Did you know...

That according to the handbook, "Clinical Toxicology of Commercial Products," fluoride is more poisonous than lead and just slightly less poisonous than arsenic.

FLUORIDE FACTS FROM BRITISH DENTAL JOURNAL

• The British Dental Journal reported that young children swallow 72% of the toothpaste used for brushing.(Click here for copy of article)

• The desired amount of fluoride in most municipal water supplies is at a level of 1 ppm (parts per million). The amount of fluoride, in many toothpastes, is 1,450 ppm!(Click here for copy of article)

• It is essential that parents fo children aged less than 7 years apply a small (pea-sized) amount of fluoride toothpaste on the toothbrush and discourage swallowing.(Click here for copy of article)

OTHER FLUORIDE FACTS

• Since mid-1997, the F.D.A. has mandated all toothpastes containing fluoride to carry this warning … "If you accidentally swallow more than used for brushing, seek professional help, or contact a poison control center immediately.".(Click here)

• Even on many fluoridated children's toothpastes, there is a warning to keep out of the reach of children under 6years of age!

• That according to the Physicians' Desk Reference: " In hypersensitive individuals, fluoride occasionally cause skin eruptions such as atopic dermatitis, eczema, or urticaria. Gastric distress, headache, and weakness have also been reported. These hypersensitive reactions usually disappear promptly after discontinuation of the fluoride."

• That the Canadian Dental Association recommends: "Fluoride supplements should not be recommended for children less than three years old."

• That from 1990 to 1992, the Journal of the American Medical Association published three separate articles linking increased hip fracture rates to fluoride in the water. (Click here for copy of article)

• That in the March 22, 1990 issue of the New England Journal of Medicine, Mayo Clinic researchers reported that fluoride treatment of osteoporosis increased hip fracture rate and bone fragility.

Toothpaste warning labels concern parents
By DON OLDENBURG The Washington Post

Last month, as 8-year-old Molly Statt stood in the bathroom brushing her teeth, something on the back of the tube of Crest caught her attention. She stopped brushing. Looking up at her father standing beside her, she asked, "Is this poison?"

"Of course not," Paul Statt reassured his daughter. "Then why does it say 'poison' on it?" she asked.

Statt looked more closely at the label. In small print were warnings he hadn't noticed before, including one that read: "If you accidentally swallow more than used for brushing, seek professional help or contact a poison control center immediately."

Like most people, the Petersborough, N.H., resident assumed that an over-the-counter health-care product like toothpaste must certainly be as safe as the water we drink. But it's not. And that's the message of the new warning labels required by the Food and Drug Administration on all fluoride toothpastes and dental care products shipped as of April 7.

"When I receive the fluoride here, it has a skull-and-bones on it," Regina Miskewitz says of the containers of the chemical at the Princeton, N.J., laboratories of Church & Dwight Co. Inc., maker of Arm & Hammer products, where she is director of research and development for oral and personal care.

"If a child was to take a big spoonful of this fluoride, I don't think he could swallow it," she says, "but if he did get it down, it is a poison and the child could die. If a child ingested a whole tube of toothpaste, he should be taken to the emergency room and he would either get his stomach pumped or get some kind of antidote."

Three ingredients found in most toothpastes pose health risks if too much is ingested, according to Miskewitz. Sorbitol, a liquid that keeps toothpaste from drying out, is a laxative that could cause diarrhea in children. Sodium lauryl sulfate, an ingredient that makes toothpaste foam,can also be a diarrhetic. But the fluoride poses the most danger if too much toothpaste is swallowed - particularly by younger children.

This summer, as toothpaste shipments with the new labeling replace older inventories, consumers will see nearly twice the warnings displayed on the back of tubes and cartons - ADA's general warnings along with the new FDA-required statement that starts with:"Keep out of reach of children under 6 years of age."

Research has shown that because they aren't yet in control of their swallowing reflex, children 4 - 6 years old typically swallow toothpaste when brushing. "That's why it's recommended that kids get only a pea-sized amount of toothpaste," says Miskewitz, "because most of that goes down their throats."

A 1995 study at the Georgia School of Dentistry found that about half of the children this age don't spit out or rinse out - they swallow the toothpaste instead. Making matters worse, they tend to use too much toothpaste on their own, especially when they use flavored children's toothpastes.

