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Controlling the fluoride dosage in a patient with compromised salivary function
Frederick C Eichmiller1, Naomi Eidelman, Clifton M Carey
1American Dental Association Foundation, Paffenbarger Research Center, National Institute of Standards and Technology, Gaithersburg, MD 20899-8546, USA. Frederick.Eichmiller@nist.gov
Journal of the American Dental Association (1939)
|February 8, 2005
Summary
High-concentration topical fluoride treatments can cause systemic fluoride toxicity, leading to symptoms like gastric distress and muscle pain. Adjusting fluoride dosage and application is crucial for patient safety.
Area of Science:
- Dentistry
- Toxicology
- Gastroenterology
Background:
- High-concentration topical fluorides are frequently prescribed for patients with xerostomia (compromised salivary function) resulting from radiation therapy or chemotherapy.
- These treatments aim to prevent dental caries in vulnerable populations.
Observation:
- A case study details a 50-year-old male patient experiencing gastric symptoms, dysphagia, and musculoskeletal pain while using tray-applied topical fluoride gel.
- Diagnostic imaging revealed esophageal wall thickening, and endoscopy showed abnormal esophageal motility.
- Urine analysis confirmed elevated systemic fluoride levels, indicating fluoride toxicity.
Findings:
- The patient's symptoms resolved, and urinary fluoride levels normalized after modifying his fluoride regimen.
- This suggests a direct correlation between the high-concentration topical fluoride application and the observed systemic toxicity.
Implications:
- Healthcare providers must be vigilant for signs of fluoride toxicity in patients using high-concentration topical fluorides.
- Careful patient monitoring for compliance and appropriate dosage adjustments are essential to prevent adverse events.
- This case highlights the importance of managing total ingested fluoride dose, even from topical applications.
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