Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Part 1 Molecular and cellular environment of bone
- Part II Determinants of peak bone mass
- Part III Pathophysiology of the aging skeleton
- Part IV Clinical aspects of osteoporosis
- 17 Biochemical markers of bone turnover
- 18 Radiologic assessment of osteoporosis
- 19 Bone mineral density measurements
- 20 Hormone replacement therapy
- 21 Selective estrogen receptor modulators
- 22 Bisphosphonate therapy of osteoporosis
- 23 The action of fluoride on bone
- 24 PTH peptides as anabolic agents in bone
- 25 Vitamin D and vitamin D analogs as therapeutic agents
- Index
23 - The action of fluoride on bone
Published online by Cambridge University Press: 01 June 2011
- Frontmatter
- Contents
- List of contributors
- Preface
- Part 1 Molecular and cellular environment of bone
- Part II Determinants of peak bone mass
- Part III Pathophysiology of the aging skeleton
- Part IV Clinical aspects of osteoporosis
- 17 Biochemical markers of bone turnover
- 18 Radiologic assessment of osteoporosis
- 19 Bone mineral density measurements
- 20 Hormone replacement therapy
- 21 Selective estrogen receptor modulators
- 22 Bisphosphonate therapy of osteoporosis
- 23 The action of fluoride on bone
- 24 PTH peptides as anabolic agents in bone
- 25 Vitamin D and vitamin D analogs as therapeutic agents
- Index
Summary
Introduction
The fluoridation of municipal water in cities of Canada and the United States for the purpose of reducing dental decay is perhaps the most important and successful public health initiative ever undertaken in these countries. Since its inception more than 50 years ago, water fluoridated at 1 ppm has dramatically reduced the incidence of caries, and this positive effect has reached across all socioeconomic groups. However, since fluoride is a mineral-seeking ion, it is incorporated into bone as well as teeth. The response of bone is known to depend on the dose, and studies in both animal models and in humans have assessed the effect of moderate to high doses of fluoride. As a consequence, it is known that moderate doses of fluoride increase bone mass, making fluoride a potential therapy for osteoporosis (see below). However, chronic exposure to high doses of fluoride (>8 mg/day), while rare in North America, can cause skeletal fluorosis, characterized initially by hypermineralization of bone and later by calcification of ligaments, bone deformation, and other crippling symptoms (Kaminsky et al., 1990). Ingestion of low doses of fluoride through water involves somewhat different mechanisms. Typically, individuals receive less than 5 mg/day of fluoride (less than a tenth of the clinical dose), but it accumulates passively in bone mineral over a timespan of decades.
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- Chapter
- Information
- The Osteoporosis Primer , pp. 318 - 330Publisher: Cambridge University PressPrint publication year: 2000
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