Sodium Fluoride (Oral Route, Dental Route, Oromucosal Route)

Sodium fluoride, commonly called fluoride, is a cavity-fighting medication often used in children who experience a tendency toward multiple cavities.

Overview

Sodium Fluoride which is generally referred to as just fluoride is typically only available with a prescription from your doctor or dentist. This medication is used to combat cavities, especially in young children. Fluoride is naturally present in drinking water, although it is not always at a sufficient level to prevent cavities. While many communities throughout the country do add fluoride to the water supply, there are instances where additional fluoride intake is appropriate.

In addition to upping your fluoride intake, your doctor may provide additional guidance on lifestyle changes that may also help to prevent the occurrence of cavities and other dental problems. Even if they are taking additional fluoride, it is important to instill proper and consistent oral hygiene health habits in your young children. Remeber, this is important even when they are receiving additional fluoride or your community is deemed to provide effective levels of the substance. Proper oral care includes brushing the teeth two times per day, and flossing at least once, if not twice on a daily basis. In addition to these healthy daily habits, regular dental check-ups should always be maintained.

Children who do not receive the necessary vitamins and minerals from their normal daily diet may be advised to take supplements. If your pediatrician or dentist recommends such a course of action, it is imperative that all directions be followed as closely as possible. These concerns are also relevant when speaking about the health of adults and the same instructions apply.

Fish is an effective source of fluoride that can be added to a patient's diet to increase the levels of fluoride in their system. However, it is important to remember that ingesting too much fluoride can cause serious problems to the patient's oral health and overall wellbeing including severe damage to the teeth and bones. Due to this concern, be sure to discuss any changes in your diet or water drinking habits with your prescribing doctor.

Most adults receive their additional fluoride from mouthwashes such as CaviRinse and Fluoridex Daily Defense which are also available as over the counter products. Children will generally be prescribed any additional fluoride that they require because the dangers of taking too much are greater in children and this drug needs to be administered under medical supervision.

Conditions Treated

  • Prevention of cavities, especially in young children

Type of Medicine

  • Monatomic Anion of Fluorine

Side Effects

Because it is possible to overdose on fluoride it is important that you review the signs of overdose with your doctor. Do not take any of the side effects listed below lightly, as they can be a sign of a severe medical issue. There are additional side effects that may occur that are not listed.

If you or your child experience any symptoms that appear to worsen over time or do not dissipate after a few days it is always best practice to contact the prescribing doctor. However, due to the danger of overdose and the harm that fluoride can cause in young children, it is best to err on the side of caution and seek medical advice or attention whenever unwanted side effects are present.

Unlikely Sign of Overdose:

Open or closed sores in the mouth and on the area surrounding the mouth, including the lips

Discontinue taking sodium fluoride and seek immediate emergency medical attention if you suffer from any of the symptoms listed below:

  • Black, tarry stools
  • Watery eyes
  • Nausea or vomiting
  • Bloody vomit
  • Tremors
  • Drowsiness
  • Shallow breathing
  • Increased watering of the mouth
  • Stomach cramps or pain
  • Faintness
  • Unusual excitement
  • Diarrhea
  • Weakness

The following side effects may occur and they should be reported to your prescribing doctor immediately as they may be a sign of a more serious problem.

Notify your healthcare provider if you suffer from:

  • White, brown, or black discoloration of the teeth in young children whose teeth are still developing
  • Pain and aching of bones
  • Any stiffness in the joints or other areas of the body

Again, due to the possible dangerous effects of a sodium fluoride overdose, all symptoms and side effects should be reported to the prescribing physician even if they appear minor. This is especially true for young children who are taking the drug.

Dosage

While there are not any RDA requirements or guidelines for fluoride currently, there are established benchmarks that most medical professionals agree upon. Those general guidelines are as follows:

In adults and teenagers, it is recommended that 1.5mg to 4mg be consumed each day.

Babies and infants up to age 3 are directed to receive 0.1mg to 1.5mg daily.

Children aged 4 to 6 are generally directed to ingest 1mg to 2.5mg every day.

For those children that are 7 to 10 years old, 1.5mg to 2.5mgs are directed for that age group.

When considering the amount of fluoride that is being taken it is important to consider all sources.

Your doctor may prescribe additional fluoride in one of the following forms:

  • Gel/Jelly
  • Tablet, Chewable
  • Lozenge
  • Liquid
  • Solution
  • Tablet
  • Tablet that is coated with Enteric
  • Paste
  • Cream

If you are taking the medication in chewable tablet form, the typical dose is administered at bedtime following the nightly teeth brushing. For parents that are administering the drug to their child, if it is easier, the tablet can be crushed into small pieces but it must be chewed and swallowed. Once the tablet has been taken, it is important that no eating or drinking occur for at least 15 minutes.

