Monofluorophosphate Physiology: The Effects of Fluoride on Bone

Abstract

Fluoride is an effective agent in the treatment of osteoporosis and is the only available agent that is capable of producing a large increment in bone mass. Fluoride stimulates bone formation largely through its action to increase osteoblast number. In vitro work suggests that the effect of fluoride to increase osteoblast number is due to a direct action of fluoride to stimulate the proliferation of osteoblast precursors. In fluoride-treated patients the increase in bone formation leads to an increase in bone mass as manifested by an increase in X-ray density, which in turn leads to a decrease in bone pain and a decrease in fracture rate. These positive effects are limited to the axial skeleton and are not observed in the appendicular skeleton in the dose used. The increase in bone formation is reflected by an increase in serum total alkaline phoshatase activity, which is due to an increase in the bone isoenzyme and which can be used to assess serially the action of fluoride on bone. Serum total alkaline phosphatase activity measurements indicate that, during 2 years of fluoride treatment, about 80% of patients respond and that the magnitude of the response is quite variable. The major disadvantages of fluoride in the treatment of osteoporosis include: (1) All patients do not exhibit a response. (2) Fluoride treatment causes gastric and joint side effects in a significant proportion of patients.

Interactive effect of fluoride burden with calcitonin receptor gene polymorphisms on the risk of F bone injury

“…F enters the body primarily through respiratory or digestive tract and accumulates in bone and soft tissue via the blood circulation. By stimulating osteoblasts, F promotes bone formation in both cortical and trabecular bone, but its eVect on trabecular bone is greater, occurs earlier, and leads to a more pronounced increase in spine density on x-ray Wlms (Baylink et al 1983) Most F bone injury patients' bone and soft tissue are involved. UF is a comprehensive index of the body F burden, bone F accumulation, and body F excretion.…”

“…F stimulates the osteogenetic process, resulting in an increase in bone mass (Baylink et al 1983). However, long-term F exposure leads to high F burden, which can Wnally result in F bone injury (Ma et al 2009).…”

Topical Fluorides: A Discussion of Risks and Benefits

“…A tooth or tooth surface that is sound will remain sound. Frequent topical fluoride applications may also promote gingival health by selectively affecting Streptococcus mutans (Tinanoff, 1985), and controlled fluoride ingestion may be beneficial to bone metabolism in both healthy and diseased individuals (Schamschula and Barmes, 1981;Baylink et al, 1983). In addition to obvious treatment benefits, there are also economic and psychosocial ones associated with fluoride therapy.…”

The effect of fluoride on bone histology in postmenopausal osteoporosis depends on adequate fluoride absorption and retention

“…Successful treatment of osteoporosis would require a signifi-cant gain in bone mass with a decrease in the fracture rate. Sodium fluoride is known to increase bone mass, (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12) and a decrease in the rate of new vertebral fractures has been re-p~r t e d . (~,~)…”