want to understand more before going ahead.

In this article you can read about:

  • The benefits for adults and children
  • Possible risks and side effects of the treatment
  • The sodium fluoride varnish application procedure
  • How much fluoride varnish costs on the NHS and privately

We hope this helps you decide if you want to go ahead with the treatment, whether for your child or yourself.

What is fluoride varnish?

Fluoride varnish is, as the name suggests, a liquid that contains a high concentration of fluoride. It may also come in the form of a gel. A thin layer is applied directly to the teeth, where it hardens and releases fluoride into the enamel.

Fluoride is a mineral that helps strengthen tooth enamel, thereby making teeth more resistant to decay. Fluoride is added to the water supply in some areas and is found in many children’s toothpastes.

Topical fluoride varnish benefits

Regular fluoride varnish application reduces the risk of cavities

Tooth decay in children is a big problem throughout the world. According to the CDC, in the US, 20% of children between the ages of 5 and 11 have at least one untreated decayed tooth and 13% of teenagers between the ages of 12 and 19 have at least one untreated decayed tooth.

Fluoride varnish treatment has been proven to reduce the prevalence of dental caries in baby teeth by 37% and permanent teeth by 43%, according to this Cochrane review. It’s particularly effective for children who are at high risk of decay and who are not exposed to fluoride from other sources.

Applying sodium fluoride varnish can also help reverse early signs of tooth decay (white spot lesions), as examined in this clinical trial.

Fluoride varnish treatment is quick, simple, and non-invasive. It must be carried out by a dental professional but doesn’t need to be done in a dentist’s office. It might be carried out at your child’s school or daycare, for example, as part of a community program. This can make it less daunting than being treated in the dentist’s chair.

Another preventative treatment often offered to children with permanent teeth is dental sealant. This fills in deep grooves and pits in the biting surfaces of the teeth, making them easier to clean and reducing the chances of decay.

Fluoride varnish for toddlers

Many parents are concerned about exposing their children to fluoride too early. While it’s completely reasonable to have these concerns, most dentists agree that even children younger than three can benefit from treatment. But it may not be necessary for all toddlers to receive it. Take a look at the following criteria for children who can benefit from fluoride varnish, provided by the American Academy of Pediatrics:

  • All children who are eligible for Medicaid
  • Premature children
  • Sibling with cavities before six years of age
  • Children with special health care needs
  • Children without a designated dentist or care network
  • Children who use a bottle after 15 months
  • Children who have sweet or starchy snacks more than three times a day

You can also consult with your child’s dentist, as they will help you make the right decision about your child’s dental health.

Risks and side effects

Fluoride varnish safety is vouched for by the majority of the medical community. Despite this, many are concerned for their children to have this treatment due to unfounded rumors of fluoride varnish toxicity. However, a research brief published by the Association of State and Territorial Dental Directors says that the small amount of fluoride that may be ingested after application causes no acute toxic effects in patients.

There are some side effects, however, One of the fluoride varnish side effects is dental fluorosis, a condition that results in white spots on the teeth while they are developing. The amount of fluoride exposure from treatment shouldn’t pose a significant risk.

That said, do make sure your child spits out all excess toothpaste after brushing—especially in the days following fluoride varnish treatment. If they regularly swallow fluoride toothpaste, the risk of fluorosis increases.

Although fluoride varnish is a very safe and widely practiced treatment, it is not suitable for everyone.

Your dentist will carry out an assessment first

If you or your child take fluoride drops or tablets, mention this before receiving treatment. You may be advised not to have fluoride varnish at all, or to stop taking the other supplement for a few days after the varnish is applied.

Patients with a medical history of allergies should be individually assessed before treatment to reduce the risk of fluoride varnish side effects. Specifically, patients may not be treated if they have allergies to sticking plaster (which contains colophony, also found in duraphat fluoride varnish) or food allergies or asthma which have resulted in hospitalization.

Finally, if you or your child have any mouth sores or ulcers on the day of treatment then it will probably be postponed.

Fluoride varnish for adults

Although this treatment is routinely offered to children in the US, it can also be beneficial for adults. Specifically, the treatment may be recommended for adults who:

  • Suffer from sensitive teeth
  • Have thin tooth enamel or significant enamel erosion, for example from teeth grinding
  • Have chronic tooth decay

Mention it to your dentist at your next visit if you think you might benefit.

Fluoride varnish application

Treatment can be carried out as soon as a baby’s first milk tooth appears. The American Dental Association (ADA) recommends that children are treated 2 to 4 times a year. Dentists may recommend more frequent treatment for children who already have tooth decay or are at high risk of developing it.

After a quick visual check, the varnish is applied

The fluoride varnish instructions for application differ a little for children and adults. For children, it usually involves drying the teeth with cotton and then applying the varnish with a small brush to coat the teeth. For adults, the dentist may first perform a teeth cleaning to remove all plaque from the teeth, before drying them and applying the varnish.

In any case, the fluoride varnish application itself should take no more than a minute or two, and it is completely pain-free.

What’s more, it has a pleasant, fruity taste and smell, and it sets quickly once applied to the teeth. The varnish has a golden yellow color, which means that the teeth may appear yellow for a while after application. Don’t worry, this color will fade after a day or two and won’t stain teeth permanently.

After application

For the varnish to be most effective, you or your child may be instructed to:

  • Avoid eating or drinking anything for 30 minutes following treatment
  • Wait until the next morning before brushing your teeth
  • Avoid crunchy, hard and chewy foods for the rest of the day, since these can scrape some of the varnish off
  • Eat and drink only cold and warm foods and drinks—nothing hot

The next day, you can go back to eating and brushing your teeth as normal.

These are general guidelines only; you should follow any other advice given by the dentist or nurse administering the treatment.

In the video below you can see how fluoride varnish is applied:

How long does fluoride varnish last?

The varnish will start to wear away when you brush your teeth and will be completely gone within a few days. By then, the fluoride has already penetrated the dental enamel and will continue to protect the teeth for several months.

It’s important to brush teeth well in addition to fluoride varnish

Fluoride varnish should be re-applied every six months, or sooner if recommended by your dentist.

You should not rely on fluoride varnish alone to keep teeth healthy. It’s important to brush twice a day using a fluoride toothpaste and a suitable toothbrush, and minimize consumption of sugary snacks and drinks. Our guide to children’s oral health has more information and tips for protecting children’s teeth against decay.

What does fluoride varnish cost?

As well as being easy to apply and pain-free, fluoride varnish is also one of the cheapest treatments around.

Is it covered by insurance?

Children and teens on Medicaid or CHIP will receive it for free. There may be programs run through schools that will also be free of charge. For adults aged 18 and over, it depends on what state you live in if this treatment is covered under Medicaid. But with a little searching, you’ll probably be able to find a free fluoride varnish program. For more information on access to low-cost dental care, check out our Medicaid and Medicare article.

