Is Fluoride Toothpaste Poisonous?

A quick glance at the back of a tube of fluoride toothpaste may give you pause. The warning label reads: "If you accidentally swallow more than used for brushing, seek professional help or contact a poison control center immediately." Suddenly the idea of brushing twice a day for healthier teeth and gums seems questionable. Though everything seems to have a warning label these days, understanding some basic facts about fluoride toothpaste may help bring peace of mind to your next oral hygiene session.

What is Fluoride?

• Fluoride is a mineral found naturally in water and foods such as sea salt, fish, seafood, eggs and tea leaves. Fluoride can also be found in the soil, and minerals such as fluorite. While fluoride is not considered an essential dietary element like calcium, iron or salt, fluoride does provide some benefits to overall dental health.

Fluoride and Dental Health

• Mostly commonly, we hear of fluoride in terms of toothpaste, mouthwash and topical applications used at the dentist's office. Fluoride has long been used to help strengthen tooth enamel and prevent tooth decay. When we eat, plaque bacteria and the sugars from foods combine to form an acidic environment in our mouths. This acid attacks the top enamel layer on our teeth, removing minerals in a process called demineralization. Demineralization leads to weaker tooth enamel and potential tooth decay. When we brush with fluoride toothpaste, the fluoride settles into demineralized spots and helps strengthen tooth enamel. This process is called remineralization. Because of the dental benefits associated with using fluoride, fluoride is often added to toothpaste and other oral hygiene products.

Proper Dosing

• The Institute of Medicine's Food and Nutrition Board is a division of the National Academies of Science; it reviews nutritional matters for the U.S. and other countries. In 1997 it established daily adequate intake levels for fluoride. At these levels, fluoride can effectively help reduce dental decay while avoiding unwanted or toxic side effects. Adequate intake levels are established at 0.05mg/kg of body weight. Generally speaking, this means adult females may safely consume 3mg per day, while adult males can consume up to 4mg per day. When it comes to children, adequate intake for 4- to 8-year olds is 1.0mg/day; 9- to 13-year olds is 2.0mg/day; and 14- to 18-year olds is 3.0mg/day. Exact levels of fluoride received when brushing depends on the toothpaste brand, how much is used and how much is swallowed. However, a single dose of toothpaste used for brushing falls well below the established adequate intake levels. Risks of overdose develop only when fluoride levels exceed adequate intake recommendations.

Fluorosis

• Dental fluorosis occurs when a person consumes high levels of fluoride over an extended period of time. Fluorosis causes the discoloration of permanent teeth while they are still forming. This generally affects children under the age of six, since permanent teeth are forming below the gum line during this time. Discoloration resulting from fluorosis ranges from light spots and streaks, to darker brown spots that may be worrisome for cosmetic reasons. Typically, fluorosis results from ingesting too much fluoride through water sources such as well water, and not through the use of fluoride toothpaste.

Fluoride Toxicity

• When consumed in large enough doses, fluoride can be toxic. For example, if a young child were to eat an entire tube of kid's toothpaste, the amount of fluoride ingested could reach levels of 143mg. Given the average weight of a six-year-old, a dose of 100mg, or 70 percent of a tube of toothpaste, at one sitting could be deadly. This is why the American Dental Academy places warnings on toothpaste tubes that warn parents to keep the tube out of the reach of children under six. Similarly, dentists often recommend that children under two brush with a toothpaste that doesn't contain fluoride. This recommendation is based on the fact that most infants swallow toothpaste, rather than spit it out, while brushing.

Fluoride Poisoning

• Signs of fluoride overdose include nausea, vomiting and diarrhea, stomach pain, drooling, headache, faintness, irregular heartbeat, shallow breathing and convulsions. All of these signs should be considered serious, and warrant seeking medical assistance immediately.