fluoride toxicity .pptx public health dentistry

fluoride toxicity .pptx public health dentistry

1. Fluoride Toxicity and defluoridation Vanshita Padwal final year Guided by Dr.Ashwini Biradar

2. Introduction The who expert committe on trace elements has included fluorine as one among physiologically essential elements required for normal growth and development of body It is known as double edged sword because inadequate ingestion lead to dental caries and excessive intake leads to toxicity Recently epidemiological studies have suggested that fluoride is a human development neurotoxicant that reduses measures of intelligence in children placing it in same category as toxic metals ( lead

3. Causes of fluoride toxicity Contaminated groundwater: Many parts of the world, including regions in India and China, have naturally high levels of fluoride in the groundwater, which can lead to endemic fluorosis in the local population. Inhalation of fumes: Industrial workers in industries like aluminum smelting or those burning high-fluoride coal indoors for cooking are at risk of inhaling fluoride fumes .
Oral hygiene products: In developed countries, accidental ingestion of dental products like toothpaste, mouthwash, or supplements is a common cause of fluoride exposure, especially in children under six .
Household products: Historically, insecticides and rodenticides containing sodium fluoride were a source of poisoning. Other products like glass-etching agents and chrome cleaners are also potential sources

4. Acute Fluoride Toxicity This results from rapid excessive ingestion of fluoride at one time Certainly lethal dose is 32to 64 mg o fluoride/kg body wt Saftey tolerated dose 8 to 16 mg of fluoride/kg body wt The severity and speed of response depends on amount of fluoride ingested and weight and age of individual

5. After 2-4 hours fatality is possible if first aid is not administered In acute poisoning fluoride causes death by blocking normal cellular metabolism Death usually results from Serious symptoms devlope within an hour or two and death occurs from 2 to 4 hours after ingestion Cardiac failure or respiratory paralysis

6. Chronic Fluoride Toxicity This results from long term ingestion of small amounts of fluoride Effect Dosage Duration Dental fluorosis >2times optimal Until 5 years Skeletal fluorosis 10-25/mg day 10-20 years

7. Dental fluorosis It is defined as hypocalcification of tooth enamel caused by excessive fluoride intake during tooth development. once the crowns are formed no further fluorosis can be induced by additional intake of fluoride.

8. Management of dental fluorosis A) Micro abrasion- conservative removal of outermost layer of enamel followed by teeth whitening can make brown discoloration less apparent B) Crowns

9. C) veneers

10. Skeletal fluorosis It affects young as well as old. The symptoms include severe pain and stiffness in the backbone, joints and/or rigidity in hip bones. X-ray examinations of the bones reveals thickening and high density of bones. In some patients with calcium deficiency, osteomalacia type changes are seen Constriction of vertebral canal and intervertebral foramen - pressure on nerves leads to paralysis

11. Defluoridation of water Defluoridation is process of removing excess naturally occurring fluoride from drinking water in order to reduce the prevalence and severity of dental fluorosis There 5 established defluoridation methods 1 bone charcoal 2 contact precipitation 3 activated alumina 4 clay 5 Nalgonda technique

12. Bone charcoal Bone charcoal is blackish porous granular material, In contact with water bone charcoal absorbs wide range of pollutants and has ability to take up fluoride from water. Water treated with bone charcoal can have foul taste and may be rejected by users One of the constraints of using bone charcoal defluoridation method is that in some communities Religious beliefs prevent the use of animal bones .. So in these cases this method is unacceptable

13. In this technique fluoride is removed from water Through addition calcium and phosphate compounds And then bringing the water into contact woth already saturated bone charcoal medium This method Is suitable for use in wider range Water + calcium and phosphate compounds Contact time : 20 -30 minutes. Pass water through a psaturated bone charcoal medium.

Bone charcoal acts as catalyst for the removal of fluoride.

Filters the precipitate. Contact precipitation

14. Activated alumina

15. Activated alumina comprises aluminium grains prepared with an adsorptive surface When water passes a packed column of activated alumina pollutant and other components in water are adsorbed onto surface of grains . This design criteria can be challenging and previously it was considered expensive This is no longer the case because under certain conditions activated alumina can be affordable for low income communities

16. Clay . It has the ability to remove pollutants from water.

⁃ It is used at domestic level.

⁃ Composed of: Fine particles of hydrous aluminium silicates,

Minerals
impurities

Any clay to be used for defluoridation prior to producing drinking water should be tested for presence of toxic materials and other possible pollutants

17. Nalgonda technique Developed by National Environmental Engineering Research Institute(NEERI) at Nagpur in 1974 by Nawlakhe et al.

⁃ Comprises of
Sodium aluminate(filter alum).
Lime,
Bleaching powder

.Useful both for domestic as well as for communtiy water supplies

18. Digram of nalgonda technique

19. Conclusion When used appropriately fluoride is safe and effective agent that can be used to prevent and control dental caries However as fluroid is considered as double edged sword it should be used judiciously so that dental caries is prevented and skeletal and dental fluorosis are avoided

20. References Essentials of public health dentistry. Soben Peter 7 th edition National institutes of health ( NIH.gov ) American dental association ResearchGate.com