Paying privately

If your child receives private dental care, fluoride treatment may well be included as part of their regular dental checkups. If paid for separately, fees start from as little as $23, but of course, costs vary from one dentist to the next.

As a preventative treatment, it is included in many dental insurance plans. Check your plan details to see if you’re covered.

Can you buy fluoride varnish to apply at home?

You may be wondering if you can buy fluoride varnish other-the-counter, and if so, how to apply fluoride varnish at home.

You can buy fluoride varnish online, however, you have to have a healthcare license, and the ADA doesn’t promote the home-use of varnish per se.

The ADA does, however, recommend prescription-strength topical fluoride application at home in the form of fluoride gel. In these guidelines, a panel of experts deems that the home-use of a 0.5% fluoride gel will benefit those prone to cavities. This particular guide is due to be updated next year, so check back soon to see if recommendations have changed.

Fluoride varnish brands

You can buy ADA-approved fluoride gel brands for home use

It’s normal that you want to be able to know what your dentist is putting in your mouth. The following is a list of some of the most well-known brands used in professional settings and approved by the ADA, so you can do your research before you go in for treatment:

  • Colgate PreviDent varnish
  • Embrace varnish
  • Enamel Pro varnish
  • Vanish 3M varnish

The above products are all actual varnishes and can only be bought with a healthcare license. But for home use by non-professionals, you can buy fluoride gel online, including from the following brands:

  • Colgate Gel-Kam fluoride preventive treatment
  • 3M Just for Kids Brush-On Gel
  • Mark3 APF Thixotrophic Fluoride Gel

Conclusion

Fluoride varnish application is an effective way to prevent tooth decay and remineralize teeth, for both children and adults. Children can receive free fluoride varnish treatment on Medicaid or through community programs at schools.

Risks associated with this treatment are minimal, but your dentist will carry out an assessment before applying the varnish.

Treatment should accompany proper teeth brushing and good oral hygiene to keep teeth in the best condition possible.

FAQs

How long do you leave fluoride varnish on teeth?

Fluoride varnish at the dentist’s office or fluoride gel at home should generally remain on your teeth until it naturally wears off, (with a normal tooth-brushing schedule of course). If you are accustomed to brushing your teeth after lunch, and you get your fluoride treatment in the morning, your dentist may instruct you to hold off brushing your teeth until before bed.

How long do you have to wait after fluoride varnish before eating?

You’ll want to refrain from eating after fluoride varnish until at least 30 minutes have passed.

What are the side effects of fluoride varnish?

Side effects of fluoride varnish are not very common. However, too much fluoride can result in fluorosis—a condition where teeth develop white patches. Fluorosis normally only affects oral health in an esthetic manner, and if your dentist recommends this treatment for your child, it’s because they sincerely believe the benefits outweigh the risks.

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Sources Karger: Efficacy of Fluoride Varnish and Casein Phosphopeptide-Amorphous Calcium Phosphate for Remineralization of Primary Teeth: A Randomized Clinical Trial. Consulted 14th November 2019. Cochrane: Fluoride varnishes for preventing dental caries in children and adolescents. Consulted 14th November 2019. ASTDD:Fluoride Varnish: An Evidence-Based Approach. Consulted 10th December 2019. CDC: Children’s Oral Health: Overview. Consulted 10th December 2019. American Association of Pediatrics:A Pediatric Guide to Children’s Oral Health. Consulted 10th December 2019. 0 Shares

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  • Fluoride is a naturally-occurring mineral that has been used for decades to prevent tooth decay. It’s added to most toothpaste and drinking water in the majority of communities in the U.S., including almost all of Tennessee. In Knox County, a fluoride varnish is applied to some children’s teeth as part of the school dental program.

    How Does Fluoride Work?

    In children, it concentrates in growing bones and teeth, helping to harden the enamel on teeth before they emerge. In adults, fluoride helps to rebuild the enamel on already-emerged teeth and reverses early signs of tooth decay.

    According to the American Dental Association, fluoride has greatly reduced tooth decay, particularly in communities where it’s added to the public water supply.

    In some cases, fluoride treatments may also be recommended, particularly if you or your children are very prone to tooth decay or if you use well water, which may have less than the recommended levels of fluoride.

    Benefits and Possible Concerns

    Fluoride can be controversial, however. Some people are worried about negative effects on health, particularly when it comes to children. A 2012 Harvard School of Public Health study raised concerns about the mineral’s impact on children’s developing brains and recommended that more research be done.

    Generally, most public health agencies strongly support the use of fluoride and believe it delivers great benefits. The Centers for Disease Control calls fluoride in public water supplies one of the 10 great public health achievements of the past century. Most experts believe that the side effects of fluoride treatments are relatively rare and mild when used in the proper amounts.

    If you or your children are at high risk for tooth decay, you might want to discuss fluoride treatments with our staff. It can be administered in the following ways:

    • In our office. We can either paint your teeth with a fluoride gel or put gel into mouth guards that you’ll wear for one to four minutes. It’s quick and easy, and all you have to do is not eat, drink, or smoke for 30 minutes afterward.
    • Using a gel at home. These are available with a prescription.
    • With tablets, drops, or lozenges. These are only recommended for children who don’t have the recommended fluoride in their drinking water and are at high risk for developing tooth decay.

    What are potential side effects of fluoride treatments?

    • White spots on your teeth – These can develop if you consume greater than the recommended amounts of fluoride in early childhood. They are often barely noticeable to anyone but your dentist.
    • Nausea, vomiting, or abdominal pain
    • Mouth sores
    • Rashes (if you’re allergic to fluoride)
    • More serious reactions such as bone problems and gastrointestinal bleeding can occur, but these are usually due to prolonged exposure to much higher doses of fluoride than those that are recommended.

    Dr. Wesley Mullins and his dental team at My Family Dentistry are always happy to speak with you. We can address your specific fluoride needs and concerns or any potential side effects of fluoride treatments.

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    Dr. Wesley Mullins

    Dentist at My Family Dentistry We’re so glad you’ve found My Family Dentistry, and we want you to get to know us! My Family Dentistry serving Powell and Knoxville, TN practices a uniquely comfortable dentistry approach to dental services.

    Latest posts by Dr. Wesley Mullins (Knoxville Dentist)

    • The Most Common Causes for Gum Disease – June 15, 2019
    • Exciting News from KöR Whitening – June 6, 2019
    • Preventing Oral Cancer – May 13, 2019
    • Early Signs of Gum Disease – May 1, 2019
    • The My Family Dentistry Team: Meet Megan Price – April 22, 2019

    GENERIC NAME: SODIUM FLUORIDE GEL – DENTAL (SO-dee-um FLOOR-ide)

    Medication Uses | How To Use | Side Effects | Precautions | Drug Interactions | Overdose | Notes | Missed Dose | Storage

    USES: This medication is used to prevent cavities. It makes teeth stronger and more resistant to decay caused by acid and bacteria.This medication is not recommended for children younger than 6 years unless directed by the dentist/doctor.

