Ask the Dental Experts

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

Labels: fluoride, fluoride toxicity

Saturday, June 13, 2009

Houston Micro-Dentistry

A new dental technology called micro-dentistry uses special tools like dyes and air abrasion to detect, and remove tiny areas of tooth decay. Micro-dentistry was developed in response to municipalities putting fluoride in city water supplies. This was done to purify water of bacterial agents that could and did cause widespread tooth decay (and other ailments) in entire populations.

While the introduction of fluoride into municipal water supplies solved the problem of pandemic tooth decay, it had the secondary effect of changing the nature of tooth enamel itself. Fluoride hardens the surface of tooth enamel and makes it resistant to the formation of larger cavities. This does not prevent tooth decay completely, however. It simply changes the way tooth decay develops. Before introduction fluoride was introduced into water supplies, cavities normally struck the exposed grooves in the surface of a tooth. These cavities were very easy to detect with a dental explorer (the small metal probe used in general dentistry) and standard film dental x-rays. Everything is different now. The changes in enamel structure caused by fluoride in public drinking have caused cavities to be much smaller and difficult to diagnose than ever before. Micro-dentistry has been developed as a response to effectively counter this problem.

What now happens when a cavity forms is tooth decay penetrates what appears to be perfectly strong, intact tooth enamel. Cavities can then penetrate the softer dentin level underneath the outer surface of the tooth. If standard treatments are used, dentists have to detect (if they can) and treat these cavities very early on while they’re still in hard outer enamel layer. If a cavity reaches the inner dentin layer, it grows much more rapidly, and if it is not dealt with and stopped, it will infect the pulp and begin to kill the tooth root. This is where micro-dentistry has stepped in to provide some amazing alternatives to treatments (such as root canals or even tooth extractions) that would cost people a great deal of pain and money.

Micro-dentistry begins with the applications of a red or green dye that stains the teeth and reveals areas of decay. The dentist then uses air abrasion to gently clean the pits in dental enamel and to expand the narrow grooves in teeth so that we can better test the surface for the presence of any decay. By using much smaller instruments than those employed in regular dentistry, we can then repair the damaged tooth surface with a dental bonding compound or sealant

One big advantage offered by Micro-dentistry is its ability to remove only the smallest possible amount of tooth structure and when removing tooth decay. It is also a painless procedure that should require no anesthetic.

Labels: air abrasion, cavities, dental dyes, fluoride, micro-dentistry, tooth decay, tooth enamel