{"id":272,"date":"2018-01-10T01:48:35","date_gmt":"2018-01-10T01:48:35","guid":{"rendered":"https:\/\/courses.lumenlearning.com\/sunyltnutrition\/chapter\/fluoride\/"},"modified":"2019-04-19T13:42:38","modified_gmt":"2019-04-19T13:42:38","slug":"fluoride","status":"publish","type":"chapter","link":"https:\/\/courses.lumenlearning.com\/sunyltnutrition\/chapter\/fluoride\/","title":{"raw":"8.7 Fluoride","rendered":"8.7 Fluoride"},"content":{"raw":"<div class=\"textbox learning-objectives\">\r\n<h3>Learning Objective<\/h3>\r\n<ul>\r\n \t<li>Learn about the role of fluoride<\/li>\r\n<\/ul>\r\n<\/div>\r\n<h2>Fluoride's Functional Role<\/h2>\r\nFluoride is known mostly as the mineral that combats tooth decay. It assists in tooth and bone development and maintenance. Fluoride combats tooth decay via three mechanisms:\r\n<ol>\r\n \t<li>Blocking acid formation by bacteria<\/li>\r\n \t<li>Preventing demineralization of teeth<\/li>\r\n \t<li>Enhancing remineralization of destroyed enamel<\/li>\r\n<\/ol>\r\nFluoride was first added to drinking water in 1945 in Grand Rapids, Michigan; now over 60 percent of the US population consumes fluoridated drinking water. The Centers for Disease Control and Prevention (CDC) has reported that fluoridation of water prevents, on average, 27 percent of cavities in children and between 20 and 40 percent of cavities in adults. The CDC considers water fluoridation one of the ten great public health achievements in the twentieth century[footnote]10 Great Public Health Achievements in the 20th Century. Centers for Disease Control, Morbidity and Mortality Weekly Report. 1999; 48(12), 241\u201343. http:\/\/www.cdc.gov\/about\/history\/tengpha.htm. Accessed November 22, 2017.[\/footnote].\r\n\r\nThe optimal fluoride concentration in water to prevent tooth decay ranges between 0.7\u20131.2 milligrams per liter. Exposure to fluoride at three to five times this concentration before the growth of permanent teeth can cause fluorosis, which is the mottling and discoloring of the teeth.\r\n\r\n[caption id=\"attachment_880\" align=\"alignnone\" width=\"205\"]<img class=\"size-full wp-image-880\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/4101\/2018\/01\/11181139\/image4.jpg\" alt=\"Teeth with discoloration due to Bellingham fluorosis\" width=\"205\" height=\"192\" \/> <em>Figure <\/em><strong>1<\/strong><em>: A Severe Case of Fluorosis.<\/em> Bellingham fluorosis by <a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Bellingham_fluorosis_3.jpg\">Editmore<\/a> \/ Public Domain[\/caption]\r\n\r\nFluoride\u2019s benefits to mineralized tissues of the teeth are well substantiated, but the effects of fluoride on bone are not as well known. Fluoride is currently being researched as a potential treatment for osteoporosis. The data are inconsistent on whether consuming fluoridated water reduces the incidence of osteoporosis and fracture risk. Fluoride does stimulate osteoblast bone building activity, and fluoride therapy in patients with osteoporosis has been shown to increase BMD. In general, it appears that at low doses, fluoride treatment increases BMD in people with osteoporosis and is more effective in increasing bone quality when the intakes of calcium and vitamin D are adequate. The Food and Drug Administration has not approved fluoride for the treatment of osteoporosis mainly because its benefits are not sufficiently known and it has several side effects including frequent stomach upset and joint pain. The doses of fluoride used to treat osteoporosis are much greater than that in fluoridated water.