    HOW TO USE: Depending on the product, this medication is applied onto the teeth, either with a mouth tray or a small brush/swab, by a dental professional. The gel should be left on for the prescribed amount of time (usually 1 to 4 minutes, depending on the product).Spit out the medication after use. Do not swallow. Children should rinse their mouths thoroughly right away. Watch children during treatment and rinsing to make sure they do not swallow the medication or rinse water. For best results in adults, do not rinse your mouth, eat, or drink for at least 30 minutes after use.Dosage and frequency of application is based on your medical condition and response to treatment. This medication is usually applied every 6 to 12 months or as directed by your dentist.Use this medication regularly to get the most benefit from it. To help you remember, mark the days on the calendar when you need to receive the medication.

    SIDE EFFECTS: Remember that your dentist has prescribed this medicine because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor/dentist immediately if your teeth become stained or pitted. This is often a result of too much fluoride.A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor/dentist or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

    PRECAUTIONS: Before receiving sodium fluoride, tell your dentist if you are allergic to it; or if you have any other allergies.Before using this medication, tell your dentist your medical history, especially of: mouth problems (e.g., sores, mucositis).Children may be more sensitive to the side effects of this drug, especially if this medication is swallowed.Tell your doctor if you are pregnant before using this medication.This medication passes into breast milk. Consult your doctor before breast-feeding.

    “Fluoride Gels” are acidic, highly concentrated fluoride products that dentists topically apply to a patient’s teeth about two times a year. Of all the fluoride products currently utilized in dentistry, these fluoride gels are – without question – the most hazardous. While fluoride gels are designed to be applied “topically” (i.e., directly to teeth), very large quantities of fluoride are absorbed into the body during the treatment.

    Due to the high exposure to fluoride during gel treatment,, many patients – particularly children – will experience nausea, gastrointestinal pain, or vomiting within an hour of the treatment. Gastric distress is not the only risk. Fluoride gels produce an enormous spike in blood fluoride levels for up to 14 hours, exposing every tissue in the body to fluoride concentrations that have been found to damage, in short-term exposures, the kidney, the male reproductive system, and glucose metabolism.

    Although the dental community has taken steps to reduce the amount of fluoride that gets into the blood, the extent of fluoride exposure from fluoride gels continues to remain excessive and toxic. Due to the conspicuous absence of any meaningful safety studies, however, the public health consequences from widespread fluoride gel use remain a disturbing mystery.

    What Are Fluoride Gels?

    Fluoride Gels are often referred to as “1.23% APF” gels. This refers to the concentration of fluoride (1.23% fluoride ion, or 12,300 ppm) and the chemical compound (“APF,” or acidulated phosphate fluoride). A 1.23% concentration of fluoride equates to 12,300 parts per million, or 12.3 mg of fluoride for every milliliter of the gel. The gel is placed in two trays (one tray for the upper teeth, and one tray for the bottom teeth), which are then placed in the patient’s mouth. The patient is then asked to bite down on the trays for 4 minutes. Due to the high acidity of the gel (pH 3.5), saliva flow is markedly increased during the course of the treatment, thus increasing the percentage of the gel that is ingested. The high acidity also enables the fluoride to cross directly through the gum membrane. (Whitford 1982). Thus, patients can be exposed to significant amounts of systemic fluoride even when no fluoride is actually swallowed. Read More.

    When scientists discovered in the 1980s the enormous spikes in blood fluoride levels that occur after fluoride gel treatment (see below), the dental community implemented measures to reduce the amount of fluoride ingested from the gel. These measures include: (a) ensuring that the patient is sitting upright; (b) reducing the amount of gel used for young children; (c) placing a suction device in the mouth during the course of the treatment to vacuum out the excess saliva; and (d) encouraging the patient to spit (i.e., expectorate) for up to one minute when the trays are removed from the mouth. (Hawkins 2003; LeCompte 1987). Even when dentists comply with these recommendations (the rate of professional compliance is unknown), significant ingestion of fluoride can still occur. Indeed, when preventive measures are used, it is estimated that children ingest an average of 7.7 mg of fluoride per treatment, while adults ingest an average of 10.3 mg. (Hawkins 2003; Johnston 1994). As discussed below, these doses are sufficient to produce toxic spikes in the blood fluoride level.

    Gastric Pain, Nausea, and Vomiting

    Gastric pain and nausea are common side effects from fluoride gel treatment. It is not uncommon, for example, for a child to vomit on the way home from the dental office after receiving a fluoride gel. Fluoride causes the gastric symptoms by combining with gastric acid in the stomach to form hydrofluoric acid, which exerts a direct toxic effect on the gastric mucosa. Scientists have found that a single dose of just 3 mg fluoride is sufficient to damage the gastric mucosa, and that tissue damage can occur in the absence of gastric symptoms. (Spak 1990). Most children receiving fluoride gel treatment will ingest doses that far exceed 3 mg. Thus, even if no gastric symptoms are experienced, tissue damage to the gastric mucosa will occur. The long-term significance of this effect has yet to be investigated. Read More.

    Toxic Spikes in Blood Fluoride Levels

    Fluoride gels were introduced in the 1960s without any clinical evidence of safety or effectiveness. (Ekstrand 1987). As with other fluoride products, the dental community assumed that the fluoride gels were safe, and thus took no measures to reduce the amount of fluoride that patients ingested. It wasn’t until the early 1980s that researchers first discovered that both children and adults were absorbing enormous quantities of fluoride from the gels, as evident by the staggering spike in blood fluoride levels that occurred following treatment. In relatively small studies, researchers found that children’s blood contained up to 1,450 parts per billion (ppb) of fluoride after treatment, and that adults’ blood contained up to 980 ppb—a near 100-fold increase from the baseline level. (Ekstrand 1980, 1981). Researchers found that the peak concentration was normally reached within 1 to 2 hours of treatment, and remained significantly elevated for up to 14 hours. (Ekstrand 1980). According to the leading researcher in the field: “It is concluded that following the use of topical fluoride products, variable amounts of fluoride are swallowed and absorbed into the systemic circulation–amounts which may be sufficient to produce acute or chronic side-effects.” (Ekstrand 1987).

    Although most dentists now use measures to prevent fluoride from getting into the bloodstream, children still swallow an average of 7.7 mg of fluoride per treatment, while adults swallow an average of 10.3 mg. (Johnston 1994). Based on prior research of fluoride’s pharmacokinetics, the blood fluoride levels resulting from these doses are still strikingly high. (Ekstrand 1983).

