Fluoride Action Network
January 2005
Don't Swallow Your Toothpaste
As of April 7th, 1997, the United States FDA (Food & Drug Administration) has required that all fluoride toothpastes sold in the U.S. carry a poison warning on the label. The warning cautions toothpaste users to:
"WARNING: Keep out of reach of children under 6 years of age. If you accidentally swallow more than used for brushing, seek professional help or contact a poison control center immediately."
Why the Need for a Warning?
One of the little-known facts about fluoride toothpaste, is that each tube of toothpaste - even those specifically marketed for children - contains enough fluoride to kill a child.
As detailed below, most "Colgate for Kids" toothpastes - with flavors ranging from bubble gum to watermelon - contain 143 milligrams (mg) of fluoride in each tube. This dose of fluoride is more than double the dose (60 mg) that could kill the average-weighing 2 year old child.
Other problems with fluoride toothpaste
As common sense might indicate, death is not the only concern with fluoride toothpaste. Other potential problems with fluoride toothpaste include:
Gastric Problems
Ingestion of fluoride has been documented to produce symptoms of gastrointestinal discomfort at doses at least 15 to 20 times lower (0.2-0.3 mg/kg) than the doses which can kill (SOURCE: Gessner 1994; Akiniwa 1997). Thus, a 2 year old child may experience gastrointestinal ailments if they ingest a mere 2 to 3 percent of the bubble-gum flavored paste.
Between 1989 and 1994, over 628 people - mostly children - were treated at health care facilities after ingesting too much fluoride from their toothpaste. Gastrointestinal symptoms appear to be the most common problem reported (SOURCE: Shulman 1997).
Moreover, ingestion of fluoride toothpaste may damage the lining of the gastrointestinal tract - even in the absence of symptoms (e.g. nausea). This was revealed by a carefully conducted study on healthy adult volunteers which found that damage to the gastrointestinal wall occurred - in the absence of symptoms - after a single ingestion of just 3 mg of fluoride (SOURCE: Spak 1990). Undoubtedly, some children will periodically ingest 3 mg of fluoride, or more, from toothpaste in single sittings, especially if they have access to the bubble-gum flavored varieties (which are still being heavily marketed for children).
Dental Fluorosis
One of the most visible and well-recognized side-effects of ingesting fluoride toothpaste is a discoloration of teeth called dental fluorosis. Fluoride produces dental fluorosis by damaging the cells (ameloblasts) which produce the tooth's enamel. The resulting discoloration of teeth can range from white spots in the mild forms of the disorder to brownish and black stains in the the moderate and severe forms. (See pictures here)
Children with dental fluorosis - particularly those with the moderate or severe kinds - can experience significant esteem problems from the perceived unattractiveness of their teeth. As one young girl with dental fluorosis told British television:
"When I first saw that my teeth were discolored, I was teased quite a lot, especially in the middle school by people. They used to say, 'oh you don't clean your teeth or anything' and they used to call me 'shit teeth' which did upset me, even though I knew it was fluorosis."
Being that dental fluorosis is such a visible and tangible effect of over-exposure to fluoride, toothpaste companies are becoming increasingly vulnerable to litigation as public awareness of dental fluorosis increases. As a possible harbinger of what lies ahead for the industry, a family in England won a settlement from Colgate to pay for the costs of treating the dental fluorosis which their toothpaste caused.
Increasing Children's Daily Intake of Fluoride beyond Recommended Levels
Since young children do not have well-developed swallowing reflexes, they tend to swallow a large percentage of the toothpaste placed on their brush. In fact, one of the more consistent findings in the recent dental literature, is that some children - even children living in unfluoridated communities - ingest more fluoride from toothbrushing alone than is recommended as the total daily exposure. As noted by Dr. Steven Levy, of the University of Iowa:
"Virtually all authors have noted that some children could ingest more fluoride from dentrifice alone than is recommended as a total daily fluoride ingestion" (SOURCE: Levy 1999).
It is clear therefore that fluoride toothpaste represents a very important source of ingested fluoride for children. The use of fluoride toothpaste may thereby contribute to the various health risks (e.g. dental fluorosis, bone fractures, bone cancer, neurotoxicity) associated with systemic fluoride exposure.
Allergic Reactions
Among some 'hypersensitive' individuals, the use of fluoride toothpaste may produce canker sores and skin rashes in and around the mouth. The evidence pointing to this possibility is compelling, but has received scant attention from the dental community.
Periodontal Disease?
Another potential side effect of fluoride toothpaste has only recently come to light. Research conducted in the 1990s from the US pharmaceutical company Sepracor indicated that the levels of fluoride in toothpaste may be sufficient to cause or contribute to periodontal bone loss. Sepracor's finding is serious because periodontal bone loss is the #1 cause of tooth loss among adults. According to the scientists at Sepracor who conducted the study:
"We have found that fluoride, in the concentration range in which it is employed for the prevention of dental caries, stimulates the production of prostaglandins and thereby exacerbates the inflammatory response in gingivitis and periodontitis.... Thus, the inclusion of fluoride in toothpastes and mouthwashes for the purpose of inhibiting the development of caries [cavities] may, at the same time, accelerate the process of chronic, destructive periodontitis."
Europe: Taking a More Cautious Approach than U.S.
Courtesy: World Malayali Club, Dubai.
