{"id":896,"date":"2017-10-26T17:00:18","date_gmt":"2017-10-26T17:00:18","guid":{"rendered":"https:\/\/courses.lumenlearning.com\/sunynutrition\/?post_type=chapter&#038;p=896"},"modified":"2017-11-14T17:27:55","modified_gmt":"2017-11-14T17:27:55","slug":"12-4-fluoride","status":"publish","type":"chapter","link":"https:\/\/courses.lumenlearning.com\/suny-nutrition\/chapter\/12-4-fluoride\/","title":{"raw":"12.4 Fluoride","rendered":"12.4 Fluoride"},"content":{"raw":"<div class=\"__UNKNOWN__\">\r\n\r\nFluoride is a nonessential mineral. It is not required by the body and it is not widely found in the food supply. The majority of what we consume comes from fluoridated water. Other good non-dietary sources are fluoridated toothpaste and dental rinses<sup>1<\/sup>. Absorption of fluoride is near 100% for both dietary and non-dietary forms and it is rapidly excreted in the urine<sup>2<\/sup>.\r\n\r\nFluoride alters the mineralization of bones and teeth. It does this by replacing hydroxyl (OH) ions in hydroxyapatite (Ca10(PO4)6(OH)2) , forming fluorohydroxyapatite. Fluorohydroxyapatite is more resistant to acid degradation than hydroxyapatite, leading to fewer cavities<sup>2<\/sup>.\r\n\r\nSince it is a nonessential mineral, there is no fluoride deficiency. However, fluoride can be quite toxic. Acute toxicity symptoms from large intakes of fluoride include<sup>1<\/sup>:\r\n\r\nNausea\r\n\r\nVomiting\r\n\r\nDiarrhea\r\n\r\nConvulsions\r\n\r\nChronic toxicity results in an irreversible condition known as fluorosis, characterized by the mottling and pitting of teeth as shown below.\r\n<div>\r\n\r\n[caption id=\"\" align=\"aligncenter\" width=\"800\"]<img src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/2569\/2017\/10\/26165626\/1000000000000320000000E8266316CD.jpg\" alt=\"\" width=\"800\" height=\"232\" \/> Figure 12.41 Fluorosis[\/caption]\r\n\r\n<\/div>\r\n<div>\r\n\r\n[caption id=\"\" align=\"aligncenter\" width=\"800\"]<img src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/2569\/2017\/10\/26165628\/10000000000003200000022CB324935B.jpg\" alt=\"\" width=\"800\" height=\"556\" \/> Figure 12.42 Severe case of fluorosis[\/caption]\r\n\r\n<\/div>\r\nAs you can see from the figure below, fluorosis is more prevalent in the United States than most people would probably believe.\r\n<div>\r\n\r\n[caption id=\"\" align=\"aligncenter\" width=\"1004\"]<img src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/2569\/2017\/10\/26165630\/10000000000003EC000002F3E9937A79.png\" alt=\"\" width=\"1004\" height=\"755\" \/> Figure 12.43 Fluorosis prevalence by age in the United States[\/caption]\r\n\r\n<\/div>\r\nA comparison of the prevalence of fluorosis in US children, ages 12-15, indicates an increase from the late 1980s to the early 2000s<sup>5<\/sup>.\r\n<div>\r\n\r\n[caption id=\"\" align=\"aligncenter\" width=\"1007\"]<img src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/2569\/2017\/10\/26165633\/10000000000003EF000002EAC9177AFD.png\" alt=\"\" width=\"1007\" height=\"746\" \/> Figure 12.44 Change in dental fluorosis in 12-15 year-old US children[\/caption]\r\n\r\n<\/div>\r\nThere is debate as to whether water should be fluoridated. The following links are examples of just how conflicted the U.S. is. The first is a New York Times article on this topic. There is also an article about Portland\u2019s decision to begin fluoridating its water in 2014. The third article is about a bill introduced by a Kansas lawmaker concerned about the effects of water fluoridation. Salina, Kansas, which is home to one of Kansas State University\u2019s campuses, voted last November to not rescind its policy of fluoridating its water, as described in the fourth link.