    A) Kidney Damage

    When scientists first discovered the high blood fluoride levels resulting from treatment with fluoride gels, little was known about the blood fluoride levels that could cause harm to human health. The only thing that scientists knew was that short-term exposures to high levels of fluoride (as occurred from the fluorinated anesthetic methoxylflurane) damaged the kidney, by impairing the kidney’s ability to concentrate urine and thereby producing a diabetes insipidus-type condition marked by excessive urination. (Mazze 1977). It is estimated that the threshold blood level that causes this effect during short exposures is 570 ppb. (Whitford 1987). While this defect is believed to be reversible (i.e., it ends when the fluoride clears from the blood), no research has yet been conducted to determine the long-term kidney health of those who have repeatedly experienced short-term toxic exposures to fluoride. Read More.

    B) Danger for Diabetics

    In 1986 and 1987, scientists funded by the National Institutes of Health (NIH) reported that the toxic effects from short-term spikes in blood fluoride levels are not limited to the kidney. (Shahed 1986; Whitford 1987). In studies on rats, the scientists reported that a blood fluoride level of just 234 ppb (the lowest level they examined) caused significant impairment in glucose metabolism, as evident by sharp rises in blood glucose and decreases in insulin. (Whitford 1987). An impairment in glucose metabolism and insulin production are hallmarks of diabetes. As the authors noted, this was the “first time” that a single, acute exposure to fluoride could reduce insulin levels in blood, which was striking because the dose that caused the effect was well within “the range of fluoride ingestion observed following a topical application of APF gel.” (Shahed 1986). The authors concluded, therefore, that “it is conceivable that normal ingestion of F following an APF application could alter several metabolic processes.” (Shahed 1986).

    Subsequent research has demonstrated that the NIH study’s findings were not a fluke. Indeed, not only have researchers confirmed that spikes in blood fluoride levels increase glucose levels, but they have found that the effect occurs at just 95 ppb – less than 10 times the fluoride level that can enter blood after fluoride-gel treatment, and exceeded on a daily basis by some children using fluoride toothpaste. (Menoyo 2005; de la Sota 1997; Rigalli 1995, 1990). Despite these findings, neither the NIH nor the dental community have conducted any research to determine the effect of fluoride gels on glucose metabolism in children or adults.

    C) Damage to Sperm

    In 2002 and 2006, Polish researchers reported that low levels of fluoride can damage sperm in ways that could impair male fertility. (Zakrzewska 2002, 2006). In the studies, the researchers exposed ram semen to 380 ppb of fluoride. After just five hours of exposure, the researchers found significant decreases in sperm motility (the ability of the sperm to move) and the number of intact acrosomes (the part of the sperm that produces enzymes necessary for egg penetration). According to the authors, such changes “undoubtedly affect the physiological function of the sperm.” (Zakrzewska 2002).

    Although no research has ever been conducted to determine the impact of fluoride gel treatment on human reproductive function, the blood fluoride concentrations that result from such treatments can exceed, for over five hours, the concentrations found to damage ram semen. Nevertheless, manufacturers make no mention of these findings in the product insert for fluoride gels. The product insert simply states: “Potential adverse reproductive effects of fluoride exposure in humans have not been adequately evaluated. Adverse reproductive effects of fluoride have been reported in animal studies, but at high concentrations sufficient to produce other manifestations of toxicity.”

    Other Effects from Fluoride Gels

    In 2008, researchers reported that fluoride gels damage the oral mucosa. (Tsai 2008). The researchers found that a single application of fluoride gel to the oral mucosa of rabbits for 4 minutes caused cell damage (e.g., DNA strand breaks) that did not disappear, but actually increased, during the 8 days of follow-up examinations. Based on their findings, the authors suggest that dentists take precautions to prevent the fluoride gels from contacting the gums.

    In addition to damaging the oral mucosa, fluoride gels have also been found to damage tooth restorations, such as porcelain or ceramic vaneers. As noted by Johnston, the “APF gel releases hydrofluoric acid which may etch and dull these restorative materials after several applications.” (Johnston 1994).

    Fluoride Gels: Only Recommended for “High-Risk” Patients

    Considering the serious hazards involved with fluoride-gel treatments, one would think the treatments must provide a very convincing, irreplaceable benefit. Amazingly, however, that is not the case. Due to the glut of over-the-counter topical fluoride products, even gel proponents note that “there seems little reason for dental professionals to apply topical fluorides for patients with a low defs/DMFS count.” (Johnston 1994).

    A Failure to Investigate

    Fluoride gels were introduced onto the market in the 1960s in the absence of “evidence of clinical efficacy.” (Ekstrand 1987). Despite the staggeringly high levels of fluoride that enter the bloodstream after fluoride gel treatment, there has been virtually no research since that time to determine the occurrence of side effects among patients receiving fluoride gel treatment. This shocking omission was confirmed in 2009, when scientists at the Cochrane Library reviewed all available human trials on fluoride gels and reported that “there is little information” on “adverse effects.” Of the 25 clinical trials that have tested fluoride gels, only two trials bothered looking for side effects, and of these two studies, only nausea and vomiting were considered (in a very limited fashion). The Cochrane review thus concluded that “more research is needed on adverse effects” because the “lack of evidence about adverse effects makes it more difficult for clinicians and policy makers to weigh the benefits of fluoride gels in preventing caries against possible side effects.”

    The lack of research on side effects from fluoride gel treatment is largely a result of the NIH’s failure to fund such research. Indeed, after NIH-funded researchers reported in 1986 that fluoride gels produced sufficient fluoride levels in blood to impair glucose metabolism, the NIH has not funded a single study, let alone a clinical trial, to further investigate the matter.

    0 Shares Modified: 23 January 2020

    Has your child’s dentist recommend that they have fluoride varnish applied to their teeth? Or perhaps you’re looking into the options for yourself as an adult and want to know more about the benefits and potential risks of fluoride varnish.

    Fluoride varnish helps keep teeth healthy

    This treatment is widely used as a preventative measure against dental caries (tooth decay). It’s routinely offered to children in the UK on the NHS but can be used on adults as well. Although it has been proven to be very effective, it’s natural you want to understand more before going ahead.

    In this article you can read about:

    • The benefits of fluoride varnish for adults and children
    • Possible risks and side effects of the treatment
    • The fluoride varnish application procedure
    • How much fluoride varnish costs on the NHS and privately

    We hope this helps you decide whether to go ahead with the treatment, whether for your child or yourself.

    Fluoride varnish is, as the name suggests, a liquid which contains a high concentration of fluoride. It may also come in the form of a gel. A thin layer is applied directly to the teeth, where it hardens and releases fluoride into the enamel.

