Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride (1997) / Chapter Skim
Currently Skimming:
8 Fluoride
8 Fluoride
Pages 288-313
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 288... ...
rather than in forms that are quickly absorbed from the GI tract. The ingestion of fluoride during the pre-eruptive development of the teeth has a cariostatic effect (it recluces the risk of dental caries)
|
From page 289... ...
Body fluici and tissue fluoride concentrations are proportional to the long-term level of intake; they are not homeostatically regulated (Guy, 1979~. About 99 percent of the bocly's fluoride is found in calcified tissues to which it is strongly but not irreversibly bounci.
|
From page 290... ...
Car~ostatic Effect of Fluoride The cariostatic action of fluoride on erupted teeth of children and adults is clue to its effects on the metabolism of bacteria in dental plaque and on the dynamics of enamel cle- and remineralization cluring an aciclogenic challenge (Marquis, 1995; Tatevossian, 1990~. Plaque fluoride concentrations are directly related to the fluoride concentrations in and frequencies of exposure to water, beverages, foocis, and dental products.
|
From page 291... ...
Results from studies with rats that haci chronically elevated plasma fluoride concentrations showed that a cliet high in calcium increases fecal fluoride excretion such that fluoride loss can equal or exceed fluoride intake (Whitforci, 1994~. It has been suggested that the co-ingestion of fluoride and caffeine or some other methylxanthines increases the bioavailability of fluoride (Chan et al., 1990)
|
From page 292... ...
Table 8-1 summarizes the results of seven studies of dietary fluoricle intake of children in the United States or Canada that were published from 1943 to 1988. The drinking water fluoride concentrations in fluoriciateci communities were between 0.7 and 1.1 ma/ liter, whereas those in nonfluoriciateci communities were less than 0.4 mg/liter.
|
From page 293... ...
Intake from Food Most foocis have fluoride concentrations well below 0.05 mg/100 g (Taves, 1983~. Exceptions to this include fluoriciateci water, beverages and some infant formulas that are macle or reconstituted with
|
From page 294... ...
reported fluoride concentrations in marine fish ranging from 0.6 to 2.7 mg/100 g. The samples, however, may have contained bones.
|
From page 295... ...
and the Canaclian Paecliatric Society (1996~. Supplements are available only by prescription and are intencleci for use by children living in areas with low water fluoride concentrations so that their intake is similar to that by children whose water fluoride concentrations are approximately 1.0 mg/liter.
|
From page 296... ...
b No data. c Toothpaste fluoride concentration = 2,400 ppm.
|
From page 297... ...
was 40 to 60 percent lower than in areas with low water fluoride concentrations. The lower concentrations within the optimal range are recommencleci for warm climates where water intake tencis to be greater than in cooler climates.
|
From page 298... ...
The figure also shows that recluction in the average number of dental caries per child was nearly maximal in communities having water fluoride concentrations close to 1.0 mg/liter. This is how 1.0 mg/liter became the "optimal" concentration.
|
From page 299... ...
The water fluoride concentrations in these cities were 0.2 mg/liter and 1.5 to 2.0 mg/liter, respectively. Caries experience in people in five different age groups (ranging from 15 to 19 to > 44 years)
|
From page 300... ...
reported that the stanciarclizeci mortality rate clue to ischemic heart disease in cities with optimally fluoriciateci water was lower than in cities with low water fluoride concentrations. Data are insufficient to justify using these effects as the basis for estimating an AI for fluoride.
|
From page 301... ...
The AI is baseci on estimated intakes that have been shown to recluce the occurrence of dental caries maximally in a population without causing unwanted sicle effects including moderate dental fluorosis. FINDINGS BY LIFE STAGE AND GENDER GROUP General Observations The cariostatic effect associated with residence in communities served with optimally fluoriciateci water (ca.
|
From page 302... ...
Since the intake of fluoride by human milk-feci infants cluring this period of life clods not appear to significantly increase the risk of dental caries, fluoride from human milk is cleemeci adequate in early life. AI for Infants O through 6 months 0.01 mg/day Ages > 6 Months Baseci on the extensively clocumenteci relationships between caries experience and both water fluoride concentrations and fluoride intake, the AI for fluoride from all sources is set at 0.05 mg/kg/ciay.
|
From page 303... ...
, the AI is 3.8 mg/day. Based on a reference weight for females ages 19 and above of 61 kg, the AI for females is 3.1 mg/ciay.
|
From page 304... ...
(1997) study was the first prospective, randomized, double blind study conducted in this area and the authors concluded that "the data do not support the hypothesis that the observed low carte levels are attributable to prenatal fluoride exposure." At this time, scientific evidence is insufficient to support a recommendation for prenatal fluoride supplementation.
|
From page 305... ...
Because fluoride concentrations in human milk are very low and relatively insensitive to differences in the fluoride concentrations of the mother's drinking water, fluoride supplementation cluring lactation would not be expected to significantly affect fluoride intake by the nursing infant or the fluoride requirements of the mother. The AI for women cluring lactation is therefore not increased above that for women in the nonpregnant state.
|
From page 306... ...
TOLERABLE UPPER INTAKE LEVELS Hazard Identification The primary adverse effects associated with chronic, excess fluoricle intake are enamel and skeletal fluorosis. Adverse Cosmetic Effect: Enamel Fluorosis Enamel fluorosis is a close-response effect caused by fluoride ingestion cluring the preeruptive development of the teeth.
|
From page 307... ...
In the asymptomatic, preclinical stage of skeletal fluorosis, patients have slight increases in bone mass that are detectable racliographically, bone ash fluoride concentrations that range from 3,500 to 5,500 ma/ kg, and bone concentrations that are 2 to ~ times higher than those of life-long residents of optimally fluoriciateci communities (Eble et al., 1992~. Stage 1 skeletal fluorosis is characterized by occasional stiffness or pain in joints and some osteosclerosis of the pelvis and vertebra.
|
From page 308... ...
Crippling skeletal fluorosis continues to be extremely rare in the United States (only ~ cases have been confirmed cluring the last 35 years) , even though for many generations there have been communities with drinking water fluoride concentrations in excess of those that have resulted in the condition in other countries (Singh and Jolly, 1970~.
|
From page 309... ...
established, with a high degree of certainty, that a chronic fluoride intake of less than 0.10 mg/kg/ciay by children at risk of enamel fluorosis was associated with a low prevalence (for example, approximately 10 percent) of the milder forms of the condition.
|
From page 310... ...
(1955) compared bone x-rays of long-term residents of Bartlett and Cameron, Texas, which haci water supplies with fluoride concentrations of 8.0 and 0.4 mg/liter, respectively.
|
From page 311... ...
Exposure Assessment Prior to the 1960s, the cliet, including water, was the only significant source of fluoride. Since then, fluoride ingestion resulting from the use of dental products and fluoride supplements has increased the risk of enamel fluorosis in children.
|
From page 312... ...
is exceeded by approximately 1 in 100 children in areas where the water fluoride concentration is 1.0 mg/liter or slightly higher. In the 1930s and 1940s, no moderate or severe cases of enamel fluorosis were recorded in these areas, and because fluoride intake from water and the diet appears not to have increased since that time, the additional · , , , , ·,, , · .
|
From page 313... ...
of the relationships among fluoride exposures from all major sources and the prevalence of dental caries and enamel fluorosis at specific life stages should continue for the purposes of detecting trencis and determining the contribution of each source to the effects clemonstratecl. · Epiclemiological and basic laboratory studies should further refine our unclerstancling of the effects of fluoride on the quality and biomechanical properties of bone and on the calcification of soft tissue.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.