Fluoride is essential trace mineral for human body.  It has both positive and negative impact on human health. Dental caries can be prevented by having adequate concentration of fluorite however it can cause tooth enamel and skeletal fluorosis in excess of fluoride.  Dental caries is the most widely observed phenomena across the globe caused by fluoride deficiency. Balanced intake of fluoride may prevent several tooth and bone related diseases. 

Functions of Fluoride

Most of the fluoride in human body is stored in tooth and bone. It is present in human body in the form of calcium fluoride. It helps in preventing dental caries in children. Children should either be provided oral fluoride supplements to avoid dental cavities or fluorinated drinking water which is able to reduce dental cavities by 50%.

What is Fluoride Deficiency?

The main source of fluorine is drinking water and its concentration varies from area to area. High doses of fluoride in drinking water will lead to tooth enamel and skeletal fluorosis however, low concentration of fluoride causes tooth decay and reduced bone density. 

Fluoride deficiency is mainly caused by the inadequate intake of fluoride for very long time.  It can also be caused by the malabsorption due to gastrointestinal disorders. Since fluoride is found in the form of calcium fluoride, calcium deficiency could be another cause of fluoride deficiency. 

Causes of Fluoride Deficiency

The condition of low fluoride concentration can be developed due to various factors. Some of the major cause have been illustrated below:

  • Drinking Water: The major source of fluoride is drinking water. In absence of water with recommended intake of fluoride may result in its deficiency. In this case fluoridated drinking water needs to be provided for reduced effects of fluorine deficiency.  
  • Calcium Deficiency: The inherent association of fluoride with calcium can be affected by the presence of lower concentration of calcium in body. 
  • Vitamin D Deficiency: The absorption of calcium in the body is affected by the presence of vitamin D which in turn affects the concentration of calcium fluoride in our body. 
  • GI Disorders: Malabsorption of calcium, vitamin D and fluoride due to several underlying health condition affects the overall concentration of fluoride in human body. The digestive and small intestinal disorders affect the ability of internal organs to absorb vitamin and minerals like calcium Vitamin D and fluoride. 

Symptoms of Fluoride Deficiency 

The common symptoms of fluoride deficiency are:

  • Weak fragile bones
  • Fracture
  • Tooth decay

Health Risks due to Fluoride Deficiency

  • Tooth Decay: Tooth caries are very common in children in the area where drinking water is deficient in fluoride. It is very essential for the healthy growth of teeth which can be eliminate by fluorinated water and toothpastes containing fluorides. 
  • Osteoporosis: This bone decay is mainly caused by the deficiency of calcium however the association of fluoride with calcium in human get affected by the deficiency of fluoride and results in osteoporosis. It is the condition in which the internal structure of the bone is like honeycomb with big pores.  It reduces the overall bone density. 

Some other health risk associated with excessive fluoride in human body is tooth enamel and skeletal fluorosis. 

Tests for Fluoride Deficiency

Fluoride is very abundant in our body. However, 99% of the fluoride is found in bone and teeth and very small quantity of fluoride is present in the blood. Blood test is required to ascertain the amount of fluoride in in our blood.

  • Fluoride Blood Test: Blood test is carried out to measure the concentration of fluoride in human body. It uses ion selective electrode potentiometry methodology for identification of fluoride.  In general, this test is done for the people who are exposed to chemical containing fluoride. 
  • Microscopic Diagnosis: The bone related disorders caused by the deficiency of calcium fluoride can be diagnosed with microscopic imaging techniques like CT scan, MRI and bone densitometry.  Low bone density is the preliminary indicative of bone related disorders. 

Remedies of Fluoride Deficiency 

  • Fluoride Supplements: If you are diagnosed with severe fluoride deficiency, you should consider medical supplements under supervision of doctors. As higher fluoride may lead to deadly health condition, like tooth enamel and skeletal fluorosis.
  • Fluorinated Drinking Water: Area where groundwater is poor in fluoride, water needs to be fluorinated before drinking in order to avoid dental caries and weak and porous bones. The recommended concentration of fluoride in drinking water is < 1 parts per million. 
  • Calcium Supplements: Calcium deficiency is one of the causes of fluoride deficiency in human body. It can either be avoided with calcium supplements or inclusion of calcium rich food items in our daily diet. Some of the food items rich in calcium are milk, cheese, leafy veggies, soybeans, tofu, sardines, pilchards.   
  • Fluoride Rich Diet: Fluoride deficiency can be prevented by consuming fluoride rich food items in our daily diet. Some of the food items rich in fluoride are fruit juice, crab, water, shellfish, grapes.

Prevention of Fluoride Deficiency

It is often said that “Prevention is better than Cure” and indeed this is very much true with reference to micronutrient deficiencies. Fluoride deficiency can be prevented through consumption of fluoride rich diet.

Food items rich in fluoride:

  • Crab
  • Drinking Water
  • Shellfish
  • Grapes
  • Fluorinated water

Food items rich in Calcium:

  • Milk
  • Cheese
  • Leafy veggies
  • Soybeans
  • Tofu
  • Sardines
  • Pilchards 
  • Sardines
  • Fortified food items

Adequate Intake (>19 yrs.):

Ideal way to prevent fluoride deficiencies is to maintain recommended daily intakes. The recommended daily intake of fluoride and calcium for an adult is 3-4 mg and 2000-2500 mg respectively.


Fluoride is something which should be treated with cautions as it can be a blessing if taken in recommended amount however it may cause severe bone and teeth disorders. In association with calcium, fluoride maintains the strong teeth and bone structure.  

Although fluoride deficiency has several ill effects, it can be treated with the right consultation and medical supplements as prescribed by medical experts. The best possible way to avoid these complications by consuming adequate amount of fluoride as per RDA through various fluoride rich diet and drinking water with concentration of less than 1 part per million.