Fluoride Toxicity also called as fluorosis from too much fluoride intake causes toxicity symptoms.
Fluoride is good for teeth but too much intake causes health problems.
Types of fluoride toxicity are:
Acute
Chronic
In acute toxicity symptoms of high fluoride dose include nausea, abdominal pain, vomiting, hypocalcemia, hyperkalemia, and cardiac failure.
Develops from long-term exposure to lower doses of fluoride. Chronic fluorosis primarily affects bones and teeth.
Chronic fluorosis is caused by prolonged exposure to low levels of fluoride intake.
Some foods and drinks made with fluoridated water or grown in high-fluoride soil. Fluoride binds with calcium and magnesium to disrupt cellular processes in body.
Epidemiology
Excessive fluoride in childhood causes tooth discoloration and mottling due to overconsumption.
Severe acute fluoride toxicity from accidental ingestion of insecticides or rodenticides with rapid symptom onset.
Increased fluoride in water causes dental and skeletal fluorosis risks.
High fluoride levels in coal burned indoors in southwestern China linked to fluorosis health condition.
Anatomy
Pathophysiology
Fluoride can cause GI irritation or corrosive effects to forms hydrofluoric acid in the stomach upon ingestion.
Fluoride is cytotoxic, oxidative phosphorylation, glycolysis, and coagulation in nature.
Fluoride blocks enzymes to cause hyperkalemia and cholinergic signs. Seizures may occur from low magnesium and calcium levels.
Fluoride in drinking water enhances bone formation in cancellous bone to reduce fracture risk with low exposure.
Etiology
The causes of fluoride toxicity are:
Groundwater
Soil and Crops
Water Fluoridation
Agricultural Pesticides
Industrial Emissions
Processed Beverages and Foods
Dental Products
Genetics
Prognostic Factors
The lethal dose of fluoride ranges from 2 g in adults to 16 mg/kg in children with potentially fatal outcomes in smaller amounts.
No deaths from fluoride toothpaste/mouthwash in 2022, but one death from hydrofluoric acid reported.
Studies show links between prenatal fluoride exposure and cognitive deficits in children.
Clinical History
Collect details including presenting symptoms, dietary, dental and medical history to understand clinical history of patient.
Physical Examination
Dental examination
Skeletal examination
Neurological examination
Age group
Associated comorbidity
Associated activity
Acuity of presentation
Acute toxicity as:
Nausea, vomiting, abdominal pain, hypocalcemia, hyperkalemia, and hypomagnesemia, dizziness, confusion
Chronic toxicity as:
Dental Fluorosis, joint stiffness, pain, mild reduced mobility, bone deformities
Differential Diagnoses
Ammonia toxicity
Arsenic toxicity
Chlorine toxicity
Heavy metal toxicity
Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Staging
Treatment Paradigm
EMS personnel should monitor patients with known fluoride ingestion and establish IV access prehospital.
Exposure to hydrogen fluoride does not significantly contaminate victims or emergency responders.
Hydrogen fluoride exposure on skin or clothing warrants immediate attention due to severe risk.
Patient needs cardiac monitoring and electrocardiogram for evaluation.
Treat calcium deficiencies with IV calcium chloride or gluconate and struggle to manage fluoride-induced arrhythmias.
Nasogastric tube aspiration with lavage is recommended due to ingestion severity and poor fluoride adsorption.
Wash with milk or calcium carbonate/magnesium hydroxide may be helpful but unproven.
Optimal outcome with gastric aspiration within one hour. Hemodialysis for critical patients unresponsive to other medical treatments.
For acute fluoride toxicity cases hemodialysis is indicated, for advanced skeletal fluorosis orthopedic surgery is required while calcium and magnesium infusions are effective in acute toxicity.
use-of-phases-in-managing-fluoride-toxicity
In the initial treatment phase, the goal is to stabilize the patient and quickly reduce fluoride levels in cases of acute fluoride poisoning.
Pharmacologic therapy is effective in the treatment phase as it includes the use of antidotes.
In supportive care and management phase, patients should receive required attention such as lifestyle modification and intervention therapies.
The regular follow-up visits with the physician are scheduled to check the improvement of patients along with treatment response.
Fluoride Toxicity also called as fluorosis from too much fluoride intake causes toxicity symptoms.
Fluoride is good for teeth but too much intake causes health problems.
Types of fluoride toxicity are:
Acute
Chronic
In acute toxicity symptoms of high fluoride dose include nausea, abdominal pain, vomiting, hypocalcemia, hyperkalemia, and cardiac failure.