    Fluoride is a mineral which helps strengthen tooth enamel, thereby making teeth more resistant to decay. Fluoride is added to the water supply in some areas, and is found in many children’s toothpastes.

    Benefits of fluoride varnish

    Regular fluoride varnish application reduces the risk of cavities

    Tooth decay in children is a big problem throughout the world. In the UK, almost half of children have some decay by age 8, and it affects a third of 5-year-olds.

    Fluoride varnish treatment has been proven to reduce the prevalence of dental caries in milk teeth by 37% and permanent teeth by 43%, according to this Cochrane review. It’s particularly effective for children who are at high risk of decay and who are not exposed to fluoride from other sources.

    Applying fluoride varnish can also help reverse early signs of tooth decay (white spot lesions), as examined in this clinical trial.

    Fluoride varnish treatment is quick, simple, and non-invasive. It must be carried out by a dental professional, but doesn’t need to be done in a dentist’s office. It might be carried out at your child’s school or nursery, for example, as part of a community program. This can make it less daunting than being treated in the dentist’s chair.

    Another preventative treatment often offered to children with permanent teeth is fissure sealant. This fills in deep grooves and pits in the biting surfaces of the teeth, making them easier to clean and reducing the chances of decay.

    Fluoride varnish risks and side effects

    Although fluoride varnish is a very safe and widely practised treatment, it is not suitable for everyone.

    One of the risks of over-exposure to fluoride is dental fluorosis, a condition which results in discolouration or white spots on the teeth while they are developing. The amount of fluoride exposure from varnish treatment shouldn’t pose a significant risk because it is applied topically, not ingested.

    That said, do make sure your child spits out all excess toothpaste after brushing – especially in the days following fluoride varnish treatment. If they regularly swallow fluoride toothpaste, the risk of fluorosis increases.

    Your dentist will carry out an assessment first

    If you or your child take fluoride drops or tablets, mention this before receiving treatment. You may be advised not to have fluoride varnish at all, or to stop taking the other supplement for a few days after the varnish is applied.

    Patients with a medical history of allergies should be individually assessed before treatment to reduce the risk of fluoride varnish side effects. Specifically, patients may not be treated if they have allergies to sticking plaster (which contains colophony, also found in duraphat fluoride varnish) or food allergies or asthma which have resulted in hospitalisation.

    Finally, if you or your child have any mouth sores or ulcers on the day of treatment then it will probably be postponed.

    Although it’s routinely offered to children in the UK, fluoride varnish can also be beneficial for adults. Specifically, the treatment may be recommended for adults who:

    • Suffer from sensitive teeth
    • Have thin tooth enamel or significant enamel erosion, for example from teeth grinding
    • Have chronic tooth decay

    Mention it to your dentist at your next visit if you think you might benefit.

    What does it cost?

    As well as being easy to apply and pain-free, fluoride varnish is also one of the cheapest treatments around.

    Getting fluoride varnish on the NHS

    Children and teens who get fluoride varnish on the NHS will receive it for free. Programs run through schools will also be free of charge. For adults aged 18 and over, the band 1 treatment charge will apply at an NHS dentist.

    If your child receives private dental care, fluoride treatment may well be included as part of their regular dental checkups. If paid for separately, fees start from as little as £10-15, but of course costs vary from one dentist to the next.

    As a preventative treatment, fluoride varnish is included in many dental insurance plans. Check your plan details to see if you’re covered.

    It is possible to buy fluoride varnish online, but we don’t recommend it. Without a proper assessment and treatment from a dental professional, you risk exposing yourself or your child to unsafe levels of fluoride and experiencing side effects.

    Fluoride varnish application is an effective way to prevent tooth decay and remineralise teeth, for both children and adults. Children can receive free fluoride varnish treatment on the NHS and through community programs at schools.

    Risks associated with this treatment are minimal, but your dentist will carry out an assessment before applying the varnish.

    Treatment should accompany proper teeth brushing and good oral hygiene to keep teeth in the best condition possible.

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    Sources Karger: Efficacy of Fluoride Varnish and Casein Phosphopeptide-Amorphous Calcium Phosphate for Remineralization of Primary Teeth: A Randomized Clinical Trial. Consulted 14th November 2019. Cochrane: Fluoride varnishes for preventing dental caries in children and adolescents. Consulted 14th November 2019. 0 Shares