\r\n<h2>Dietary Reference Intake<\/h2>\r\nThe IOM has given Adequate Intakes (AI) for fluoride, but has not yet developed RDAs. The AIs are based on the doses of fluoride shown to reduce the incidence of cavities, but not cause dental fluorosis. From infancy to adolescence, the AIs for fluoride increase from 0.01 milligrams per day for ages less than six months to 2 milligrams per day for those between the ages of fourteen and eighteen. In adulthood, the AI for males is 4 milligrams per day and for females is 3 milligrams per day. The UL for young children is set at 1.3 and 2.2 milligrams per day for girls and boys, respectively. For adults, the UL is set at 10 milligrams per day.\r\n<h4><em>Table 11.10 Dietary Reference Intakes for Fluoride<\/em><\/h4>\r\n<div>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td>Age Group<\/td>\r\n<td>AI (mg\/day)<\/td>\r\n<td>UL (mg\/day)<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Infants (0\u20136 months)<\/td>\r\n<td>0.01<\/td>\r\n<td>0.7<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Infants (6\u201312 months)<\/td>\r\n<td>0.50<\/td>\r\n<td>0.9<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Children (1\u20133 years)<\/td>\r\n<td>0.70<\/td>\r\n<td>1.3<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Children (4\u20138 years)<\/td>\r\n<td>1.00<\/td>\r\n<td>2.2<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Children (9\u201313 years)<\/td>\r\n<td>2.00<\/td>\r\n<td>10.0<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Adolescents (14\u201318 years)<\/td>\r\n<td>3.00<\/td>\r\n<td>10.0<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Adult Males (&gt; 19 years)<\/td>\r\n<td>4.00<\/td>\r\n<td>10.0<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Adult Females (&gt; 19 years)<\/td>\r\n<td>3.00<\/td>\r\n<td>10.0<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<em>Source: Institute of Medicine. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. January 1, 1997. http:\/\/www.iom.edu\/Reports\/1997\/Dietary-Reference-Intakes-for-Calcium-Phosphorus-Magnesium-Vitamin-D-and-Fluoride.aspx.<\/em>\r\n\r\n<\/div>\r\n<h2>Dietary Sources of Fluoride<\/h2>\r\n<div>Greater than 70 percent of a person\u2019s fluoride comes from drinking fluoridated water when they live in a community that fluoridates the drinking water. Other beverages with a high amount of fluoride include teas and grape juice. Solid foods do not contain a large amount of fluoride. Fluoride content in foods depends on whether it was grown in soils and water that contained fluoride or cooked with fluoridated water. Canned meats and fish that contain bones do contain some fluoride.<\/div>\r\n<div><\/div>\r\n<div>\r\n\r\n<em>Table <\/em><strong>1<\/strong><em>: Fluoride Content of Various Foods<\/em>\r\n<div>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td>Food<\/td>\r\n<td>Serving<\/td>\r\n<td>Fluoride (mg)<\/td>\r\n<td>Percent Daily Value*<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Fruit Juice<\/td>\r\n<td>3.5 fl oz.<\/td>\r\n<td>0.02-2.1<\/td>\r\n<td>0.7-70<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Crab, canned<\/td>\r\n<td>3.5 oz.<\/td>\r\n<td>0.21<\/td>\r\n<td>7<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Rice, cooked<\/td>\r\n<td>3.5 oz.<\/td>\r\n<td>0.04<\/td>\r\n<td>1.3<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Fish, cooked<\/td>\r\n<td>3.5 oz.<\/td>\r\n<td>0.02<\/td>\r\n<td>0.7<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Chicken<\/td>\r\n<td>3.5 oz.