Develops from long-term exposure to lower doses of fluoride. Chronic fluorosis primarily affects bones and teeth.
Chronic fluorosis is caused by prolonged exposure to low levels of fluoride intake.
Some foods and drinks made with fluoridated water or grown in high-fluoride soil. Fluoride binds with calcium and magnesium to disrupt cellular processes in body.
Excessive fluoride in childhood causes tooth discoloration and mottling due to overconsumption.
Severe acute fluoride toxicity from accidental ingestion of insecticides or rodenticides with rapid symptom onset.
Increased fluoride in water causes dental and skeletal fluorosis risks.
High fluoride levels in coal burned indoors in southwestern China linked to fluorosis health condition.
Fluoride can cause GI irritation or corrosive effects to forms hydrofluoric acid in the stomach upon ingestion.
Fluoride is cytotoxic, oxidative phosphorylation, glycolysis, and coagulation in nature.
Fluoride blocks enzymes to cause hyperkalemia and cholinergic signs. Seizures may occur from low magnesium and calcium levels.
Fluoride in drinking water enhances bone formation in cancellous bone to reduce fracture risk with low exposure.
The causes of fluoride toxicity are:
Groundwater
Soil and Crops
Water Fluoridation
Agricultural Pesticides
Industrial Emissions
Processed Beverages and Foods
Dental Products
The lethal dose of fluoride ranges from 2 g in adults to 16 mg/kg in children with potentially fatal outcomes in smaller amounts.
No deaths from fluoride toothpaste/mouthwash in 2022, but one death from hydrofluoric acid reported.
Studies show links between prenatal fluoride exposure and cognitive deficits in children.
Collect details including presenting symptoms, dietary, dental and medical history to understand clinical history of patient.
Dental examination
Skeletal examination
Neurological examination
Acute toxicity as:
Nausea, vomiting, abdominal pain, hypocalcemia, hyperkalemia, and hypomagnesemia, dizziness, confusion
Chronic toxicity as:
Dental Fluorosis, joint stiffness, pain, mild reduced mobility, bone deformities
Ammonia toxicity
Arsenic toxicity
Chlorine toxicity
Heavy metal toxicity
EMS personnel should monitor patients with known fluoride ingestion and establish IV access prehospital.
Exposure to hydrogen fluoride does not significantly contaminate victims or emergency responders.
Hydrogen fluoride exposure on skin or clothing warrants immediate attention due to severe risk.
Patient needs cardiac monitoring and electrocardiogram for evaluation.
Treat calcium deficiencies with IV calcium chloride or gluconate and struggle to manage fluoride-induced arrhythmias.
Nasogastric tube aspiration with lavage is recommended due to ingestion severity and poor fluoride adsorption.
Wash with milk or calcium carbonate/magnesium hydroxide may be helpful but unproven.
Optimal outcome with gastric aspiration within one hour. Hemodialysis for critical patients unresponsive to other medical treatments.
Emergency Medicine
Install household or community-level filtration systems to reduce fluoride levels in drinking water.
Industries must install control systems to reduce fluoride in air and water.
Fluoride-exposed workers required PPE kit with masks, gloves, and eye protection to prevent exposure risks.
Regular monitoring of workplace air quality should be conducted.
Lime acidic soils in high-fluoride regions to decrease plant fluoride uptake, while using low-fluoride water for irrigation.
Proper awareness about fluoride toxicity should be provided and its related causes with management strategies.
Appointments with a physician and preventing recurrence of disorder is an ongoing life-long effort.
Emergency Medicine
Calcium chloride:
It has higher calcium content than calcium gluconate.
Calcium gluconate:
It moderates nerve and muscle performance to facilitate normal cardiac function.
Emergency Medicine
For acute fluoride toxicity cases hemodialysis is indicated, for advanced skeletal fluorosis orthopedic surgery is required while calcium and magnesium infusions are effective in acute toxicity.
Emergency Medicine
In the initial treatment phase, the goal is to stabilize the patient and quickly reduce fluoride levels in cases of acute fluoride poisoning.
Pharmacologic therapy is effective in the treatment phase as it includes the use of antidotes.
In supportive care and management phase, patients should receive required attention such as lifestyle modification and intervention therapies.
The regular follow-up visits with the physician are scheduled to check the improvement of patients along with treatment response.
Fluoride Toxicity also called as fluorosis from too much fluoride intake causes toxicity symptoms.
Fluoride is good for teeth but too much intake causes health problems.
