Fluoride is a natural compound which is widely distributed in nature including in earth’s crust. It is a reduced form of fluorine. Fluorine rarely occurs in its free state. Mostly fluorine is available in salts of fluoride. This natural substance is found in few foods and food supplements as well as in varying quantity in water.
Fluoride poisoning occurs when large amount of fluoride containing products is ingested. Fluoride in its normal required amount is beneficial for dental and bone health. But frequent consumption of large amount of fluoride can be devastating to health. Elevated level of fluoride in rivers and ground water is known to cause chronic fluoride poisoning.
Very large amount of fluoride can cause mottling of teeth and changes in the bones, a condition called fluorosis. There are several types of fluoride salts present in different substances. For example toothpaste contains sodium monofluorophosphate, certain diet products contain sodium fluoride.
What Are The Causes Of Fluoride Poisoning?
Fluoride is required by the body but in limited amount. The normal level of fluoride in potable water must be between 0.5 and 1 ppm. This level is good for mineralization of teeth and bones. However, fluoride more than this level in water is not good for health. Slight high level may produce milder symptoms of toxicity, but the symptoms of fluoride poisoning can be life threatening if the level of fluoride exceeds more than 10ppm.
The toxic symptoms are more serious in children and in women of child bearing age. A person may also suffer from fluoride poisoning if he accidentally consumes insecticide or pesticide. People working in factories that emit fluoride in the form of fumes and vapors are also at risk of suffering from fluoride poisoning. Living near such factories can also be a risk factor.
How Does Excess Of Fluoride Affect Human Beings?
Fluoride poisoning can cause mild to devastating effect on health of human beings. The effect can be long term and may be acute and serious. Here is the pathophysiology:
- When excess fluoride enters into the stomach and intestine, it may irritate the lining of stomach and intestine. It reacts with the stomach and intestinal enzymes to produce hydrofluoric acid. This acid produces irritation in the intestinal and stomach lining.
- Fluoride poisoning or excess can cause demineralization of bone. The bones lose calcium and hence become weak. Person suffers from low calcium level known as hypocalcemia.
- Elevated level of fluoride in body can be detrimental to the nervous system. It hampers the signaling network of nerves.
- Excess of fluoride can increase potassium level in blood. This causes symptoms of hyperkalemia.
Signs And Symptoms Of Fluoride Poisoning
All the above problems related with fluoride poisoning produce symptoms as follows:
- Mottling and crumbling of teeth known as dental flurosis. Especially this condition is seen more commonly among children suffering from fluoride poisoning. There is yellow or brownish discoloration of teeth. The child may also have pitted teeth and cavities in tooth.
- Irritation in stomach cause burning pain, nausea, vomiting, diarrhea, unable to swallow properly due to damage to esophagus.
- Joint pain and stiffening of joints.
- Muscle pain
- Headache Tremor
- Breathing difficulty
- Reduced level of calcium and magnesium in blood which can cause bone deformities such as rickets and osteomalacia in children.
- Due to weakness of bones and low calcium content, patient with fluoride poisoning may frequently suffer from fractures.
Treatment Guidelines For Fluoride Poisoning
Fluoride poisoning can be slow or in acute form. In chronic form the person remains exposed to fluoride for long duration of time in small amount excess of the normal requirement. Acute fluoride poisoning requires quick treatment. Normally patient suffering from acute poisoning needs treatment in emergency room where all medical equipment and facilities are available.
Once the patient’s blood pressure, pulse, heartbeats and respiration are normal, a gastric wash is performed to clean the content present in stomach. Hyperkalemia, hypocalcemia, are corrected with medications. Gastric wash with milk or calcium carbonate is used in some cases. In most patients, permanent damage is to lesser extent.
The first requirement for patients suffering from chronic fluoride poisoning is to quit from the source which is chronically causing increased level of fluoride in the body. The normal drinking water must be less than 0.5 ppm for such patients. Patient must eat calcium supplements and food containing calcium and vitamin D. Calcium is best for curtailing the bad effects of fluoride poisoning.