<\/td>\r\n<td>0.015<\/td>\r\n<td>0.5<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>* Current AI used to determine Percent Daily Value<\/td>\r\n<td><\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<\/div>\r\n<\/div>\r\nMicronutrient Information Center: Fluoride. Oregon State University, Linus Pauling Institute. lpi.oregonstate.edu\/mic\/minerals\/fluoride . Updated in April 29, 2015. Accessed October 22, 2017.","rendered":"<div class=\"textbox learning-objectives\">\n<h3>Learning Objective<\/h3>\n<ul>\n<li>Learn about the role of fluoride<\/li>\n<\/ul>\n<\/div>\n<h2>Fluoride&#8217;s Functional Role<\/h2>\n<p>Fluoride is known mostly as the mineral that combats tooth decay. It assists in tooth and bone development and maintenance. Fluoride combats tooth decay via three mechanisms:<\/p>\n<ol>\n<li>Blocking acid formation by bacteria<\/li>\n<li>Preventing demineralization of teeth<\/li>\n<li>Enhancing remineralization of destroyed enamel<\/li>\n<\/ol>\n<p>Fluoride was first added to drinking water in 1945 in Grand Rapids, Michigan; now over 60 percent of the US population consumes fluoridated drinking water. The Centers for Disease Control and Prevention (CDC) has reported that fluoridation of water prevents, on average, 27 percent of cavities in children and between 20 and 40 percent of cavities in adults. The CDC considers water fluoridation one of the ten great public health achievements in the twentieth century<a class=\"footnote\" title=\"10 Great Public Health Achievements in the 20th Century. Centers for Disease Control, Morbidity and Mortality Weekly Report. 1999; 48(12), 241\u201343. http:\/\/www.cdc.gov\/about\/history\/tengpha.htm. Accessed November 22, 2017.\" id=\"return-footnote-272-1\" href=\"#footnote-272-1\" aria-label=\"Footnote 1\"><sup class=\"footnote\">[1]<\/sup><\/a>.<\/p>\n<p>The optimal fluoride concentration in water to prevent tooth decay ranges between 0.7\u20131.2 milligrams per liter. Exposure to fluoride at three to five times this concentration before the growth of permanent teeth can cause fluorosis, which is the mottling and discoloring of the teeth.<\/p>\n<div id=\"attachment_880\" style=\"width: 215px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-880\" class=\"size-full wp-image-880\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/4101\/2018\/01\/11181139\/image4.jpg\" alt=\"Teeth with discoloration due to Bellingham fluorosis\" width=\"205\" height=\"192\" \/><\/p>\n<p id=\"caption-attachment-880\" class=\"wp-caption-text\"><em>Figure <\/em><strong>1<\/strong><em>: A Severe Case of Fluorosis.<\/em> Bellingham fluorosis by <a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Bellingham_fluorosis_3.jpg\">Editmore<\/a> \/ Public Domain<\/p>\n<\/div>\n<p>Fluoride\u2019s benefits to mineralized tissues of the teeth are well substantiated, but the effects of fluoride on bone are not as well known. Fluoride is currently being researched as a potential treatment for osteoporosis. The data are inconsistent on whether consuming fluoridated water reduces the incidence of osteoporosis and fracture risk. Fluoride does stimulate osteoblast bone building activity, and fluoride therapy in patients with osteoporosis has been shown to increase BMD. In general, it appears that at low doses, fluoride treatment increases BMD in people with osteoporosis and is more effective in increasing bone quality when the intakes of calcium and vitamin D are adequate. The Food and Drug Administration has not approved fluoride for the treatment of osteoporosis mainly because its benefits are not sufficiently known and it has several side effects including frequent stomach upset and joint pain. The doses of fluoride used to treat osteoporosis are much greater than that in fluoridated water.