Fluoride intoxication

Waldbott, George L.

doi:10.1001/jama.244.4.331b

Cited by 7 publications

(9 citation statements)

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“…The toxicities of different fluoride compounds are likely related to their individual chemical properties, which may affect both accessibility to tissues as well as the potential to release free fluoride anion. Potassium fluoroborate and potassium hexafluorophosphate have no systemic toxicity, presumably due to tight binding of the fluoride anion (20). In contrast, sodium fluoroacetate is a highly toxic compound that penetrates mitochondria and disrupts oxidative metabolism through inhibition of the Krebs cycle enzyme aconitase.…”

Section: Discussionmentioning

confidence: 99%

“…Sulfuryl fluoride, an insecticide compound used in fumigation, causes rapid incapacitation, respiratory depression, and convulsions after inhalational exposure (30,31). Fluoride compounds also interfere with acetylcholinesterase and carbohydrate metabolism, but a contribution of these mechanisms to toxicity is not clear (20).…”

Section: Discussionmentioning

confidence: 99%

“…Discussions of the management of fluoride toxicity have emphasized the importance of hypocalcemia and its prompt treatment to avoid cardiac complications (1,2,11,(17)(18)(19)(20)(21)(22). Hyperkalemia, which may be delayed in onset, has also been proposed as an etiology of fluoride-associated ventricular dysrhythmias (4,18,(23)(24)(25)(26)(27).…”

Section: Introductionmentioning

confidence: 99%

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Recurrent life-threatening ventricular dysrhythmias associated with acute hydrofluoric acid ingestion: Observations in one case and implications for mechanism of toxicity

Vohra

Velez

Rivera

et al. 2008

Clinical Toxicology

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University of Texas, Southwestern Medical Center at Dallas, Dallas, Texas, USAIntroduction. Hydrofluoric acid (HF) is a weak inorganic acid used for etching and as rust remover. Systemic toxicity is manifested as ventricular dysrhythmias. The mechanisms for these dysrhythmias are not well elucidated. Case report. An 82-year-old woman ingested 8 ounces of 7% HF. Shortly after emergency department (ED) arrival, she became pulseless, developing recurrent ventricular dysrhythmias. She was defibrillated 17 times and received several doses of calcium, magnesium, and lidocaine. After three hours, she returned to sustained NSR. She was discharged home after four days. Discussion. The electrocardiographic findings in this patient demonstrate hypocalcemia, which has been implicated as the culprit in HF-induced arrhythmias. However, despite correction of the hypocalcemia, the ventricular arrhythmias persisted. The proposed mechanisms of systemic HF toxicity and the relevant literature are discussed. Conclusion. Ventricular dysrhythmias due to HF toxicity seem to be independent of either hypocalcemia or hyperkalemia. Systemic toxicity after ingestions may be delayed and precipitous.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Recurrent life-threatening ventricular dysrhythmias associated with acute hydrofluoric acid ingestion: Observations in one case and implications for mechanism of toxicity

Vohra

Velez

Rivera

et al. 2008

Clinical Toxicology

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“…The hydrogen fluoric acid content of some of the topical solutions is interesting due to the specific burning effect of this compound [Roholm, 1937;Waldbott, 1963], partly because of the risk of local ized interoral burns after repeated intense application, partly because the microbial plaque may be seriously affected. The characteristics of the acidic fluoride solu tions -the ability to dissolve the enamel, the increased ability to induce formation of a layer of calcium fluoride covering the enamel and the toxicity due to the hydrogen fluoride content -may be responsible for some of the recent findings of desorption of pellicle and proteins from apatite [Rôlla, 1977] and of reduced plaque formation after exposure of en amel to various fluoride and other salt so lutions [Skjorland et al, 1978;Kilianet al, 1979], The two procedures for testing the cal cium fluoride formation of the various topical solutions were designed to study two relations: using the standardized procedure in which all solutions were used in the same way and in which the enamel surface was rinsed in a solution saturated with calcium fluoride to avoid dissolution of this salt, a comparison of the calcium fluoride formation potentials was possible irrespective of the actual clinical treatment procedure.…”

Section: Discussionmentioning

confidence: 99%

On the Properties of Fluoride Solutions Used for Topical Treatment and Mouth Rinse

Larsen¹,

Jensen²

1986

Caries Res

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A number of solutions used for topical application and mouth rinsing were analyzed and calcium fluoride formation on human enamel at 20 °C determined. In most solutions free fluoride and hydrogen fluoride were the main ion species, whereas stannous hydroxide and stannous fluoride ion pairs were the dominating components of stannous fluoride solutions. The calcium fluoride formation on enamel was assessed by chemical analysis. It was found that an increase in fluoride activity and a decrease in pH increased the calcium fluoride formation to almost the same extent.

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“…Fluoride also binds to potassium and magnesium ions leading to myocardial irritability and arrhythmia. Chronic exposure to HF may cause skeletal fluorosis that can be fatal [53][54][55][56].…”

Section: Systemic Toxicitymentioning

confidence: 99%

Possible hazardous effects of hydrofluoric acid and recommendations for treatment approach: a review

2011

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Hydrofluoric acid (HF) is commonly used for conditioning the glass ceramics either prior to cementation or for intraoral repair in prosthetic and restorative dentistry. The present study offers a review of chemical properties of HF used, highlight the possible hazardous effects of this agent, and to recommend the treatment approach for potential risks. Available published information documented in PubMed, Medline, and Picarta literature databases was reviewed. Additional information was derived from scientific reports, medical and chemical textbooks, handbooks, product information, manufacturers' instructions, Internet web sites of the HF manufacturers. No report was found on the incidence of the hazardous effects of HF in dentistry. Reports from other fields presented incidences of acute and chronic symptoms in exposure to HF. While acute symptoms include skin or nail burns, chronic ones involve systemic toxicity, eye injuries, inhalation and ingestion-related symptoms that can be even fatal. HF can be harmful and particularly aggressive to soft tissues, but symptoms may not be apparent immediately after exposure. The hazardous effects are not based on the pH value, but on the toxicity of HF. Potential hazards of HF known from other applications than dentistry should be considered also in dental applications. Especially the clinicians, who often deal with adhesive cementation or repair of glass ceramics, should take necessary precautions for possible hazards of HF. Scientific reports, medical and chemical textbooks, handbooks, product information, manufacturers instructions, Internet web sites of the HF manufacturers were also referred. In dentistry, HF is most commonly used for conditioning the glass ceramics either prior to cementation or for intraoral repair.Exposure to HF can be harmful and may not be immediately apparent being particularly aggressive for soft tissues. This is not based on the pH value, but on its toxicity. Common routes of exposure are inhalation, dermal exposure and ingestion that lead to the general symptoms of toxicity such as lung injury, skin burns, systemic toxicity and painful necrotic lesions. General symptoms are skin burns, systemic toxication and eye irritation by fume exposure. No report was found on the hazardous effects of HF in dentistry. HF is commonly used to condition the ceramic surfaces prior to cementation or repair. Especially the clinicians, who often deal with glass ceramics, should take necessary precautions for possible hazards of HF.

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Fluoride intoxication

Cited by 7 publications

References 0 publications

Recurrent life-threatening ventricular dysrhythmias associated with acute hydrofluoric acid ingestion: Observations in one case and implications for mechanism of toxicity

Recurrent life-threatening ventricular dysrhythmias associated with acute hydrofluoric acid ingestion: Observations in one case and implications for mechanism of toxicity

On the Properties of Fluoride Solutions Used for Topical Treatment and Mouth Rinse

Possible hazardous effects of hydrofluoric acid and recommendations for treatment approach: a review

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