Fluoride toothpaste - what are the dangers of chronic ingestion in adults?

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Publisher: North West Medicines Information Centre

Keywords: Fluorides; Dentifrices; Toothbrushing; Adverse Effects; osteosclerosis

Date published: 04/01/2012 15:08

Review date: 31/12/2013 00:00

Summary

by: Christine Randall

Chronic toxicity from fluoride ingestion is rare in the UK and other developed countries. The principal sources of potentially excessive fluoride intake are drinking water, in areas where levels are naturally high, and toothpaste ingestion.
US guidance suggests that the tolerable upper limit for fluoride ingestion is 10 mg per day.
Most public water supplies in the UK contain less than 0.7 mg/L fluoride; 10% of supplies are fluoridated to a level of 1.0 mg/L (1 part per million fluoride – ppmF).
Standard over-the-counter adult toothpastes contain between 1,000 ppmF and 1,500 ppmF. There are two toothpastes, available only on prescription, with fluoride contents above 1,500 ppmF. They are Duraphatâ 2800 (2,800 ppmF) and Duraphatâ 5000 (5,000 ppmF).
A 70 kg adult, who does not expectorate after brushing, could ingest a total of 10 mg fluoride by swallowing 2.0 ml of Duraphatâ 5000 toothpaste, assuming a fluoride free water supply, or 1.7 ml Duraphatâ 5000 toothpaste plus 1.5 litres water containing 1 ppmF.
Caution is required if high-strength fluoride toothpastes are used in people who may swallow rather than expectorate after toothbrushing.

About this library entry

Category: 9.5.3 Fluoride | Adverse Drug Reactions | Dentistry

NeLM area: Evidence > Medicines Q & A