To function properly, the human body requires several minerals in addition to the proteins, carbohydrates, and fats that are frequently discussed. The list of minerals helps the body perform essential functions such as influencing nerve function, assisting muscles in working, and determining the level of water in the body.
One of the key minerals is fluoride, which is necessary for maintaining dental health and preventing tooth decay. Fluoride is found naturally in various water sources, soil, and certain foods. It is so important in the body that it also is found in many dental products.
However, excessive intake of fluoride during critical periods of tooth and bone development causes a condition known as fluorosis. The overabundance can lead to undesirable effects on teeth and bones.
Fluorosis is most common in Kenya in areas where the water supply contains naturally high levels of fluoride. Most of Kenya’s population is reliant on underground water sources where water interacts with fluoride-rich rocks. According to the Kenya National Oral Health Strategic Plan, this increases the risk of fluorosis with fluorosis affecting 23.7% of Kenyans. The prevalence in children is significantly higher, at 41.4%.
Fluorosis symptoms can vary depending on the severity of the condition. Individuals with dental fluorosis, the most common form, may have barely visible discoloration as streaks or spots on the tooth enamel. Brown discoloration and pitting of the enamel occur as the condition worsens. This makes the teeth more prone to decay.
If unchecked, excessive fluoride intake can lead to skeletal fluorosis, which affects the bones and joints. The pain, stiffness, and limited joint mobility caused by skeletal fluorosis, especially in the later stages, result in crippling deformities that have a negative impact on an individual’s quality of life.
The good news is that, despite the high levels of fluoride in Kenya’s water supply, fluorosis is preventable. To promote dental health while avoiding overexposure, an appropriate level of fluoride intake must be maintained. While this may be difficult for many Kenyans whose water contains more fluoride than the World Health Organization’s recommended 1.5 milligrams per liter, there are some options for fluoride removal.
Fluorosis prevention entails maintaining an appropriate level of fluoride intake to promote dental health while avoiding excessive exposure. It is critical to check the fluoride content of drinking water on a regular basis to ensure that it is within the optimal range (0.7 to 1.2 mg/L or ppm). Individuals should consider using alternative water sources or fluoride-removal methods if natural fluoride levels in the water are high. While a lab test is the most accurate way to determine fluoride levels in water, there are some reasonably priced home testing kits available. Unfortunately, they are not widely available in Kenya and must be ordered online or from a specialist shop.
This is especially important given that fluorosis can only be prevented, but its effects cannot be reversed. Because the condition mostly occurs during critical developmental stages, parents and caregivers can help prevent it. They must be cautious about the water sources they use for their children and supervise their use of fluoride-enriched products such as toothpaste. For children under the age of six, a pea-sized amount of toothpaste is sufficient to prevent excessive fluoride ingestion.
Maintaining a well-balanced diet that includes foods with low fluoride content can help reduce the risk of excessive fluoride intake from food sources. Fluoride is commonly found in foods like marine fish, black tea and coffee, and shellfish. Processed foods are also high in fluoride because the water used in their production frequently contains fluoride. To avoid fluorosis, consume these fluoride-rich foods sparingly.
If fluoride supplements are deemed necessary, they should only be taken under the supervision and prescription of a dentist or healthcare professional, and the recommended dosage should be strictly followed.
Regular dental check-ups are critical for monitoring oral health and detecting early signs of fluorosis. Dentists can provide personalized advice on fluoride use based on an individual’s risk factors, allowing people to strike a balance between reaping the benefits of fluoride for dental health and minimizing the risks of excessive fluoride consumption.
To summarize, fluorosis is a dental and skeletal condition that can be avoided through education, proper fluoride monitoring, and informed dental care practices. Understanding the causes, symptoms, and preventive measures associated with fluorosis allows individuals to practice good oral hygiene and seek professional dental advice, promoting lifelong dental well-being and overall health.
Dr. Sylvia O. Noah, Dental surgeon, Dental Manager Gertrude’s Children’s Hospital. Her e-mail address is snoah@gerties.org