\r\n<table><colgroup> <col \/><\/colgroup>\r\n<tbody>\r\n<tr>\r\n<td><h3>Web Links<\/h3>\r\n\r\n<a href=\"http:\/\/www.nytimes.com\/2012\/03\/18\/opinion\/sunday\/fluoridation-debate-redux.html?partner=rss&amp;emc=rss\"><u>Fluoridation Debate, Redux<\/u><\/a>\r\n\r\n<a href=\"http:\/\/www.nytimes.com\/2012\/09\/13\/us\/portland-approves-adding-fluoride-to-water-by-14.html\"><u>Portland Approves Fluoridation by \u201814<\/u><\/a>\r\n\r\n<a href=\"http:\/\/ksn.com\/2014\/02\/10\/dentists-speak-out-as-fluoride-bill-nears-hearing\/\"><u>Dentists speak out as fluoride bill nears hearing<\/u><\/a><\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<h3>References &amp; Links<\/h3>\r\n\r\n1. Byrd-Bredbenner C, Moe G, Beshgetoor D, Berning J. (2009) Wardlaw's perspectives in nutrition. New York, NY: McGraw-Hill.\r\n\r\n2. Gropper SS, Smith JL, Groff JL. (2008) Advanced nutrition and human metabolism. Belmont, CA: Wadsworth Publishing.\r\n\r\n3. http:\/\/en.wikipedia.org\/wiki\/File:Fluorosisb%26a.jpg\r\n\r\n4. https:\/\/en.wikipedia.org\/wiki\/Dental_fluorosis#\/media\/File:FluorosisFromNIH.jpg\r\n\r\n5. Beltran-Aguilar, ED, Barker, L, Dye, BA. (2010) Prevalence and Severity of Dental Fluorosis in the United States, 1999-2004. http:\/\/www.cdc.gov\/nchs\/data\/databriefs\/db53.htm\r\n\r\n<h3>Links<\/h3>\r\n\r\nFluoridation Debate, Redux - http:\/\/www.nytimes.com\/2012\/03\/18\/opinion\/sunday\/fluoridation-debate-redux.html?\r\n\r\nPortland Approves Fluoridation by \u201814 - http:\/\/www.nytimes.com\/2012\/09\/13\/us\/portland-approves-adding-fluoride-to-water-by-14.html?\r\n\r\nDentists speak out as fluoride bill nears hearing - http:\/\/ksn.com\/2014\/02\/10\/dentists-speak-out-as-fluoride-bill-nears-hearing\/\r\n\r\n<\/div>","rendered":"<div class=\"__UNKNOWN__\">\n<p>Fluoride is a nonessential mineral. It is not required by the body and it is not widely found in the food supply. The majority of what we consume comes from fluoridated water. Other good non-dietary sources are fluoridated toothpaste and dental rinses<sup>1<\/sup>. Absorption of fluoride is near 100% for both dietary and non-dietary forms and it is rapidly excreted in the urine<sup>2<\/sup>.<\/p>\n<p>Fluoride alters the mineralization of bones and teeth. It does this by replacing hydroxyl (OH) ions in hydroxyapatite (Ca10(PO4)6(OH)2) , forming fluorohydroxyapatite. Fluorohydroxyapatite is more resistant to acid degradation than hydroxyapatite, leading to fewer cavities<sup>2<\/sup>.<\/p>\n<p>Since it is a nonessential mineral, there is no fluoride deficiency. However, fluoride can be quite toxic. Acute toxicity symptoms from large intakes of fluoride include<sup>1<\/sup>:<\/p>\n<p>Nausea<\/p>\n<p>Vomiting<\/p>\n<p>Diarrhea<\/p>\n<p>Convulsions<\/p>\n<p>Chronic toxicity results in an irreversible condition known as fluorosis, characterized by the mottling and pitting of teeth as shown below.