Fluoride supplements, Therapeutic uses of supplements

Fluoridation of water

Approximately half of the US water supply is fluoridated in an effort to reduce tooth decay. Studies have shown that one part per million of fluoride in drinking water can substantially reduce tooth decay. This effect is particularly noticeable if treatment is started during early childhood when teeth are still forming. However, water fluoridation is a controversial issue and many experts feel that the practice should be discontinued.

Fluoride supplementsChildren living in areas were the water is fluoridated are at increased risk of dental fluorosis, in which teeth become mottled with yellow or brown spots. Mottle fed babies are at particular risk if formula is made with fluoridated tap water. Breast milk and ready-to-feed formula contain safe fluoride levels and experts recommend using low fluoride filtered or distilled water with formula. Fluoridation may also increase the risk of dermatitis in sensitive people.

Tooth decay

Fluoride is used in the treatment of dental caries. It is available in the form of fluoride toothpaste, oral fluoride tablets, fluoride gel and mouth rinses with fluoride solutions. It can help reduce sensitivity to external stimuli in gums which have receded to expose dentine. Fluoride supplements discourage the formation of dental caries in children by reducing the susceptibility to erosion of tooth minerals and by preventing the growth of acid-producing bacteria in the mouth.


Sodium fluoride, along with calcium, has also been used to treat osteoporosis as it appears to increase bone mass. Researchers involved in a 1998 study published in the Annals of Internal Medicine compared the vertebral fracture rates in 200 women over a four-year period. One group was given 20 mg of fluoride and 1000 mg of calcium daily, and the other group received only calcium. The rate of new fractures in the fluoride group was 2.4 per cent compared to 10 per cent in the calcium only group.

Sustained release fluoride in doses of 23 mg per day appears to be more beneficial than forms which are quickly absorbed from the gut. However, a 1996 study done in Argentina suggests that the increases in bone mineral density are not maintained after sodium fluoride therapy is stopped.

The treatment of osteoporosis with fluoride supplements is controversial as there is the possibility that fluoride bone is not always stronger than normal bone. There may be an increase in the number of hairline fractures in the hips, knees, feet and ankles. In 1983/1984, a study of bone mass and fractures was begun in 827 women aged 20-80 years in three rural Iowa communities selected for the fluoride and calcium content of their community water supplies.
Residence in the higher-fluoride community was associated with a significantly lower radial bone mass in premenopausal and postmenopausal women, an increased rate of radial bone mass loss in premenopausal women, and significantly more fractures among postmenopausal women. Fluoride therapy may increase the requirement for calcium as more is needed for bone formation.

Fluoride therapy has also been used to prevent rheumatoid arthritis-induced bone loss.

Other uses

Fluoride may also aid in wound-healing after dental surgery, possibly due to antibacterial action. Fluoride supplements have been used to treat Paget' s disease, bone pain, and to stabilize loss of hearing in patients with otosclerosis, a disorder in which deposits in the ear lead to deafness.

Fluoride supplementsInteractions with other nutrients

Fluoride works with calcium, phosphorus, magnesium and vitamin D in the formation of healthy bones and teeth. Magnesium and calcium salts may reduce absorption of fluoride supplements. High calcium intakes may increase fluoride excretion. Caffeine may improve fluoride absorption.


Fluoride supplements should be used with caution in patients with joint pain or rheumatic disease. Fluoride supplements may exacerbate gastrointestinal disease and ulcers.

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