Efficacy and Safety of Fluoride in Children: A Narrative Review

Abstract

Context: Fluoride is a necessary element for bone growth and the prevention of dental caries. Diet and dentifrices are the most significant sources of fluoride exposure in children. The concentration of fluoride differs in various types of foods. Although at optimal levels, fluoride has beneficial effects on dental health, in high concentrations, it has some adverse effects, such as structural and functional defects in organs like the kidney and interference with thyroid function. High doses of fluoride can lead to fluoride toxicity, affecting different parts of the body like teeth. Our study aimed to review the previous studies on fluoride toxicity and provide relevant information to dentists and specialists about fluoride safety in children. Evidence Acquisition:The data we used in our review were found from articles published until 2019 and collected from official web pages and documents published from different international institutions. Topics discussed in this review were dietary intake of fluoride, fluoride metabolism, history of fluoride use, mechanism of fluoride action, overuse, and toxicity of fluoride. After the abstract screening, we reviewed relevant studies for full-text review.Results: Fluoride is generally found in the human daily diet. There are different sources of fluoride, such as fluoride supplements or fluoride dentifrices. Fluoride also has a topical protective effect against teeth decay. Ingestion of high doses of fluoride in a short time can lead to fluoride poisoning. Emergency treatment is needed when the toxic dose of 15 mg/kg has been exceeded. This problem usually happens in children while using products such as fluoridated toothpaste for oral hygiene; this illness can threaten their overall health. Conclusions:Fluoride can damage organs such as the liver and kidney as the principal organs susceptible to toxicity induced by fluoride. Although the intake of high doses of fluoride has some adverse health effects, its topical use is considered safe. Fluoride can improve children's dental health in different ways and prevent caries.

Fluoride; An Updated Review

“…Dean made an index frequently used for classifying different types of dental fluorosis in 1934. Table 1 shows the Dean's fluorosis index (88).…”