<\/p>\n<div>\n<div style=\"width: 810px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/2569\/2017\/10\/26165626\/1000000000000320000000E8266316CD.jpg\" alt=\"\" width=\"800\" height=\"232\" \/><\/p>\n<p class=\"wp-caption-text\">Figure 12.41 Fluorosis<\/p>\n<\/div>\n<\/div>\n<div>\n<div style=\"width: 810px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/2569\/2017\/10\/26165628\/10000000000003200000022CB324935B.jpg\" alt=\"\" width=\"800\" height=\"556\" \/><\/p>\n<p class=\"wp-caption-text\">Figure 12.42 Severe case of fluorosis<\/p>\n<\/div>\n<\/div>\n<p>As you can see from the figure below, fluorosis is more prevalent in the United States than most people would probably believe.<\/p>\n<div>\n<div style=\"width: 1014px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/2569\/2017\/10\/26165630\/10000000000003EC000002F3E9937A79.png\" alt=\"\" width=\"1004\" height=\"755\" \/><\/p>\n<p class=\"wp-caption-text\">Figure 12.43 Fluorosis prevalence by age in the United States<\/p>\n<\/div>\n<\/div>\n<p>A comparison of the prevalence of fluorosis in US children, ages 12-15, indicates an increase from the late 1980s to the early 2000s<sup>5<\/sup>.<\/p>\n<div>\n<div style=\"width: 1017px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/2569\/2017\/10\/26165633\/10000000000003EF000002EAC9177AFD.png\" alt=\"\" width=\"1007\" height=\"746\" \/><\/p>\n<p class=\"wp-caption-text\">Figure 12.44 Change in dental fluorosis in 12-15 year-old US children<\/p>\n<\/div>\n<\/div>\n<p>There is debate as to whether water should be fluoridated. The following links are examples of just how conflicted the U.S. is. The first is a New York Times article on this topic. There is also an article about Portland\u2019s decision to begin fluoridating its water in 2014. The third article is about a bill introduced by a Kansas lawmaker concerned about the effects of water fluoridation. Salina, Kansas, which is home to one of Kansas State University\u2019s campuses, voted last November to not rescind its policy of fluoridating its water, as described in the fourth link.<\/p>\n<table>\n<colgroup>\n<col \/><\/colgroup>\n<tbody>\n<tr>\n<td>\n<h3>Web Links<\/h3>\n<p><a href=\"http:\/\/www.nytimes.com\/2012\/03\/18\/opinion\/sunday\/fluoridation-debate-redux.html?partner=rss&amp;emc=rss\"><u>Fluoridation Debate, Redux<\/u><\/a><\/p>\n<p><a href=\"http:\/\/www.nytimes.com\/2012\/09\/13\/us\/portland-approves-adding-fluoride-to-water-by-14.html\"><u>Portland Approves Fluoridation by \u201814<\/u><\/a><\/p>\n<p><a href=\"http:\/\/ksn.com\/2014\/02\/10\/dentists-speak-out-as-fluoride-bill-nears-hearing\/\"><u>Dentists speak out as fluoride bill nears hearing<\/u><\/a><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h3>References &amp; Links<\/h3>\n<p>1. Byrd-Bredbenner C, Moe G, Beshgetoor D, Berning J. (2009) Wardlaw&#8217;s perspectives in nutrition. New York, NY: McGraw-Hill.<\/p>\n<p>2. Gropper SS, Smith JL, Groff JL. (2008) Advanced nutrition and human metabolism. Belmont, CA: Wadsworth Publishing.