While the cavity-preventing effectiveness of fluoride has been demonstrated, too much fluoride not only can be dangerous, it can cause a condition known as fluorosis, which discolors or spots developing teeth. Research conducted by the School of Dental Medicine at the University of Connecticut Health Center concluded that brushing with more than a pea-size amount of toothpaste more than once daily contributed to most of the fluorosis cases it observed in young children. In areas where the drinking water contains fluoride, children who swallow even the pea-size amount of toothpaste are getting too much fluoride and are at risk for fluorosis.

"It is always kind of a trade-off," says Nancy Rosenzweig, vice-president of corporate communication and market development at Tom's of Maine, which in 1975 introduced the first "natural" toothpaste on the market. The company recently began marketing a new line of natural toothpastes for children which eliminates synthetic sweetners but contains fluoride.

"We made a decision to have only fluoride toothpaste for children because that has been proven to be the overall benefit of toothpaste for children," Rosenzweig says. "We feel the benefit outweighs the negative."

In fact, many in the toothpaste industry feel the new FDA warnings may be overstating the risks.

"Our position was that they went a little too far" says Clifford Whall, director of product evaluations on the ADA's Council on Scientific affairs. "There wasn't really a need for the cautionary statement about the danger of poisoning if you've ingested too much.".

While Whall concedes that poison control centers do receive reports of fluoride "poisonings" every year, he says the ADA isn't aware of any of those cases resulting in adverse affects. "It just hasn't proven to be that kind of problem....we didn't think you needed a label like that because it could unnecessarily scare consumers into not using toothpaste."

FLUORIDATION AND HIP FRACTURES [JAMA]

Although oral fluoride is sometimes used to treat osteoporosis, recent studies suggest that fluoride may increase the risk of hip fracture. This cohort study compared the incidence of femoral neck fractures in a community with longstanding water fluoridation (to 1 ppm) with the incidence in two communities without water fluoridation (less than 0.3 ppm). The authors identified cases of first hip fractures in persons at least 65 years old from a database of all Medicare discharges in Utah between 1984 and 1990. Excluded were subjects with surgical revisions of hip fractures or fractures secondary to metastatic disease. The relative risks of fracture in fluoridated areas, compared with nonfluoridated areas, were 1.27 for women and 1.41 for men. In the fluoridated community, women under age 79 had a higher rate of hip fracture than older women. In contrast, increased risk for men occurred after age 75. The findings of this report support other epidemiologic studies suggesting that fluoride increases the risk of hip fracture. However, the multiple causes of hip fracture make it difficult to interpret single-factor studies and to establish cause-and-effect relations. These results should not be used as an argument against water fluoridation, which has benefits in controlling tooth decay, but should encourage further study of the risks and benefits of fluoride in the elderly. —COM. TITLE: Danielson C et al; Hip fractures and fluoridation in Utah's elderly population. AUTHORS: REFERENCE: JAMA 1992 Aug 12; 268:746-8.

British Dental Journal

1: Br Dent J 1999 May 8;186(9):460-2
Fluoride ingestion from toothpaste by young children. Bentley EM, Ellwood RP, Davies RM.
Dental Health Unit, Manchester.
OBJECTIVE: To investigate the reported and observed brushing habits of young children and their ingestion of fluoride from toothpaste. DESIGN: In 1997, a random sample of 50 children, aged 30 months, from three districts in the North West region of England, were visited at home. METHODS: The reported and observed toothbrushing behaviour was determined and the weight of toothpaste applied to the toothbrush was measured. The amount of fluoride retained in the mouth after brushing with either a 400 ppm F or 1,450 ppm F toothpaste was determined. RESULTS: All parents claimed that their children's teeth were being brushed with a fluoride toothpaste at least once daily. The mean amount of toothpaste applied on the brush was 0.36 g of which 0.27 g (72%) was retained in the mouth. The mean amount of fluoride ingested per brushing was 0.42 mg when using the 1,450 ppm F toothpaste and 0.10 mg when using the 400 ppm F toothpaste. Although most parents applied a small amount of toothpaste a small minority applied a large amount. If using the 400 ppm F toothpaste twice daily no children of average weight would have exceeded ingestion of 0.05 mgF/kg body weight whereas 14 average weight children would have exceeded this value if using the 1450 ppm F toothpaste. CONCLUSIONS: It is essential that parents of children aged less than 7 years apply a small (pea-sized) amount of fluoride toothpaste on the toothbrush and discourage swallowing.
PMID: 10365494 [PubMed - indexed for MEDLINE]
#2, From http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5014a1.htm