Dental Screening in fluoride deficient area-Teen

Summary of Recommendation and Evidence

Population	Recommendation	Grade (What's This?)
Screening of both Genders	This screening is recommended for adolescents.	B

Overview

Fluoride is a trace mineral, as only small amounts are present in the body, and intake needed is only a few milligrams per day. Around 95% of it is found in bones and teeth as calcium fluoride with some of the remainder in soft tissues and blood.

Fluoride has long been added to drinking water on evidence that it reduces tooth cavities in children and helps strengthen bones. However, there is some controversy about this, as conflicting research claims that not only does water fluoridation not help fight tooth decay, but that it can lead to fluoride poisoning and cause liver damage, hip fractures and cancer, mainly due to the lack of control over daily intake level of fluoride in water.

How Fluoride Benefits Health?

Fluoride is best known for its role in reducing tooth decay. In addition, it has recently been found to be important for maintaining strong bones.

FLUORIDE BENEFITS & FUNCTIONS

Decreases incidence of tooth cavities, as fluoride is incorporated into teeth as they form and hardens teeth enamel, making teeth more resistant to acids and cavity-forming bacteria
Builds and maintains healthy bones
Strengthens bones and helps prevent bone fractures
May lower risk of osteoporosis in menopausal women

How Fluoride Prevents Tooth Decay?

Tooth decay happens when plaque — that sticky film of bacteria that builds up on teeth — breaks down sugars in food. The bacteria produce damaging acids that dissolve the hard enamel surfaces of teeth.

Fluoride combats tooth decay in two ways:

It is incorporated into the structure of developing teeth when it is ingested.
It protects teeth when it comes in contact with the surface of the teeth.

Fluoride prevents the acid produced by the bacteria in plaque from dissolving, or demineralizing, tooth enamel. Fluoride also allows teeth damaged by acid to repair, or remineralize, themselves.

Fluoride Deficiency Symptoms and Causes

In places where tap water is fluoridated, small amounts of fluoride (about 1mg/liter) is added to the water. This is considered by the World Health Organization to be able to protect against dental caries with minimal toxic effects.

In such cases, it is unnecessary to take additional fluoride supplements, as fluoride in water is normally almost all absorbed.

Symptoms include:

Badly formed or weak teeth or increase in tooth cavities
Brittle or weak bones
Fractured hips in the elderly

Fluoride RDA (Recommended Dietary Allowance)

The Food & Nutrition Board of the Institute of Medicine, National Academy of Sciences, in their 1997-2001 collaboration between the US and Canada, set the daily Adequate Intake (AI) of Fluoride as follows.

Life Stage \| Gender	Fluoride dosage \| Day
Girls 9-13 Yrs	2* mg
Boys 9-13 Yrs	2* mg
Females 14-18 Yrs	3* mg
Males 14-18 Yrs	3* mg

* Indicates AI figures based on Dietary Reference Intake (DRI) figures

These dosages are the minimum required per day to ward off deficiency. In therapeutic use of this nutrient, dosage is increased as necessary for the ailment, keeping in mind Fluoride toxicity levels.

Fluoride Foods and Supplements

Foods

Fluoride is found in certain mouthwashes, and toothpastes and fluoridated water. It occurs naturally in the sea as sodium fluoride, so most seafood contains fluoride.

Other foods containing fluoride include:

Chicken
Canned sardines (with bones)
Fish
Gelatin
Grape juice
Tea

Supplements

Taking vitamins and minerals in their correct balance is vital to the proper functioning of all vitamins. They work synergistically, which means that the effectiveness of any one nutrient requires, or is enhanced, sometimes dramatically, by the presence of certain other nutrients.

For this reason, if you are looking to take supplements for maintenance of optimal health, the recommended approach is to take a multi-vitamin that has the proper balance of all the necessary nutrients your body needs.

Fluoride Overdose Toxicity & Side Effects

Excessive fluoride intake (more than 20mg, or more than 0.5mg per kg of body weight for a child weighing less than 40 kg) is toxic. It neutralizes important enzymes and inhibits calcium absorption, which causes calcium deficiency that can lead to brittle bones and nervousness.

Excess flourine can also cause fluorosis, a condition that adversely affects teeth. This means that fluoride overdose can have the same impact as fluoride deficiency. Fluorosis shows up as chalky white patches on teeth.

Tolerable Upper Intake Levels (UL) for Fluoride per Day

Age	Male	Female	Pregnancy	Lactation
9 to 13 years	10 mg
14 years and above	10 mg	10 mg	10 mg	10 mg