Fluoride poisoning usually occurs due to ingestion of high amount of fluoride containing products. It may be accidental ingestion or intentional. Fluorine is rarely available in its natural free state, but it combines chemically to form fluoride salts. Generally fluoride is found in many different household products such as toothpaste, vitamins, dietary supplements, chrome cleaning agents, insecticides and rodenticides.
In its low concentration fluoride is useful for strengthening teeth and preventing cavities. However, constant consumption of fluoride salts in large amount is dangerous for health. In some parts of world especially in parts of India and China, high amount of fluoride is found in ground water and surface water, it than finds its way into human body.Drinking this water remains a major source of high intake of fluoride and fluoride poisoning in these countries.
You may find different type of fluoride products in different substances such as sodium monofluorophosphate in toothpaste, sodium fluoride in dietary supplements. Fluoride has industrial use in glass etching and chrome cleaning. Sodium fluoroacetate is also one of the ingredients used in rodenticides and insecticides.
Sources Of Fluoride Poisoning
Fluoride poisoning usually occurs due to ingestion of high level of fluoride in drinking water. The severity of poisoning depends mainly on concentration of fluoride in drinking water, daily intake of fluoride, continuity and duration of exposure to fluoride.The toxic symptoms are more severe in children with growing teeth and bones, women of child bearing age with depleted calcium level.
The safe level of fluoride in potable drinking water is from 0.5 ppm to 1 ppm. Drinking water more than this may be harmful, especially for children. Levels slightly higher than normal requirement may produce mild symptoms, but symptoms of fluoride poisoning are severe and serious when the level exceeds 10 ppm.
There are other modes of exposure to too much of fluoride resulting in fluoride poisoning. This can be accidental or intentional consumption of insecticides and rodenticides.Industrial workers are at risk of swallowing or inhaling fluoride emissions as fumes, vapors, smokes from industrial factories. It can also affect people living nearby this plant and factory.
Effects Of Fluoride Toxicity
Fluoride toxicity can contribute number of health effects in human body.
- It causes irritation and inflammation of the mucus lining of gastrointestinal system. Too much of fluoride precipitates hydrofluoric acid in stomach which leads to irritation of the stomach and intestinal lining.
- Too much of fluoride in the body can lead to demineralization of bones. It leads to hypocalcemia.
- It can affect transmission of nerve impulses and coagulation mechanism of blood.
- Raises potassium level leading to hyperkalemia in blood.
Signs And Symptoms Of Fluoride Poisoning
Fluoride poisoning presents with wide variety of symptoms. It ranges from asymptomatic to more serious bed ridden condition.
- Dental fluorosis occurs due to defective formation of enamel. It is more severe in children with low calcium. The teeth are discolored and appear yellow or brown instead of white, especially in children. It is associated with pitting of teeth. As the enamel is damaged it increases risk of tooth cavities.
- Fluoride poisoning also causes gastrointestinal irritation. This leads to symptoms such as increased salivation, nausea and vomiting, difficulty in swallowing, pain in abdomen, diarrhea, etc.
- Cramps in muscles
- Muscle weakness
- Stiffness of joints
- Shortness of breath
- Rise of potassium level in body.
- Convulsion in case of acute poisoning.
- Increased risk of fractures.
In severe cases it may lead to shock and cardiac arrest.
Treatment For Fluoride Poisoning
Fluoride toxicity can be acute or chronic. While acute fluoride poisoning is sudden in onset, chronic poisoning occurs due to exposure to fluoride for a long period of time in small doses. Acute poisoning is serious and requires immediate medical attention. Ideally patient should contact emergency medical services as soon as he or she experiences discomfort.
Once in the hospital the vital condition of patient is stabilized. A gastric lavage is done to wash out the gastric content. Calcium or milk will help to treat fluoride poisoning. In majority of cases after treatment there is no permanent damage observed in the patient. One of the major deciding factors is the speed at which the patient receives treatment after acute poisoning.
Patients who have established skeletal fluorosis due to chronic fluoride poisoning, drinking normal water, improving intake of calcium and vitamin D in diet and correction of nutritional imbalance will provide clinical recovery. Calcium remains the strongest antagonist for fluoride poisoning.