[Osteofluorosis caused by excess use of toothpaste]

Area of Science:

• Endocrinology
• Toxicology
• Rheumatology

Background:

• Osteofluorosis results from chronic fluoride intoxication.
• Fluoride toothpaste prevents dental caries, but ingestion can cause dental fluorosis, especially in children.
• This case highlights adult osteofluorosis from excessive toothpaste use.

Observation:

• A 45-year-old woman presented with painful finger swelling and brown teeth staining.
• Hand X-rays revealed periosteal apposition; blood and urine tests showed significantly elevated fluoride levels.
• The patient consumed one tube of toothpaste every two days due to liking the taste, ingesting 68.5 mg of fluoride daily.

Findings:

• Discontinuation of fluoride toothpaste led to symptom resolution within 16 weeks.
• Post-intervention, blood and urine fluoride levels decreased substantially, though they remained elevated.
• The patient's excessive toothpaste consumption was identified as the sole cause of chronic fluoride intoxication.

Implications:

• Misuse of seemingly harmless products like fluoride toothpaste can lead to severe health issues such as osteofluorosis.
• This case underscores the importance of patient education regarding proper product usage, even for over-the-counter items.
• Awareness of potential fluoride toxicity from toothpaste is crucial for both healthcare providers and the public.