<\/p>\n<h2>Dietary Reference Intake<\/h2>\n<p>The IOM has given Adequate Intakes (AI) for fluoride, but has not yet developed RDAs. The AIs are based on the doses of fluoride shown to reduce the incidence of cavities, but not cause dental fluorosis. From infancy to adolescence, the AIs for fluoride increase from 0.01 milligrams per day for ages less than six months to 2 milligrams per day for those between the ages of fourteen and eighteen. In adulthood, the AI for males is 4 milligrams per day and for females is 3 milligrams per day. The UL for young children is set at 1.3 and 2.2 milligrams per day for girls and boys, respectively. For adults, the UL is set at 10 milligrams per day.<\/p>\n<h4><em>Table 11.10 Dietary Reference Intakes for Fluoride<\/em><\/h4>\n<div>\n<table>\n<tbody>\n<tr>\n<td>Age Group<\/td>\n<td>AI (mg\/day)<\/td>\n<td>UL (mg\/day)<\/td>\n<\/tr>\n<tr>\n<td>Infants (0\u20136 months)<\/td>\n<td>0.01<\/td>\n<td>0.7<\/td>\n<\/tr>\n<tr>\n<td>Infants (6\u201312 months)<\/td>\n<td>0.50<\/td>\n<td>0.9<\/td>\n<\/tr>\n<tr>\n<td>Children (1\u20133 years)<\/td>\n<td>0.70<\/td>\n<td>1.3<\/td>\n<\/tr>\n<tr>\n<td>Children (4\u20138 years)<\/td>\n<td>1.00<\/td>\n<td>2.2<\/td>\n<\/tr>\n<tr>\n<td>Children (9\u201313 years)<\/td>\n<td>2.00<\/td>\n<td>10.0<\/td>\n<\/tr>\n<tr>\n<td>Adolescents (14\u201318 years)<\/td>\n<td>3.00<\/td>\n<td>10.0<\/td>\n<\/tr>\n<tr>\n<td>Adult Males (&gt; 19 years)<\/td>\n<td>4.00<\/td>\n<td>10.0<\/td>\n<\/tr>\n<tr>\n<td>Adult Females (&gt; 19 years)<\/td>\n<td>3.00<\/td>\n<td>10.0<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><em>Source: Institute of Medicine. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. January 1, 1997. http:\/\/www.iom.edu\/Reports\/1997\/Dietary-Reference-Intakes-for-Calcium-Phosphorus-Magnesium-Vitamin-D-and-Fluoride.aspx.<\/em><\/p>\n<\/div>\n<h2>Dietary Sources of Fluoride<\/h2>\n<div>Greater than 70 percent of a person\u2019s fluoride comes from drinking fluoridated water when they live in a community that fluoridates the drinking water. Other beverages with a high amount of fluoride include teas and grape juice. Solid foods do not contain a large amount of fluoride. Fluoride content in foods depends on whether it was grown in soils and water that contained fluoride or cooked with fluoridated water. Canned meats and fish that contain bones do contain some fluoride.<\/div>\n<div><\/div>\n<div>\n<p><em>Table <\/em><strong>1<\/strong><em>: Fluoride Content of Various Foods<\/em><\/p>\n<div>\n<table>\n<tbody>\n<tr>\n<td>Food<\/td>\n<td>Serving<\/td>\n<td>Fluoride (mg)<\/td>\n<td>Percent Daily Value*<\/td>\n<\/tr>\n<tr>\n<td>Fruit Juice<\/td>\n<td>3.5 fl oz.<\/td>\n<td>0.02-2.1<\/td>\n<td>0.7-70<\/td>\n<\/tr>\n<tr>\n<td>Crab, canned<\/td>\n<td>3.5 oz.<\/td>\n<td>0.21<\/td>\n<td>7<\/td>\n<\/tr>\n<tr>\n<td>Rice, cooked<\/td>\n<td>3.5 oz.<\/td>\n<td>0.04<\/td>\n<td>1.3<\/td>\n<\/tr>\n<tr>\n<td>Fish, cooked<\/td>\n<td>3.5 oz.<\/td>\n<td>0.02<\/td>\n<td>0.7<\/td>\n<\/tr>\n<tr>\n<td>Chicken<\/td>\n<td>3.5 oz.<\/td>\n<td>0.015<\/td>\n<td>0.5<\/td>\n<\/tr>\n<tr>\n<td>* Current AI used to determine Percent Daily Value<\/td>\n<td><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<\/div>\n<p>Micronutrient Information Center: Fluoride. Oregon State University, Linus Pauling Institute. lpi.oregonstate.edu\/mic\/minerals\/fluoride . Updated in April 29, 2015. Accessed October 22, 2017.<\/p>\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-272\">\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>Flouride. <strong>Authored by<\/strong>: Allison Calabrese, Cheryl Gibby, Billy Meinke, Marie Kainoa Fialkowski Revilla, and Alan Titchenal. <strong>Provided by<\/strong>: University of Hawai&#039;i at Manoa. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"http:\/\/pressbooks.oer.hawaii.edu\/humannutrition\/chapter\/fluoride\/\">http:\/\/pressbooks.oer.hawaii.edu\/humannutrition\/chapter\/fluoride\/<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/\">CC BY-NC-SA: Attribution-NonCommercial-ShareAlike<\/a><\/em><\/li><li>Flouride. <strong>Authored by<\/strong>: Medical LibreTexts Contributors. <strong>Provided by<\/strong>: LibreTexts. