Fluorides, which are usually referred to as fluoride, are minerals containing fluorine, one of the most reactive elements found on the periodic table. Unlike some minerals that are harder to obtain, fluorides are commonly found in the earth’s crust and water supply. The most common fluorides are sodium fluoride and calcium fluoride, which are naturally found in water and in some foods. Other fluorides, such as hexafluorosilicic acid and sodium hexafluorosilicate, are added to city water supplies to aid in the prevention of tooth decay. Sodium fluoride, stannous fluoride, and sodium monofluorophosphate are fluorine compounds that may be in toothpaste.
Fluoride is best known for helping to prevent tooth decay and cavities and promoting strong teeth and enamel. Adding fluoride to city and town water supplies is a practice that began in the United States in the 1940s. It is believed that adults and children who live in communities with fluoridated water experience 40 to 60 percent reductions in tooth decay. Although they tend to market themselves as if they come from the most pristine of sources, bottled water may be obtained from the tap or another fluoride-containing water source. As a result, bottled waters may contain fluoride.
Still, not everyone agrees that even small amounts of fluoride should be added to the water. In fact, many people cite studies that have found an association between fluoride and a number of different medical problems and concerns. The American Dental Association disagrees. “More than 70 years of scientific research have shown that an optimal level of fluoride in community water is safe or effective in preventing tooth decay by at least 25% in both children and adults.”
What Are Fluoride Sources in the Human Diet?
The best source of fluoride is fluoridated water. In general, well water contains little or no fluoride. Food cooked in fluoridated water also has fluoride. Tea and gelatin are food sources of fluoride. People who know that their water supply is not fluoridated may want to discuss fluoride supplementation with their medical provider. Fluoride supplementation is available as a liquid, tablet, and chewable tablet. Normally, it is taken once a day by mouth. Fluoride may be taken by itself or combined with a food, such as cereal, or a liquid, such as juice. Fluoride supplements should not be taken at the same time as dairy products. A wait of at least one hour between fluoride and dairy is advised. Missed doses should be taken as soon as possible. However, if it is almost time for the next dose, the missed dose should be skipped. Double doses should be avoided. Supplemental fluoride may cause a number of side effects, including stained teeth, increases in saliva, a salty or soapy taste in the mouth, stomach pain, gastrointestinal upset, vomiting, diarrhea, rash, tremors, weakness, and/or seizures.
Even if a mother drinks fluoridated water, breast milk contains little fluoride. Babies who are breastfed or drink formula prepared with water that is not fluoridated may require supplementation at around six months of age. Babies who are fed formula prepared with fluoridated water probably obtain sufficient amounts of fluoride. It is best to discuss these concerns with a medical provider.
| Food name | Weight (g) | Fluoride (µg) | DV% |
| Raisins | 165 | 385 | 9% |
| Grape juice | 253 | 349 | 8% |
| Crab | 135 | 283 | 7% |
| Shrimp | 128 | 257 | 6% |
| Orange juice | 249 | 77 | 1.93% |
| Oyster | 85 | 53 | 1.33% |
| Sweet corn | 256 | 46 | 1.15% |
| Tuna | 146 | 45 | 1.13% |
| Cottage cheese | 113 | 35 | 0.88% |
| Honey | 339 | 23 | 0.58% |
| Asparagus | 90 | 19 | 0.48% |
| Pecans | 109 | 10 | 0.25% |
| Avocados | 150 | 10 | 0.25% |
| Sweet potato | 105 | 8 | 0.20% |
| Prunes | 174 | 7 | 0.18% |
| Radishes | 116 | 7 | 0.18% |
| Strawberries | 152 | 6 | 0.15% |
| Bananas | 225 | 5 | 0.13% |
| Carrots | 9 | 4 | 0.10% |
| Peanuts | 28 | 4 | 0.10% |
What Are Current Recommendations for Fluoride Intake?