Another popular method of administering sodium fluoride is via a dropper bottle. This is the method of choice for infants and small children. The liquid should be dropped directly into the mouth and swallowed. If the child will not tolerate this administration method, the liquid medication can be added to water or juice. Do not add to cold cereals and milk, as the calcium in the milk can decrease the effectiveness of the fluoride.

Actual dosage levels will vary by the age and size of the child and the amount of fluoride that they receive from both their drinking water and daily diet. It is important that the exact dosage recommendations are followed without any variance as taking to much of this drug can lead to serious side effects.

It is imperative that this drug is administered exactly as you are directed by the patient's doctor or dentist. If you do miss a dose it is standard practice to take the skipped medication as soon as you remember. However, if it is close in time to the next scheduled dose, it may be best to skip the missed dose entirely. In cases where you are unsure what to do, it is always advisable that the prescribing doctor or pharmacist be consulted. Do not ever take a double dose or more of the drug than the amount that is prescribed.

Because fluoride is added to municipal water supplies, discuss any changes in your living situation with your doctor, ideally before they occur. If you are planning to move to a neighboring county or your child is going to change schools, the implications of such changes need to be discussed with your doctor. Likewise, any changes in diet or if your household changes from tap to filtered or bottled water, your doctor will need to be advised of such actions as soon as possible.

Interactions

While there are no known negative interactions with major drugs currently known, it is imperative that all medications that the patient is currently taking are disclosed to the prescribing doctor. This includes both prescription and non-prescription drugs as well as over the counter medications. If you are taking any herbal remedies or vitamin and mineral supplements, you should also tell your doctor about those treatments.

Patients that are concurrently taking sodium fluoride and aluminum hydroxide or calcium supplements must be aware of the timing of their dosage. It is best practice to allow 2 hours in between the administration of these drugs to ensure that they both provide maximum efficacy.

Warnings

Do not take this drug before or after ingesting any dairy products, and you should consult with your prescribing physician about how much and when your child should drink milk while they are taking any type of fluoride treatment. Combing this drug with calcium will reduce its effectiveness.

This medication has been known to cause discoloration of the teeth, with black, brown, and white discoloration reported.

All of these ailments can be exacerbated by the use of fluoride:

  • Kidney Problems
  • Stomach Ulcers
  • Joint Pain

Be sure to discuss these ailments with your prescribing doctor as they may recommend a different course of treatment as its use may cause these conditions to become worse.

Because it is possible to overdose on fluoride, it is important that the prescribing doctor is notified of any side effects that occur while taking this drug, even if they appear to be mild or moderate. If any changes occur in where you live, where your child goes to school, or if you begin using filtered or bottled water in your household, it is important that your doctor is notified as soon as possible as these changes will likely alter the amount of additional fluoride that the patient requires. The same is true for any substantive changes to the diet of anyone taking sodium fluoride.

Storage

It is always best to store any medication, whether prescription or over the counter, in its original packaging. The medications should be stored at room temperature and away from direct light. Do not expose your medications to extreme hot or cold and do not allow it to freeze. Keep it in a dry area without excess moisture, which makes a room in the house other than the bathroom a good choice.

Keep this and all medications out of the reach of children.

As this drug is often administered to children in a chewable tablet form, it is important that they understand that the fluoride tablets are not candy. Alert your household to the possibility of overdose from this medication and if necessary, enhance the safeguards that are already in place.

If you have any unused or expired medications at the conclusion of the course of treatment it is advised that you check with your prescribing doctor or pharmacist about the most appropriate way to dispose of the excess medication. Do not throw medications in the trash or flush them down the toilet.

Summary

Sodium fluoride is an effective drug that is used in the prevention of cavities, especially in young children. There is the possibility of overdose with this drug which makes it imperative that all dosage instructions be followed exactly as prescribed. Additionally, due to the various sources through which fluoride can be ingested, any substantive changes in the patient's daily habits or domicile must be reported to the prescribing doctor as soon as possible.

If you or your child experience any side effects while taking fluoride it is important to report them to your doctor immediately as they can be signs of overdose or a more serious health issue. Do not ignore any side effects, even if they appear to be mild in nature.

While taking fluoride, it is important to limit the amount of dairy products that are ingested as the calcium that they contain has been shown to decrease the efficacy and absorption of fluoride. This medication is best taken after the nightly teeth brushing and the patient should wait at least 15 minutes before eating and drinking anything.

Children that are taking additional fluoride medication must still practice proper oral hygiene. They will still need to brush their teeth two times per day and also floss. Regular dental visits are also important to monitor the effects of the fluoride medication and ensure that the correct level is being administered.

Fluoride is an effective treatment and also one that must be taken carefully. Inform yourself of the signs and symptoms of overdose and seek immediate emergency attention if they arise. Do not take more than the prescribed dosage and consult with the prescribing physician in the event of any concerns that arise while taking this medication.

 

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Last Reviewed:
January 31, 2018
Last Updated:
February 10, 2018
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