Types of fluoride toxicity are:
Acute
Chronic
In acute toxicity symptoms of high fluoride dose include nausea, abdominal pain, vomiting, hypocalcemia, hyperkalemia, and cardiac failure.
Develops from long-term exposure to lower doses of fluoride. Chronic fluorosis primarily affects bones and teeth.
Chronic fluorosis is caused by prolonged exposure to low levels of fluoride intake.
Some foods and drinks made with fluoridated water or grown in high-fluoride soil. Fluoride binds with calcium and magnesium to disrupt cellular processes in body.
Excessive fluoride in childhood causes tooth discoloration and mottling due to overconsumption.
Severe acute fluoride toxicity from accidental ingestion of insecticides or rodenticides with rapid symptom onset.
Increased fluoride in water causes dental and skeletal fluorosis risks.
High fluoride levels in coal burned indoors in southwestern China linked to fluorosis health condition.
Fluoride can cause GI irritation or corrosive effects to forms hydrofluoric acid in the stomach upon ingestion.
Fluoride is cytotoxic, oxidative phosphorylation, glycolysis, and coagulation in nature.
Fluoride blocks enzymes to cause hyperkalemia and cholinergic signs. Seizures may occur from low magnesium and calcium levels.
Fluoride in drinking water enhances bone formation in cancellous bone to reduce fracture risk with low exposure.
The causes of fluoride toxicity are:
Groundwater
Soil and Crops
Water Fluoridation
Agricultural Pesticides
Industrial Emissions
Processed Beverages and Foods
Dental Products
The lethal dose of fluoride ranges from 2 g in adults to 16 mg/kg in children with potentially fatal outcomes in smaller amounts.
No deaths from fluoride toothpaste/mouthwash in 2022, but one death from hydrofluoric acid reported.
Studies show links between prenatal fluoride exposure and cognitive deficits in children.
Collect details including presenting symptoms, dietary, dental and medical history to understand clinical history of patient.
Dental examination
Skeletal examination
Neurological examination
Acute toxicity as:
Nausea, vomiting, abdominal pain, hypocalcemia, hyperkalemia, and hypomagnesemia, dizziness, confusion
Chronic toxicity as:
Dental Fluorosis, joint stiffness, pain, mild reduced mobility, bone deformities
Ammonia toxicity
Arsenic toxicity
Chlorine toxicity
Heavy metal toxicity
EMS personnel should monitor patients with known fluoride ingestion and establish IV access prehospital.
Exposure to hydrogen fluoride does not significantly contaminate victims or emergency responders.
Hydrogen fluoride exposure on skin or clothing warrants immediate attention due to severe risk.
Patient needs cardiac monitoring and electrocardiogram for evaluation.
Treat calcium deficiencies with IV calcium chloride or gluconate and struggle to manage fluoride-induced arrhythmias.
Nasogastric tube aspiration with lavage is recommended due to ingestion severity and poor fluoride adsorption.
Wash with milk or calcium carbonate/magnesium hydroxide may be helpful but unproven.
Optimal outcome with gastric aspiration within one hour. Hemodialysis for critical patients unresponsive to other medical treatments.
Emergency Medicine
Install household or community-level filtration systems to reduce fluoride levels in drinking water.
Industries must install control systems to reduce fluoride in air and water.
Fluoride-exposed workers required PPE kit with masks, gloves, and eye protection to prevent exposure risks.
Regular monitoring of workplace air quality should be conducted.
Lime acidic soils in high-fluoride regions to decrease plant fluoride uptake, while using low-fluoride water for irrigation.
Proper awareness about fluoride toxicity should be provided and its related causes with management strategies.
Appointments with a physician and preventing recurrence of disorder is an ongoing life-long effort.
Emergency Medicine
Calcium chloride:
It has higher calcium content than calcium gluconate.
Calcium gluconate:
It moderates nerve and muscle performance to facilitate normal cardiac function.
Emergency Medicine
For acute fluoride toxicity cases hemodialysis is indicated, for advanced skeletal fluorosis orthopedic surgery is required while calcium and magnesium infusions are effective in acute toxicity.
Emergency Medicine
In the initial treatment phase, the goal is to stabilize the patient and quickly reduce fluoride levels in cases of acute fluoride poisoning.
Pharmacologic therapy is effective in the treatment phase as it includes the use of antidotes.
In supportive care and management phase, patients should receive required attention such as lifestyle modification and intervention therapies.
The regular follow-up visits with the physician are scheduled to check the improvement of patients along with treatment response.
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