In order to meet adequate intake requirements, the National Institutes of Health recommends that adult males take in 4 mg per day and adult females, including those who are pregnant or lactating, take in 3 mg per day. Teens between the ages of 14 and 18 years should take in 3 mg per day, and children between the ages of 9 and 13 years should take in 2 mg per day. Children between the ages of four and eight years should take in 1 mg per day, while children between the ages of one and three years should take in 0.7 mg per day. Infants between the ages of 7 and 12 months should take in 0.5 mg per day, while infants between the ages of birth and 6 months should take in 0.1 mg per day.
For males and females eight years of age and older, the Tolerable Upper Intake level is 10 mg per day. For children between the ages of 4 and 8 years, the level is 2.2 mg per day; for children 1 to 3 years, that level is 1.3 mg per day; for children 7 to 12 months that level is 0.9 mg per day; and for children under the age of 6 months, that level is 0.7 mg per day.
What Happens If Too Much Fluoride Is Consumed?
Fluoride seems to be very efficiently absorbed from the digestive tract regardless of the amount consumed. Even though excessive fluoride in the body is removed in the urine, humans can overwhelm this function by ingesting larger quantities of supplemental fluoride. Fluoride toxicity is called fluorosis and problems such as alterations in bones, teeth, and possibly excitable cells may result. Mottling of teeth is evidence of dental fluorosis in children. Taking gram doses of fluoride, 5 to 10 grams of sodium fluoride, can lead to subsequent nausea, vomiting, and a decrease in body pH (acidosis). Furthermore, irregular heart activity and death may also result.
What happens with deficiency and excess Fluoride?
A deficiency of fluoride may result in more cavities and weak bones and teeth. It is almost impossible to obtain an excess of fluoride from the diet. When consumed in excess supplementation, fluoride is toxic. Large doses may result in nausea, abdominal pain, and vomiting.
Though it is rarely seen, infants who take in too much fluoride before their teeth have broken through the gums may have changes in the enamel, such as faint white lines or streaks. The following recommendations may help to ensure that infants and young children do not take in too much fluoride. When preparing formula, it is important to check the type of water that is advised. Fluoride supplements should not be used without the recommendation of a trusted medical provider. Children under the age of two years should not use toothpaste that contains fluoride. Until they are six years old, children should not use a mouthwash containing fluoride.
Health Benefits of Fluoride
Let us know about the health benefits of Fluoride:
- Prevent cavities
In a retrospective, longitudinal analysis published in 2014 in the Journal of the American Dental Association, researchers from various Veterans’ Administration dental clinics in the United States tested the use of fluoride applications on veterans at increased risk for caries—those who have two or more fillings during a one-year period of time. During fiscal year 2009, the first year of the trial, the goal was to provide fluoride treatments to at least 60 percent of high-risk patients.
By fiscal year 2012, the dental providers were providing the treatment to 81 percent. That meant that 8 out of every 10 clinics gave fluoride treatments to at least 90 percent of high-risk patients. And the fluoride treatments translated into a significant reduction in the need for new fillings. In fact, the high-risk dental patients experienced a 10-point drop in the rate of new fillings. The researchers noted that their fluoride treatment program demonstrated how positive changes may be made in a “large system of care.”
- Protect all ages against cavities
Study have shown that fluoride in community water systems prevents at least 25 percent of tooth decay in adults and children even in era with widespread availability of fluoride from other sources such as fluoride toothpaste.
- Effective and safe
For 70 years, scientific evidence indicates that community water fluoridation is effective and safe. It is endorsed by various U.S. Surgeons General and more than 100 health organizations recognized health benefits of water fluoridations for preventing dental decay including Centers for Disease control or prevention, the World Health Organization, the American Medical Association, the American Academy of Pediatrics and the American Dental Association.
- Money saving
Average lifetime cost per person to fluoridate water supply is lower than cost of one dental filling. In most cities, $1 invested in water fluoridation economize $38 in dental treatment costs.
- Natural
Naturally fluoride is present in oceans and groundwater. Water fluoridation is adjustment of fluoride to recommended level in order to prevent tooth decay. Similar to food fortification of other foods or beverages such as fortifying salt with iodine, milk with Vitamin D, bread with folic acid and orange juice with calcium.
References: