Thursday, June 18, 2009

Ask the Dentist: Fluoride Toxicity

Ask The Dentist
This forum gives you the opportunity to ask a dentist about conditions you may be experiencing and treatment options you may want to consider. This forum is free and open to the public.

My daughter just turned 3, and has gotten a hold of a couple of tubes of toothpaste over the course of the past 6 months. We always tried to keep it locked up, but some how or another, she got at it anyway. At least 3 tubes of toothpaste that I can count were destroyed. I was never sure how much of the toothpaste was actually consumed as apposed to just being smeared over things. I never called poison control because she never showed any signs of fluoride overdose so I didn't worry when it happened.

However, now I'm concerned about the possibility of her having problems when her adult teeth come in. What is the likelihood that she will have dental fluorosis from having consumed toothpaste at this age (2.5 to 3). Is there anything that can be done NOW, several weeks/months after the incident, or are there any precautions I can take at this point to improve the outlook for her adult teeth?

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Thanks for the question. There can certainly be problems from fluoride ingestion. Much depends on how much your child truly swallowed, what the body weight of the child is, etc. There can be serious effects. No one knows the answers absolutely to your questions, it will all depend on how much was actually swallowed. Hopefully there will be no long term problems that ensue from the ingestion of toothpaste, but only time will tell.

In years past, we would routinely write prescriptions for supplementary fluoride to be given to children, either by drops or by pill form. The realization that kids get more fluoride than we realize -- in the water they drink as well in ingested toothpaste -- led pediatric dentistry to just about eliminate the supplements.

The only precaution I would make is to move your toothpaste higher in the cabinet.


FACTS ABOUT FLUORIDE TOXICITY:

-Early symptoms of acute fluoride toxicity (gastrointestinal pain, nausea, vomiting, headaches) can be produced at doses as low as 0.1 to 0.3 mg/kg.
-Swallowing fluoride at the amount of 5 mg/kg can be fatal
-Ingestion of as little as 1 percent of a tube of flavored children’s toothpaste can produce acute fluoride toxicity in a young child


THE MOST COMMON SYMPTOMS OF ACUTE FLUORIDE TOXICITY INCLUDE:

Nausea – 97%
Vomiting – 68%
Diarrhea – 65%
Abdominal cramps – 53%
Headaches – 41%
Burning sensation in the throat or chest – 12%


Chuck Campbell, DDS

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