fluoride

Action and Spectrum

Actions and spectrum: 

fluoride is an inorganic anion of fluorine that has a wide spectrum of actions. fluoride ions can incorporate into the hydroxyapatite crystals in teeth and bones, forming fluorapatite.

fluoride ions also inhibit bacterial enolase and other enzymes, leading to the inhibition of bacterial growth.

Additionally, fluoride ions can form complexes with calcium ions, leading to the strengthening of bones. However, high levels of fluoride can lead to toxicity, particularly in developing teeth and bones. 

Drug Interaction

Adverse Reaction

Frequency not defined 

Rash 

Teeth Discoloration 

Nausea 

Vomiting 

Black Box Warning

Black Box Warning: 

There is no black box warning associated with the use of fluoride. However, excessive exposure to fluoride can cause adverse effects such as dental fluorosis, skeletal fluorosis, and other health issues.

Therefore, it is important to use fluoride products in appropriate amounts and follow recommended dosing guidelines. 

Contraindication / Caution

Contraindication/Caution: 

Contraindication: 

• Hypersensitivity to fluoride or any other components of the product 
• Severe renal impairment or failure 
• Hypocalcemia (low blood calcium levels) 
• Hyperkalemia (high blood potassium levels) 
• Hypophosphatemia (low blood phosphate levels) 
• Acute fluoride toxicity 
• Chronic fluoride toxicity 
• Severe dental fluorosis

Caution: 

• Hypersensitivity: Individuals with a known hypersensitivity or allergy to fluoride should avoid its use. 
• Kidney disease: Patients with severe renal impairment or end-stage kidney disease should avoid high-dose fluoride supplements. 
• Dental fluorosis: Excessive fluoride intake during the tooth-forming years (birth to 8 years old) can result in dental fluorosis, which is a cosmetic condition that affects the appearance of tooth enamel. 
• Skeletal fluorosis: Long-term exposure to high levels of fluoride may lead to skeletal fluorosis, which is a rare bone disease characterized by joint pain and stiffness, bone and joint deformities, and weakened bones. 
• Pregnancy and breastfeeding: While fluoride is safe for most pregnant and breastfeeding women, high doses should be avoided as they can harm the developing fetus or infant. 
• Medications: Certain medications such as antacids and some antibiotics can interact with fluoride and reduce its absorption, thereby reducing its effectiveness.

Comorbidities: 

fluoride is a commonly used mineral for dental and bone health. As it is a mineral, it is not typically associated with comorbidities. However, people with certain medical conditions, such as kidney disease, may be more susceptible to the harmful effects of excessive fluoride intake. 

Pregnancy / Lactation

Pregnancy consideration: pregnancy category B 

Lactation: fluoride is excreted in human milk in low concentrations, and there is no evidence of adverse effects on breastfed infants.  

Pregnancy category: 

• Category A: Satisfactory and well-controlled studies show no risk to the fetus in the first or later trimester. 
• Category B: There is no evidence of risk to the fetus found in animal reproduction studies and there are not enough studies on pregnant women. 
• Category C: Adverse effects on the fetus found with evidence in animal reproduction studies and no adequate evidence for an effect in humans, care must be taken for potential risks in pregnant women. 
• Category D: There is adequate data available with sufficient evidence of human fetal risk from various platforms, but despite potential risks may be used only in emergency cases for potential benefits. 
• Category X: Drugs listed in this category outweigh risks over benefits These category drugs should be prohibited for pregnant women. 
• Category N: There is no data available for the drug under this category. 

Pharmacology

Pharmacology: 

fluoride is a naturally occurring element that has a number of pharmacological effects on the human body. It is commonly used in dentistry to prevent tooth decay and in the treatment of osteoporosis. 

fluoride ions form strong bonds with calcium and other minerals in the teeth, which helps to prevent the demineralization of tooth enamel by acid-producing bacteria. This process is known as remineralization and is the basis for the use of fluoride in toothpaste, mouthwash, and water fluoridation. 

fluoride can also have toxic effects on the body when consumed in large quantities. Acute fluoride toxicity can cause nausea, vomiting, abdominal pain, and diarrhea, while chronic exposure can lead to skeletal fluorosis, a condition characterized by the buildup of fluoride in bones and teeth.  

Pharmacodynamics: 

fluoride is a mineral that has a variety of pharmacodynamic effects in the body. It works by incorporating into the structure of developing teeth and bones, making them stronger and more resistant to decay and fracture. fluoride also affects the activity of oral bacteria, reducing their ability to produce acid and decreasing the risk of tooth decay. 

In addition to its effects on teeth and bones, fluoride can also have systemic effects on the body. It can inhibit various enzymes and metabolic processes, and can affect the absorption, distribution, metabolism, and excretion of other substances in the body.  

Pharmacokinetics: 

Absorption 

fluoride can be absorbed from the gastrointestinal tract, although the degree of absorption depends on the form in which it is ingested. For example, the absorption of fluoride from water is generally high, while that from foods is lower. fluoride can also be absorbed through the skin and lungs. 

Distribution 

Once absorbed, fluoride is distributed throughout the body, with the highest concentrations found in bones and teeth. fluoride can also cross the blood-brain barrier and placenta and can be found in breast milk. 

Metabolism 

fluoride is not metabolized in the body, but it can undergo chemical reactions such as binding to minerals in bones and teeth. 

Elimination and excretion 

fluoride is primarily excreted in the urine, with a half-life of around 2-3 hours. A smaller amount is excreted in the feces and sweat. 

Adminstartion

Administration: 

fluoride can be administered through different routes depending on the intended use. 

For dental purposes, fluoride can be administered topically in the form of gels, varnishes, foams, and rinses. These formulations are applied directly to the teeth and left in contact with them for a period, usually a few minutes. 

fluoride supplements can also be administered orally in the form of tablets, drops, or lozenges. These are typically used in areas where the fluoride content of the water is low. 

In some cases, fluoride can also be administered systemically through water fluoridation programs, where fluoride is added to the public water supply to achieve a level that is effective in preventing dental caries. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: fluoride 

Pronounced: (FLOR-ide)  

Why do we use fluoride? 

• Prevention of dental caries: fluoride helps prevent tooth decay making it more resistant to acid attacks from bacteria in the mouth. 
• Treatment of osteoporosis: fluoride supplements can help increase in bone density and reduce the risk of fractures in people with osteoporosis. 
• Radiography: fluoride is used as a contrast agent in radiographic procedures to enhance the quality of images. 
• Water fluoridation: fluoride is added to public water supplies to improve dental health in communities. 
• Topical applications: fluoride gels, varnishes, and rinses are applied topically to teeth to prevent dental caries. 
• Industrial applications: fluoride is used in the production of various industrial products, including aluminium, uranium, and refrigerants.