<\/p>\n<p>3. http:\/\/en.wikipedia.org\/wiki\/File:Fluorosisb%26a.jpg<\/p>\n<p>4. https:\/\/en.wikipedia.org\/wiki\/Dental_fluorosis#\/media\/File:FluorosisFromNIH.jpg<\/p>\n<p>5. Beltran-Aguilar, ED, Barker, L, Dye, BA. (2010) Prevalence and Severity of Dental Fluorosis in the United States, 1999-2004. http:\/\/www.cdc.gov\/nchs\/data\/databriefs\/db53.htm<\/p>\n<h3>Links<\/h3>\n<p>Fluoridation Debate, Redux &#8211; http:\/\/www.nytimes.com\/2012\/03\/18\/opinion\/sunday\/fluoridation-debate-redux.html?<\/p>\n<p>Portland Approves Fluoridation by \u201814 &#8211; http:\/\/www.nytimes.com\/2012\/09\/13\/us\/portland-approves-adding-fluoride-to-water-by-14.html?<\/p>\n<p>Dentists speak out as fluoride bill nears hearing &#8211; http:\/\/ksn.com\/2014\/02\/10\/dentists-speak-out-as-fluoride-bill-nears-hearing\/<\/p>\n<\/div>\n\n\t\t\t <section class=\"citations-section\" role=\"contentinfo\">\n\t\t\t <h3>Candela Citations<\/h3>\n\t\t\t\t\t <div>\n\t\t\t\t\t\t <div id=\"citation-list-896\">\n\t\t\t\t\t\t\t <div class=\"licensing\"><div class=\"license-attribution-dropdown-subheading\">CC licensed content, Shared previously<\/div><ul class=\"citation-list\"><li>Kansas State University Human Nutrition Flexbook. <strong>Authored by<\/strong>: Brian Lindshield. <strong>Provided by<\/strong>: Kansas State University. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"http:\/\/goo.gl\/vOAnR\">http:\/\/goo.gl\/vOAnR<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\">CC BY: Attribution<\/a><\/em><\/li><\/ul><\/div>\n\t\t\t\t\t\t <\/div>\n\t\t\t\t\t <\/div>\n\t\t\t <\/section>","protected":false},"author":311,"menu_order":16,"template":"","meta":{"_candela_citation":"[{\"type\":\"cc\",\"description\":\"Kansas State University Human Nutrition Flexbook\",\"author\":\"Brian Lindshield\",\"organization\":\"Kansas State University\",\"url\":\"goo.gl\/vOAnR\",\"project\":\"\",\"license\":\"cc-by\",\"license_terms\":\"\"}]","CANDELA_OUTCOMES_GUID":"","pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-896","chapter","type-chapter","status-publish","hentry"],"part":883,"_links":{"self":[{"href":"https:\/\/courses.lumenlearning.com\/suny-nutrition\/wp-json\/pressbooks\/v2\/chapters\/896","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/courses.lumenlearning.com\/suny-nutrition\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/courses.lumenlearning.com\/suny-nutrition\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/suny-nutrition\/wp-json\/wp\/v2\/users\/311"}],"version-history":[{"count":4,"href":"https:\/\/courses.lumenlearning.com\/suny-nutrition\/wp-json\/pressbooks\/v2\/chapters\/896\/revisions"}],"predecessor-version":[{"id":1834,"href":"https:\/\/courses.lumenlearning.com\/suny-nutrition\/wp-json\/pressbooks\/v2\/chapters\/896\/revisions\/1834"}],"part":[{"href":"https:\/\/courses.lumenlearning.com\/suny-nutrition\/wp-json\/pressbooks\/v2\/parts\/883"}],"metadata":[{"href":"https:\/\/courses.lumenlearning.com\/suny-nutrition\/wp-json\/pressbooks\/v2\/chapters\/896\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/courses.lumenlearning.com\/suny-nutrition\/wp-json\/wp\/v2\/media?parent=896"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/suny-nutrition\/wp-json\/pressbooks\/v2\/chapter-type?post=896"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/suny-nutrition\/wp-json\/wp\/v2\/contributor?post=896"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/suny-nutrition\/wp-json\/wp\/v2\/license?post=896"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}