Effects of fluoride in water on health

Introduction:
Proper oral health care is very important for any person’s health. Dental caries is still one of the major public health problems. The most effective way of caries prevention is the use of fluoride.

Fluoride is known to have both beneficial and adverse effects on humans, depending on the total intake. Drinking water is usually, but not always, the main source of fluoride and fluoride is sometimes added to public water supplies to help prevent dental caries. This paper considers exposure to natural fluoride through public drinking water supplies in Estonia in 2004. The WHO health-based guideline value for drinking water, which is also the basis of the value in the EC Drinking Water Directive transposed into Estonian Law by the Estonian regulations, is 1.5 mg/L.

Aim:
The aim of our research was to review the literature about fluoride toxicity and to inform physicians, dentists and public health specialists whether fluoride use is expedient and safe.

Methods:
Data we used in our review were systematically searched and collected from web pages and documents published from different international institutions.

Results:
Fluoride occurs naturally in our environment but we consume it in small amounts. Exposure can occur through dietary intake, respiration and fluoride supplements. The most important factor for fluoride presence in alimentation is fluoridated water. Methods, which led to greater fluoride exposure and lowered caries prevalence, are considered to be one of the greatest accomplishments in the 20th century`s public dental health. During pregnancy, the placenta acts as a barrier. The fluoride, therefore, crosses the placenta in low concentrations. Fluoride can be transmitted through the plasma into the mother’s milk; however, the concentration is low. The most important action of fluoride is topical, when it is present in the saliva in the appropriate concentration. The most important effect of fluoride on caries incidence is through its role in the process of remineralization and demineralization of tooth enamel. Acute toxicity can occur after ingesting one or more doses of fluoride over a short time period which then leads to poisoning. Today, poisoning is mainly due to unsupervised ingestion of products for dental and oral hygiene and over-fluoridated water.

Conclusion:
Even though fluoride can be toxic in extremely high concentrations, it`s topical use is safe. The European Academy of Paediatric Dentistry (EAPD) recommends a preventive topical use of fluoride supplements because of their cariostatic effect.