    “What really determines whether fluoride is safe, is the amount that is swallowed,” says Amid I. Ismail, BDS, MPH, MBA, DrPH, and Dean, Temple University, School of Dentistry in Dear Doctor Magazine. (1)
    Dr. Ismail says, “Fluoride occurs naturally in soil, fresh and seawater varying dramatically in levels from as low as 0.01 to 8ppm or more….In actuality the “optimal” (most desirable or satisfactory) level is virtually impossible to calculate because of variations in fluoride levels in all sorts of foods and beverages. ‘For example, people living in temperate climates drink less than those in tropical climates. However, it cannot even be assumed that because a person lives in a community with non-fluoridated water, they are receiving low levels of fluoride. Fluoride ingestion can also result from drinking substantial amounts of soft drinks or juices. Most bottled waters contain less than 0.3 ppm; however, some contain close to or more than 1 ppm.” “Breast milk and cow’s milk are very low in fluoride,” says Ismail. Manufacturers voluntarily lowered fluoride levels in infant formula. But when concentrated infant formula is mixed with fluoridated water, infant formula fluoride levels are higher, says Dr. Ismail. Federal agencies, health departments and organized dentistry advise using non-fluoridated water to make infant formula to avoid damaging babies’ teeth.
    “Also, soy-based formulas are consistently higher in fluoride content than milk-based products. Other foods that have high fluoride content are teas, dry infant cereals and processed chicken, fish and seafood products,” says Ismail.
    “It should also be emphasized that “topical” fluorides such as toothpaste can also have a systemic effect if inadvertently swallowed by young children,” cautions Dr. Ismail. Fluoride also gets absorbed into the bloodstream even when not swallowed.
    “Tooth mottling should be monitored in communities to assess fluoride intake and recommendations made accordingly,” writes Ismail.
    However, few communities follow Dr. Ismail’s advice and fluoridate the water without considering residents’ total fluoride intake from other sources. In fact, a Connersville, Indiana, study indicated children already ingested too much fluoride; but dentists lobbied successfully for fluoridation anyway. To our knowledge, no dental fluorosis studies have ever been published on this population.
    Dr. Ismail questions whether mild fluorosis is acceptable any more with esthetics becoming more important in this day and age. He says, “decisions concerning this tradeoff could warrant reconsideration. Fluorosis varies in appearance from small white striations to stained pitting and severe brown mottling of enamel,” he writes.
    “The main documented risk factors for fluorosis (in no particular order) are fluoride in water, infant formula reconstituted with fluoridated water, supplements and dentifrices,” he writes.
    Dr. Ismail reports that “Commissioned by the EPA, a 2006 National Research Council (NRC) study has sparked the latest controversy. In addition to unsightly enamel fluorosis at 4 ppm and above, it claims: a possible increased risk of bone fracture in certain conditions; skeletal fluorosis; and potential to cause bone cancer…”
    “Fluoride is incorporated into bone…after a point though it can make bone more brittle and at higher levels can cause “skeletal” fluorosis, which has a greater potential for painful joints and even fractures,” reports Ismail.
    “The over use of fluoride during the first six to eight years of life represents the important period of tooth development when enamel fluorosis can occur. It is critical for parents to monitor fluoride sources to reduce the occurrence of white spots from fluorosis,” he writes.
    The Centers for Disease Control reports that 60% of adolescents now suffer with dental fluorosis – 3% of it is moderate or severe. At the same time tooth decay rates are increasing in toddlers and untreated tooth decay has become epidemic.
    In Kentucky, despite a 1977 fluoridation state-wide mandate, preschoolers cavity rates went from 28% in 1987 to 47% in 2001, according to the July/August 2003 journal, Pediatric Dentistry,
    According to an 11/27/2011 news article, “In recent years, Northern Kentucky health officials have encountered more children with cavities in a state known for some of the worst teeth in the nation. Kentucky has the second highest rate of toothlessness in the U.S. The national average is 20.5 percent, while 38 percent of Kentuckians have lost their teeth.”(2) The article quotes Linda Poynter, the Northern Kentucky Health Department’s oral health program manager. “I’ve seen too many 5-year-olds with rampant decay who are going to have a body full of abscesses, if (their dental problems) aren’t taken care of,” Poynter said. The article continues, “In recent years, pupils in the Northern Kentucky schools that the local health department visits are experiencing more tooth decay. The percentage of students with tooth decay was 45 percent in 2009. That rose to 47 percent in 2010, and so far this school year, 49 percent of the children screened have tooth decay.”
    It’s not just Kentucky, tooth decay went up after fluoridation began in San Antonio, Texas, also.
    Last week, KENS 5 – TV reported “After 9 years and $3 million of adding fluoride, research shows tooth decay hasn’t dropped among the poorest of Bexar County’s children. It has only increased—up 13% in 2010, the latest date that data was available.
    One out of two children in the Head Start program who were checked for cavities had some decay last year.”
    Actually tooth decay crises are occurring in all fluoridated cities, states and countries.
    Fluoride Supplements Just as Useless
    Dr. Ismail reported “There is weak and inconsistent evidence that the use of fluoride supplements prevents dental caries in primary teeth,” according to a systematic review of fluoride supplement research published in the November 2008 Journal of the American Dental Association. Dr. Ismail is also an organizer of the American Dental Association Clinical Recommendation Panels on Fluoride Supplement.
    “This review confirmed that, in non-fluoridated communities, the use of fluoride supplements during the first 6 years of life is associated with a significant increase in the risk of developing dental fluorosis, write researchers Ismail&Bandekar and first published in Community Dentistry and Oral Epidemiology, February 1999 and to the ADA’s website July 2007 but then taken down.
    The FDA never safety tested nor approved fluoride supplements for use in children or adults.(4)

    1) Dear Doctor Magazine, “Fluoride&Fluoridation in Dentistry”
    2) “N.Ky. kids’ teeth at risk,” NKY.com
    3) “Added to our drinking water: A chemical ‘more toxic than lead’? “ by Joe Conger

    Fluoride and Water

    • Larger text sizeLarge text sizeRegular text size

    Keeping kids’ teeth healthy means more than just daily brushing. During a routine well-child exam, you may be surprised to find the doctor examining your child’s teeth and asking you about your water supply. That’s because fluoride, a substance found naturally in water, plays an important role in healthy tooth development and cavity prevention.

    About Fluoride

    Fluoride, which exists naturally in water sources, is derived from fluorine, a common element in the Earth’s crust. It is well known that fluoride helps prevent and even reverse the early stages of tooth decay.

    Tooth decay happens when plaque — that sticky film of bacteria that builds up on teeth — breaks down sugars in food. The bacteria produce damaging acids that dissolve the hard enamel surfaces of teeth.

    If the damage is not stopped or treated, the bacteria can penetrate through the enamel and cause tooth decay (also called cavities or caries). Cavities weaken teeth and can lead to pain, tooth loss, or even widespread infection in the most severe cases.

    Fluoride combats tooth decay in two ways:

    1. It is incorporated into the structure of developing teeth when it is ingested.
    2. It protects teeth when it comes in contact with the surface of the teeth.

    Fluoride prevents the acid produced by the bacteria in plaque from dissolving, or demineralizing, tooth enamel, the hard and shiny substance that protects the teeth. Fluoride also allows teeth damaged by acid to repair, or remineralize, themselves. Fluoride cannot repair cavities, but it can reverse low levels of tooth decay and thus prevent new cavities from forming.

    Despite the good news about dental health, tooth decay remains one of the most common diseases of childhood. According to the Centers for Disease Control and Prevention (CDC):

    • more than 25% of 2- to 5-year-olds have one or more cavities
    • half of kids 12 to 15 years old have one or more cavities
    • tooth decay affects two thirds of 16- to 19-year-olds

    Fluoride and the Water Supply

    For more than 60 years, water fluoridation has proved to be a safe and cost-effective way to reduce dental caries. Today, water fluoridation is estimated to reduce tooth decay by 20%-40%.

    As of 2012, CDC statistics show that more than 60% of the U.S. population receives fluoridated water through the taps in their homes. Some communities have naturally occurring fluoride in their water; others add it at water-processing plants.

    Your doctor or dentist may know whether local water supplies contain optimal levels of fluoride, which is 0.7 milligrams per liter of water (previously it was a range of 0.7 to 1.2 milligrams). If your water comes from a public system, you also can call your local water authority or public health department, or check online at the Environmental Protection Agency’s (EPA) database of local water safety reports.

    If you use well water or water from a private source, fluoride levels should be checked by a laboratory or public health department.

    Some parents buy bottled water for their kids to drink instead of tap water. Most bottled waters lack fluoride, but fluoridated bottled water is now available. If fluoride is added, the manufacturer is required to list the amount. If fluoride concentration is greater than 0.6 ppm (parts per million), you might see the health claim “Drinking fluoridated water may reduce the risk of tooth decay” on the label.

    The Controversy Over Fluoride

    Opponents of water fluoridation have questioned its safety and effectiveness; however, there has been little evidence to support these concerns.

    Scientific research continues to show the benefits of fluoride when it comes to prevention of tooth decay and its safety. Dramatic reductions in tooth decay in the past 30 years is attributed to fluoridation of the water supply, and parents and health professionals should continue to ensure that kids receive enough fluoride to prevent cavities.