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/med.libretexts.org\/Courses\/Sacramento_City_College\/SCC%3A_Nutri_300_(Coppola)\/Chapters\/8%3A_Water_and_Minerals\/8.7%3A_Trace_Minerals\/8.04J%3A_Fluoride\">https:\/\/med.libretexts.org\/Courses\/Sacramento_City_College\/SCC%3A_Nutri_300_(Coppola)\/Chapters\/8%3A_Water_and_Minerals\/8.7%3A_Trace_Minerals\/8.04J%3A_Fluoride<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/\">CC BY-NC-SA: Attribution-NonCommercial-ShareAlike<\/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><hr class=\"before-footnotes clear\" \/><div class=\"footnotes\"><ol><li id=\"footnote-272-1\">10 Great Public Health Achievements in the 20th Century. Centers for Disease Control, Morbidity and Mortality Weekly Report. 1999; 48(12), 241\u201343. http:\/\/www.cdc.gov\/about\/history\/tengpha.htm. Accessed November 22, 2017. <a href=\"#return-footnote-272-1\" class=\"return-footnote\" aria-label=\"Return to footnote 1\">&crarr;<\/a><\/li><\/ol><\/div>","protected":false},"author":44985,"menu_order":22,"template":"","meta":{"_candela_citation":"[{\"type\":\"cc\",\"description\":\"Flouride\",\"author\":\"Allison Calabrese, Cheryl Gibby, Billy Meinke, Marie Kainoa Fialkowski Revilla, and Alan Titchenal\",\"organization\":\"University of Hawai\\'i at Manoa\",\"url\":\"http:\/\/pressbooks.oer.hawaii.edu\/humannutrition\/chapter\/fluoride\/\",\"project\":\"\",\"license\":\"cc-by-nc-sa\",\"license_terms\":\"\"},{\"type\":\"cc\",\"description\":\"Flouride\",\"author\":\"Medical LibreTexts Contributors\",\"organization\":\"LibreTexts\",\"url\":\"https:\/\/med.libretexts.org\/Courses\/Sacramento_City_College\/SCC%3A_Nutri_300_(Coppola)\/Chapters\/8%3A_Water_and_Minerals\/8.7%3A_Trace_Minerals\/8.04J%3A_Fluoride\",\"project\":\"\",\"license\":\"cc-by-nc-sa\",\"license_terms\":\"\"}]","CANDELA_OUTCOMES_GUID":"","pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":"cc-by-nc-sa"},"chapter-type":[],"contributor":[],"license":[54],"class_list":["post-272","chapter","type-chapter","status-publish","hentry","license-cc-by-nc-sa"],"part":180,"_links":{"self":[{"href":"https:\/\/courses.lumenlearning.com\/sunyltnutrition\/wp-json\/pressbooks\/v2\/chapters\/272","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/courses.lumenlearning.com\/sunyltnutrition\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/courses.lumenlearning.com\/sunyltnutrition\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/sunyltnutrition\/wp-json\/wp\/v2\/users\/44985"}],"version-history":[{"count":5,"href":"https:\/\/courses.lumenlearning.com\/sunyltnutrition\/wp-json\/pressbooks\/v2\/chapters\/272\/revisions"}],"predecessor-version":[{"id":903,"href":"https:\/\/courses.lumenlearning.com\/sunyltnutrition\/wp-json\/pressbooks\/v2\/chapters\/272\/revisions\/903"}],"part":[{"href":"https:\/\/courses.lumenlearning.com\/sunyltnutrition\/wp-json\/pressbooks\/v2\/parts\/180"}],"metadata":[{"href":"https:\/\/courses.lumenlearning.com\/sunyltnutrition\/wp-json\/pressbooks\/v2\/chapters\/272\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/courses.lumenlearning.com\/sunyltnutrition\/wp-json\/wp\/v2\/media?parent=272"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/sunyltnutrition\/wp-json\/pressbooks\/v2\/chapter-type?post=272"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/sunyltnutrition\/wp-json\/wp\/v2\/contributor?post=272"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/sunyltnutrition\/wp-json\/wp\/v2\/license?post=272"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}