Fluorosis is caused by excessive fluoride intake and can manifest as dental or skeletal fluorosis. Prevention is important, especially in endemic regions like China and India. Dental fluorosis appears before skeletal fluorosis and excess fluoride can come from various sources. Symptoms of dental fluorosis include marks and stains on teeth, while skeletal fluorosis causes brittle bones and joint pain. Fluoride is still important for preventing tooth decay, but caution is necessary to avoid fluorosis.
Fluorosis is a condition caused by excessive fluoride intake. This condition can manifest itself in the form of skeletal fluorosis, which means that it attacks the bones of the body, or dental fluorosis, sometimes called enamel fluorosis. The damage caused by fluorosis is permanent, making prevention very important in regions of the world where the problem is endemic, such as China and India. Fluorosis appears to be especially common in developing countries for a variety of reasons, but it can also appear in the West.
As a general rule, someone must consume 10 times the recommended daily amount of fluoride over a long period of time for fluorosis to develop. Dental fluorosis usually appears before the skeletal form, which can allow medical professionals to spot the problem early. An excess of fluoride can result from fluoride pollution, inhalation of fluoride dust and fumes, heavily fluoridated water, supplements, drinking too much tea, and consuming fluoride toothpaste.
Dental fluorosis begins with small marks and stains on the teeth, sometimes accompanied by a slight transparency of the tooth enamel. If the condition is allowed to progress, the teeth will become pitted, cracked and brittle. If dental fluorosis is identified, the patient is usually educated about sources of fluoride so that he or she can learn to avoid them, and the teeth may be veneered or covered for cosmetic reasons and to protect them from further damage.
The skeletal form of fluorosis causes brittle bones and joint pain. It can be difficult to identify because the bones are not easily visible and because other conditions can cause similar problems. In regions of the world where fluorosis is endemic, these symptoms are often considered a sign that a patient has the condition, while in areas where the condition is rarer, it may take some time to get to the bottom of the problem. Sometimes, X-rays can be used to visualize the bones.
Fluoride is an important dietary supplement that has been shown to be very effective in preventing tooth decay in numerous studies. The fact that fluorosis exists is not a reason to stop using fluoride in dental care, but it is a reason to be careful. People with a naturally higher intake of fluoride due to their diet should watch out for fluorosis and consider using filters that can help eliminate the fluorides in their water. In the West, where water is typically fluoridated along with toothpaste and other dental care products, people may want to avoid fluoride supplements unless recommended by a dentist or doctor.
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