Comparison of recommended and actual mean intakes of fluoride by Canadians

The findings of two separate 1993 reports, one of the actual intake of fluoride by Canadians and the other on their recommended fluoride intake, are summarized and compared. Recent increases in very mild and mild dental fluorosis suggest that the gap between current fluoride intake and recommended intake is narrowing. The daily swallowing of fluoride dentifrice makes a large contribution to the actual total daily fluoride intake, especially in children seven months to four years of age, the age group most susceptible to fluorosis in the anterior permanent teeth. Because of the available data and methods used in each study, the reported actual and recommended fluoride intakes vary greatly both within and between age groups. It is likely that individual variation in fluoride intake also varies greatly. Comparison of the data in the two reports revealed that, for breast-fed infants and nearly all other age groups without fluoridated water, the ranges of the estimates of actual intake are lower than the recommended ranges. However, for formula-fed infants and all other age groups using fluoridated water, the estimates of actual intake greatly exceed the recommended intake, especially for the seven months to four years age group. Ingestion of fluoride at these levels during tooth development will contribute to dental fluorosis. All of the age groups have fluoride intake estimates below levels at which skeletal signs of fluoride exposure are noticed. Nevertheless, exposure to fluoride should be closely monitored and inappropriate use of discretionary fluorides curtailed.