Dental care: Fluoride safety considerations and your child

I know that fluoride can help prevent cavities, but I have also heard that it can be toxic in large amounts. Is it possible to overdose on fluoride? What are some fluoride safety considerations for children?

Question:

First and foremost, I wish to stress that fluoride is safe and effective when it is taken as directed. Small children do tend to swallow fluoride toothpaste. This is why I recommend that only a match head size amount of fluoride toothpaste should be placed on their toothbrush. This will ensure that they receive the safe, effective cavity fighting protection they need without ill effects.

Most drugs can be harmful or even deadly if they are not taken as directed. Yes, fluoride can be toxic if it is ingested in very large quantities. The medical and dental professions, as well as the US Food and Drug Administration, recognize the potential harmful effects when very large amounts of fluoride are swallowed. This is one reason that fluoride supplements must be prescribed by a licensed physician or dentist. Fluoride overdoses are rare. I am not aware of any documented human deaths directly attributed to acute fluoride toxicity.

A lethal dose of sodium fluoride for an adult weighing 70kg is considered to be between 5g and 10g. One quarter of this dose can be ingested without producing serious acute toxicity. This is known as the safely tolerated dose.

Comparisons of lethal and safely tolerated doses for commonly used fluoride agents and procedures show that they can be applied as long as they are used correctly. If their use is abused, there is a risk of illness or even death in extreme cases. If a lethal amount of fluoride is ingested, prompt first-aid is critical. If the person that swallowed large quantities of fluoride is not vomiting already, vomiting should be induced. Fluoride-binding liquids, such as milk or antacids, should be given. The patient should be taken to the nearest hospital for emergency care.

Frequent ingestion of low but excessive amounts of fluoride during the period of tooth formation can lead to dental fluorosis. Dental fluorosis has been widely studied and numerous papers have been published on this topic. Again, most concern is warranted for the ingestion of fluoride-containing toothpastes by young children. Dental fluorosis may also be a concern when dietary fluoride supplements are used inappropriately or when fluoride is already present in sufficient amounts in drinking water.

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