Fluoride is a naturally occurring mineral that has an important role in the mineralisation of bones and teeth. The main natural dietary sources of fluoride are tea, milk and fish. Artificial sources, to which fluoride has been added, include water, chewing gum, salt, infant cereal, juices and milk. GETTY In the UK’s adult population, tea supplies 70% of the average daily intake of fluoride ( Department of Health (DH) 1991 ), making tea a major contributor to fluoride intake. While an adequate flouride consumption can be beneficial for bone and dental health, excessive intake can have adverse effects. Flouride intake is dependent largely on either naturally or artificially fluoridated water. The recommended daily intake of fluoride in the UK is 0.05mg/kg body weight (DH 1991), which is about 4.2mg for men, 3.6mg for women and 1.2mg for children per day. Potential risks I am aware that the main benefit of fluoride is the prevention of tooth decay, and that bone containing flouride is more stable and compact, which may protect against fracture. However, there are potential risks associated with too much fluoride, including dental and skeletal fluorosis. Dental flourosis causes mottling on the tooth enamel and, although it can be unsightly, also boosts the resilience of teeth to caries. A chronically high intake of fluoride may lead to skeletal fluorosis. This is a serious condition that, when mild to moderate, can result in bone deformation and pain, and when more severe can cause crippling and muscle weakness. Skeletal flourosis is rare in the UK and more common in countries where it is hot and dry, for example, China, Zimbabwe and some parts of India, because the drinking water is naturally higher in fluoride. After reading this article, I can now advise patients on appropriate fluoride intake, and would suggest consumption of two portions of fish per week, as well as four cups of tea a day and the use of fluoride toothpaste. This will help patients achieve their ideal fluoride intake, as well as providing health benefits through increased intake of protein, vitamin D, omega-3 fatty acids and polyphenols. I am also better informed to talk to patients about any concerns over fluoride intake. I intend to discuss this information with my colleagues over a nice cup of tea.
Nursing Standard – Royal College of Nursing (RCN)
Published: Apr 8, 2015
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