    The American Dental Association (ADA), the United States Public Health Service (USPHS), the American Academy of Pediatric (AAP), and the World Health Organization (WHO), among many other national and international organizations, endorse community water fluoridation. In fact, the CDC recognized fluoridation of water as one of the 10 greatest public health achievements of the 20th century.

    Kids’ Fluoride Needs

    So how much fluoride do kids need? In general, kids under the age of 6 months do not need fluoride supplements. Your child’s 6-month checkup offers a great chance to discuss fluoride supplementation with your doctor.

    If you live in a nonfluoridated area, your doctor or dentist may prescribe fluoride drops, tablets, or vitamins after your baby is 6 months old. The dosage depends on how much fluoride naturally occurs in the water and your child’s age. Only kids living in nonfluoridated areas or those who drink only nonfluoridated bottled water should receive supplements.

    Here are some other tips:

    • Use a fluoride-containing toothpaste that carries the ADA’s seal of acceptance.
    • Brush babies’ teeth as they come in with an infant toothbrush. Use water and a tiny bit of fluoride toothpaste (about the size of a grain of rice). If you are using baby toothpaste without the fluoride, keep it to the same amount because you still want to minimize any toothpaste that is swallowed.
    • Kids ages 3 and up should use only a pea-sized amount of fluoride toothpaste.
    • Kids younger than 6 may swallow too much toothpaste while brushing. Supervise them when brushing and teach them to spit, not swallow, the toothpaste.
    • Kids under age 6 should never use fluoride-containing mouth rinses. But older kids at high risk for tooth decay may benefit from them. Your dentist can talk with you about risk factors such as a family history of dental disease, recent periodontal surgery or disease, or a physical impediment to brushing regularly and thoroughly.

    Your family dentist or pediatric dentist (one who specializes in the care of children’s teeth) is a great resource for information about dental care and fluoride needs. A dentist can help you understand more about how fluoride affects the teeth, and may even recommend applying a topical fluoride varnish during routine dental visits.

    Overexposure to Fluoride

    If some fluoride is good, why isn’t more fluoride better? As with most medications, including vitamins and mineral supplements, too much can be harmful. Most kids get the right amount of fluoride through a combination of fluoridated toothpaste and fluoridated water or supplements.

    Too much fluoride before 8 years of age, a time when teeth are developing, can cause enamel fluorosis, a discoloration or mottling of the permanent teeth. For most, the changes are subtle. In one study, 94% of identified fluorosis cases were very mild to mild. Most cases are due to accidental swallowing of fluoride-containing dental products, including toothpaste and mouth rinses. Sometimes kids take daily fluoride supplements but may be getting adequate fluoride from other sources, which also puts them at risk.

    Recently, the National Research Council found that some naturally occurring fluoride levels exceeded the optimal levels used in community fluoridation programs, putting kids under 8 years old at risk for severe enamel fluorosis. The CDC recommends that in communities where natural fluoride levels are high, parents should give kids water from other sources.

    The ADA also recognizes that infants need less fluoride than older kids and adults. Some infants may be getting too much fluoride in the water used to reconstitute infant formula. If you’re concerned that your infant may be getting too much fluoride, talk with your doctor or dentist, who may recommend ready-to-feed formula or formula reconstituted with fluoride-free or low-fluoride water.

    Very rarely, fluoride poisoning can happen if large amounts of fluoride are ingested during a short period of time. Kids under age 6 account for more than 80% of reports of suspected overingestion. Although this is generally not serious, fluoride poisoning sends several hundred children to emergency rooms each year.

    Symptoms of fluoride poisoning may include nausea, diarrhea, vomiting, abdominal pain, increased salivation, or increased thirst. Symptoms begin 30 minutes after ingestion and can last up to 24 hours. If you suspect your child may have eaten a substantial amount of a fluoridated product or supplement, call the poison control center (1-800-222-1222) or 911.

    Be sure to keep toothpaste, supplements, mouth rinses, and other fluoride-containing products out of kids’ reach or in a locked cabinet. Also, supervise young kids when they brush their teeth to prevent swallowing of toothpaste or other fluoridated products.

    If you have any questions about your water’s fluoride content, the fluoridated products your child uses, or whether your child is receiving too much or too little fluoride, talk to your doctor or dentist.

    Reviewed by: Rupal Christine Gupta, MD Date reviewed: April 2015

    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 form toxic concentrations of hydrofluoric acid in the stomach. While the dentists now use measures to reduce the amount of fluoride that is swallowed, it is estimated that children still swallow an average of 7.7 mg per treatment, while adults swallow an average of 10.3 mg. (Johnston 1994). Such doses still exceed the doses that cause damage to the gastric mucosa. Indeed, as the data in the table below shows, a single dose of just 3 mg (the lowest dose tested) can cause widespread erosion of the gastric lining. (Spak 1990).

    Gastric Symptoms following application of Fluoride Gel:

    “he most likely symptoms to manifest in patients from professionally applied topical fluorides are nausea and possibly vomiting. The irritation caused by topical fluoride gel to the gastric mucosa has been described. The observation by clinicians and researchers that nausea and vomiting are occasional manifestations of inadvertent ingestion of high fluoride ion from topical fluorides, particularly by young children, identifies the need to minimize unintentional swallowing of excess fluoride from dental products.”
    SOURCE: Johnston DW. (1994). Current status of professionally applied topical fluorides. Community Dent Oral Epidemiol. 22(3):159-63.

    “Several investigations have shown tissue disruption and cellular injury of rat gastric mucosa following the administration of amounts and concentrations of F much lower than . This may help explain why children and adults sometimes complain of nausea and occasionally exhibit vomiting following topical F treatments.”
    SOURCE: Lecompte EJ. (1987). Clinical application of topical fluoride products–risks, benefits, and recommendations. J Dent Res. 66(5):1066-71.

    “Complaints of nausea, vomiting, or epigastric pain by patients receiving topical APF gel applications or those who have ingested other high-concentration fluoride preparations are not uncommon. . . . unctional and structural findings from laboratory animal studies support the argument that patient complaints of epigastric distress after swallowing fluoride in high concentrations are due to a direct local toxic effect of the ion on the gastric mucosa. They also indicate the need to adopt standard application techniques that will reduce the quantities of fluoride available for swallowing.”
    SOURCE: Whitford GM, et al. (1987). Topical fluorides: effects on physiologic and biochemical processes. J Dent Res. 66(5):1072-8.

    “The amount and concentration of F ingested may help to explain why children often complain of nausea and occasionally exhibit vomiting following topical F application. Easmann et al have shown disruption of rat gastric mucosa following the administration of amounts and concentrations of F lower than those used in this study.”
    SOURCE: LeCompte EJ, Whitford GM. (1982). Pharmacokinetics of fluoride from APF gel and fluoride tablets in children. J Dent Res. 61(3):469-72.