January 2005
Don't Swallow Your Toothpaste
As of April 7th, 1997, the United States FDA (Food & Drug Administration) has required that all fluoride toothpastes sold in the U.S. carry a poison warning on the label. The warning cautions toothpaste users to:
"WARNING: Keep out of reach of children under 6 years of age. If you accidentally swallow more than used for brushing, seek professional help or contact a poison control center immediately."
Why the Need for a Warning?
One of the little-known facts about fluoride toothpaste, is that each tube of toothpaste - even those specifically marketed for children - contains enough fluoride to kill a child.
As detailed below, most "Colgate for Kids" toothpastes - with flavors ranging from bubble gum to watermelon - contain 143 milligrams (mg) of fluoride in each tube. This dose of fluoride is more than double the dose (60 mg) that could kill the average-weighing 2 year old child.
Other problems with fluoride toothpaste
As common sense might indicate, death is not the only concern with fluoride toothpaste. Other potential problems with fluoride toothpaste include:
Gastric Problems
Ingestion of fluoride has been documented to produce symptoms of gastrointestinal discomfort at doses at least 15 to 20 times lower (0.2-0.3 mg/kg) than the doses which can kill (SOURCE: Gessner 1994; Akiniwa 1997). Thus, a 2 year old child may experience gastrointestinal ailments if they ingest a mere 2 to 3 percent of the bubble-gum flavored paste.
Between 1989 and 1994, over 628 people - mostly children - were treated at health care facilities after ingesting too much fluoride from their toothpaste. Gastrointestinal symptoms appear to be the most common problem reported (SOURCE: Shulman 1997).
Moreover, ingestion of fluoride toothpaste may damage the lining of the gastrointestinal tract - even in the absence of symptoms (e.g. nausea). This was revealed by a carefully conducted study on healthy adult volunteers which found that damage to the gastrointestinal wall occurred - in the absence of symptoms - after a single ingestion of just 3 mg of fluoride (SOURCE: Spak 1990). Undoubtedly, some children will periodically ingest 3 mg of fluoride, or more, from toothpaste in single sittings, especially if they have access to the bubble-gum flavored varieties (which are still being heavily marketed for children).
Dental Fluorosis
One of the most visible and well-recognized side-effects of ingesting fluoride toothpaste is a discoloration of teeth called dental fluorosis. Fluoride produces dental fluorosis by damaging the cells (ameloblasts) which produce the tooth's enamel. The resulting discoloration of teeth can range from white spots in the mild forms of the disorder to brownish and black stains in the the moderate and severe forms. (See pictures here)
Children with dental fluorosis - particularly those with the moderate or severe kinds - can experience significant esteem problems from the perceived unattractiveness of their teeth. As one young girl with dental fluorosis told British television:
"When I first saw that my teeth were discolored, I was teased quite a lot, especially in the middle school by people. They used to say, 'oh you don't clean your teeth or anything' and they used to call me 'shit teeth' which did upset me, even though I knew it was fluorosis."
Being that dental fluorosis is such a visible and tangible effect of over-exposure to fluoride, toothpaste companies are becoming increasingly vulnerable to litigation as public awareness of dental fluorosis increases. As a possible harbinger of what lies ahead for the industry, a family in England won a settlement from Colgate to pay for the costs of treating the dental fluorosis which their toothpaste caused.
Increasing Children's Daily Intake of Fluoride beyond Recommended Levels
Since young children do not have well-developed swallowing reflexes, they tend to swallow a large percentage of the toothpaste placed on their brush. In fact, one of the more consistent findings in the recent dental literature, is that some children - even children living in unfluoridated communities - ingest more fluoride from toothbrushing alone than is recommended as the total daily exposure. As noted by Dr. Steven Levy, of the University of Iowa:
"Virtually all authors have noted that some children could ingest more fluoride from dentrifice alone than is recommended as a total daily fluoride ingestion" (SOURCE: Levy 1999).
It is clear therefore that fluoride toothpaste represents a very important source of ingested fluoride for children. The use of fluoride toothpaste may thereby contribute to the various health risks (e.g. dental fluorosis, bone fractures, bone cancer, neurotoxicity) associated with systemic fluoride exposure.
Allergic Reactions
Among some 'hypersensitive' individuals, the use of fluoride toothpaste may produce canker sores and skin rashes in and around the mouth. The evidence pointing to this possibility is compelling, but has received scant attention from the dental community.
Periodontal Disease?
Another potential side effect of fluoride toothpaste has only recently come to light. Research conducted in the 1990s from the US pharmaceutical company Sepracor indicated that the levels of fluoride in toothpaste may be sufficient to cause or contribute to periodontal bone loss. Sepracor's finding is serious because periodontal bone loss is the #1 cause of tooth loss among adults. According to the scientists at Sepracor who conducted the study:
"We have found that fluoride, in the concentration range in which it is employed for the prevention of dental caries, stimulates the production of prostaglandins and thereby exacerbates the inflammatory response in gingivitis and periodontitis.... Thus, the inclusion of fluoride in toothpastes and mouthwashes for the purpose of inhibiting the development of caries [cavities] may, at the same time, accelerate the process of chronic, destructive periodontitis."
Europe: Taking a More Cautious Approach than U.S.
Courtesy: World Malayali Club, Dubai.
.Many thanks.
