1. FLUORIDE TOXICITY Dr. Shahzadi Tayyaba Hashmi shahzadi@inaya.edu.sa

2. The term toxicity refers to the symptoms manifested as a result of over dosage or excessive administration Fluoride can cause acute as well as chronic toxicity TOXICITY OF FLUORIDE

3. 1.The acute lethal dose of fluoride for man is probably 5 g 2.Acute fluoride intoxication is rare 3.Acute fluoride poisoning have been recorded As a result of accidents Deliberate attempts to suicide Certainly Lethal Dose (CLD): A lethal dose is the amount of drug likely to cause death Adult lethal dose=34-64mgF/kg body weight Safely tolerated dose (STD): STD=1/4 Certainly Lethal Dose ACUTE FLUORIDE TOXICITY

4. Symptoms: 1.Vomiting, nausea and diarrhea 2.Pain in abdomen 3.Difficulty in speech 4.Thirst 5.Perspiration 6.Weak pulse 7.Coma 8.Convulsions 9.Cardiac arrhythmias which causes death 10.Death will occur within four hours 11. If the patient survives for 24 hours the prognosis is good SYMPTOMS

5. Symptomatic Treatment:  Milk or egg can be given  Lime water  Vomiting…so that majority of ingested fluoride is expelled In an hospital: Cardiac monitoring Gastric lavage General supportive measures TREATMENT

6. Effects on Enamel: The influence of chronic fluorine intoxication is on the structure of enamel in the development of mottled enamel Mottled enamel is characterized by minute white flecks, yellow or brown spot areas, scattered irregularly all over the tooth surface Premolars are most commonly affected Permanent teeth are particularly affected CHRONIC FLUORIDE TOXICITY

8. Milder form diminish with time Removing minor blemished stains by grinding or polishing and etching by acid Bleaching with hydrogen peroxide Use of composites Use of veneers TREATMENT

9. The need to fluoridate water supplies to reduce dental caries is balanced by a similar need to remove excessive amounts of fluorides from naturally fluoridated water Defluoridation of water is 10 times more expensive than fluoridation Methods: The ideal method to defluoridate an area is to blend the water from the well with the excess amount of fluoride with another water supply deficient in fluoride Advantages: The only expenditure is the connecting pipes DEFLUORIDATION