    “One the subjects experienced nausea and slight dizziness.”
    SOURCE: Ekstrand J, Koch G. (1980). Systemic fluoride absorption following fluoride gel application. J Dent Res. 59(6):1067.

    TABLE: Dose of Fluoride vs. Gastric Mucosa Damage

    Values for Macroscopic and Microscopic Evaluation of the Gastric Mucosa in Control Conditions (C) and After Fluoride Application (F)
    Subject Macroscopic Evaluation* Microscopic Evaluation ** Retained Amount
    of Fluoride
    (mg)
    Corpus Antrum Corpus Antrum
    C F C F C F C F
    LB 0 1 0 1 0 1 0 1 6.0
    KT 2 4 0 3 0 1 0 0 3.4
    EF 0 4 0 3 0 1 0 0 7.8
    IT 0 4 0 2 0 1 0 1 9.2
    AL 0 1 0 0 0 1 0 1 3.1
    MJ 0 0 0 0 0 1 0 1 3.2
    MW 0 4 0 1 1 2 0 0 3.9
    HD 0 0 0 0 0 1 0 0 5.3
    LJ 0 0 0 0 1 0 1 1 4.1
    PK 0 3 0 2 0 1 0 1 5.3
    Mean 5.1
    SD 2.1
    * Macroscopic Evaluation:0 = normal
    1 = 1 petechia or erosion
    2 = 2 – 5 petechiae or erosions
    3 = 6 – 10 petechiae or erosions
    4 = >10 petechiae or erosions, widespread involvement of the stomach with petechiae or erosions, ulcer of any size.

    ** Microscopic Evaluation

    0 = normal
    1 = either surface epithelium alteration with stroma edema/ hemorrhage or gastric pit damage
    2 = both surface epithelium and gastric pit damage
    3 = as number 2 combined with acute inflammatory cellular response

    SOURCE: Spak CJ, et al. (1990). Studies of human gastric mucosa after application of 0.42% fluoride gel.Journal of Dental Research 69:426-9.

    If you have a fluoride allergy it could make you sick. However, having a fluoride allergy is quite rare and for the people who do have it, it can be a mild to severe reaction and will need to be treated immediately. Here at Belmont Dental Associates in Belmont, North Carolina, we care about our patients and we make sure we have a full workup of your medical history along with all of your allergies. That’s why we are one of the best dental offices in Belmont. In this article, we will be going over the signs and the main symptoms of a fluoride allergy and also how to prevent and treat it.

    What are the Signs and Symptoms of a Fluoride Allergy?

    What happens when you have a fluoride allergy is when you ingest the fluoride your immune system sees the fluoride as a harmful bacterium that needs to be dealt with. So, what your immune system does is that it produces antibodies to ward it off and this is how you get the reaction from the fluoride allergy. Fluoride can be found in many dental products, but you can also find it in certain foods and drinks. Here are the main signs and symptoms of a fluoride allergy.

    · Cuts or lesions in your mouth.

    · Mild to severe headaches.

    · Weakness in your muscles or joints.

    · Joint and muscle pain.

    · Nausea, upset stomach.

    · Feeling tired or mental weakness.

    · Blurred vision or trouble seeing.

    · Any swelling of your mouth, tongue, or your face.

    · Emesis.

    In some extreme cases of a fluoride allergy you may experience an anaphylactic shock, which is a condition that causes your body to shut down.

    How to Treat a Fluoride Allergy

    When you have this allergic reaction, antihistamines are commonly prescribed, and it can take up to 10-15 minutes to take effect. Try to steer clear from any sodas, juices that are bottled, processes cereals, chicken and fish. They can contain a high amount of fluoride and that can also give you the reaction. Avoid drinking tap water. Tap water is full of rich fluoride instead, drink bottled water or natural spring water.

    There has been so much debate weather fluoride will help you or hurt you and recent studies have shown that a number of people has had allergic reactions to it. So, please let us know if you are allergic to fluoride when you come to see us at Belmont Dental Associates. We take pride in our work and strive to give you the best patient care possible. If you have any questions or concerns, please don’t hesitate to call us or stop by the office in Belmont, North Carolina. We’re always here to help in any way we can.

    Fluoride’s Effect on the Gastrointestinal Tract

    Gastrointestinal symptoms like nausea, abdominal pain and vomiting are the most common early symptoms of acute fluoride poisoning. For people who are sensitive to fluoride, ingesting 1 mg tablets of fluoride or drinking 1 parts per million of fluoridated water can cause these gastrointestinal symptoms. A 5-to-10 gram dose of fluoride for an adult or 500 mg dose for a child can cause damage to the body’s major organs and even cause death.
    Fluorine is a gas–an element. In very small amounts it is sometimes listed as a trace mineral for human nutrition. However, the fluoride that is added to our drinking water is hydrofluoric acid—a compound of fluorine that is a chemical side effect of aluminum, cement, phosphate, steel and nuclear weapons manufacturing. Therefore, this fluoride is man made and has no nutritional value. It is a destructive chemical that is the active toxin in cockroach powder and rat poison.
    When fluoride is ingested, it can form hydrofluoric acid in the stomach, resulting in gastrointestinal (GI) irritation. Once fluoride is swallowed, the GI tract is the first and most commonly affected body system.
    “Ingested fluoride is transformed in the stomach to hydrofluoric acid, which has a corrosive effect on the … lining of the gastrointestinal tract. Thirst, abdominal pain, vomiting, and diarrhea are usual symptoms,” states the Environmental Protection Agency.
    Even supporters of fluoridation are now admitting that fluoride’s benefits are topical—working from the outside of the tooth instead of from inside of the body. So why swallow fluoride?
    In clinical studies that used fluoride at doses of 18-34 mg per day as an experimental drug to treat osteoporosis, GI disturbances were one of the two major side effects that were constantly experienced.
    “The fluoride-treated women had about three times as many side effects as the women given placebo … The gastric symptoms consisted mainly of nausea or, less commonly, epigastric pain and vomiting, or both. The fluoride-treated women had these symptoms 2.9 times more frequently than the women given placebo.” .
    An Indian researcher with 30 years experience researching and publishing fluoride’s effects says, “It is concluded that in an endemic zone, where the inhabitants are consuming water of high fluoride content, the occurrence of gastrointestinal complaints … –loss of appetite, nausea, abdominal pain, flatulence, constipation, and intermittent diarrhea—is one of the early warning signs of fluoride toxicity and fluorosis. When water with negligible amounts of fluoride is provided the complaints disappear within .”

    What can you do to limit your fluoride exposure?

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