Fluorine is an essential trace mineral essential for the solidification of cones and teeth when present in small amounts in drinking water. The most abundant form of fluorine is the fluoride ion (F-) which is present in nature in the association of other minerals. Compared to other essential minerals, fluoride ion has both positive and negative impacts on human health. Neither deficiency is good for health nor the excess which may lead to fluoride toxicity.
Chronic exposure to an excess concentration of fluoride may lead to tooth decay, osteoporosis, impaired kidney functions, reproductive organs, nerve, and muscle. It is also observed to interfere with thyroid production (1). These adverse impacts of fluoride concentration can be avoided by continuously monitoring the amount of fluoride in drinking water.
Fluoride water or fluoridated water is one of the WHO-approved techniques used by the USA to overcome the deficiency of fluoride in our system. Some of the countries choose to use fluoridated salt as a technique to eradicate fluoride deficit. (4, 5)
In this article, we will try to cover the health impact caused by fluoride imbalance in our body and how to overcome the condition of excess and deficit fluoride. It will also cover the impact of our diet making the fluoride balance and protect from its adverse impacts.
Most of the fluoride in the human body is stored in teeth and bone. It is present in the 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 can reduce dental cavities by 50%.
What is Fluoride Deficiency?
The main source of fluoride 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, a low concentration of fluoride causes tooth decay and reduced bone density.
Fluoride deficiency is mainly caused by the inadequate intake of fluoride for a very long time. It can also be caused by 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 has been illustrated below:
- Drinking-Water: The major source of fluoride is drinking water. In absence of water with the 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 a lower concentration of calcium in the 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 conditions affects the overall concentration of fluoride in the human body. The digestive and small intestinal disorders affect the ability of internal organs to absorb vitamins and minerals like calcium Vitamin D and fluoride.
Symptoms of Fluoride Deficiency
The common symptoms of fluoride deficiency are:
- Weak fragile bones
- Tooth decay
Health Risks due to Fluoride Deficiency
- Tooth Decay: Tooth caries is 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 eliminated by fluorinated water and toothpaste 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 a honeycomb with big pores. It reduces the overall bone density.
Some other health risk associated with excessive fluoride in the human body is tooth enamel and skeletal fluorosis.
Tests for Fluoride Deficiency
Fluoride is very abundant in our bodies. However, 99% of the fluoride is found in bone and teeth and a very small quantity of fluoride is present in the blood. A blood test is required to ascertain the amount of fluoride is in our blood.
- Fluoride Blood Test: A blood test is carried out to measure the concentration of fluoride in the human body. It uses an ion-selective electrode potentiometry methodology for the identification of fluoride. In general, this test is done for people who are exposed to chemicals 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 indication of bone-related disorders.
Remedies of Fluoride Deficiency
- Fluoride Supplements: If you are diagnosed with severe fluoride deficiency, you should consider medical supplements under the supervision of doctors. As higher fluoride may lead to a deadly health conditions, like tooth enamel and skeletal fluorosis.
- Fluorinated Drinking Water: Area where groundwater is poor in fluoride, water needs to be fluorinated before drinking to avoid dental caries and weak and porous bones. The recommended concentration of fluoride in drinking water is < 1 part per million.
- Calcium Supplements: Calcium deficiency is one of the causes of fluoride deficiency in the human body. It can either be avoided with calcium supplements or the 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 about micronutrient deficiencies. Fluoride deficiency can be prevented through the consumption of a fluoride-rich diet.
- Fluorinated water
- Leafy veggies
- Fortified food items
Adequate Intake (>19 yrs.):
The 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 that 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 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 an adequate amount of fluoride as per RDA through various fluoride-rich diets and drinking water with a concentration of less than 1 part per million.