I have written articles about systemic fluoride before, and you can find the main one here if you want my complete take on the subject. However, today I want to focus on one outcome of excess fluoride called fluorosis. Fluorosis means fluoride toxicity and its manifestations. The symptoms range from mild to severe and typically show up in teeth and bones but include other aspects of the body. 

Causes

Too much fluoride at any time can cause fluorosis; however, teeth will not show any signs unless the exposure happens during their development. Although baby teeth can show signs of fluorosis, it is rare since they develop very early in life, even in utero, when fluoride exposure is minimal. Only children eight years of age and younger are at risk because permanent teeth develop during this period. Older children, adolescents, and adults cannot develop dental fluorosis. The severity of the condition depends on the dose (how much), duration (how long), and timing (when consumed) of fluoride intake.

Where Fluoride Comes From

The primary sources include drinking water with fluoride, fluoride toothpaste—especially if swallowed by young children—and dietary prescription supplements, mainly when prescribed to children already drinking fluoridated water. 1 Some areas have extremely high concentrations of fluoride in drinking water – such as in Colorado (11.2 mg/l), Oklahoma (12.0 mg/l), New Mexico (13.0 mg/l), and Idaho (15.9 mg/l). 2 Many natural drinking water sources have high fluoride levels already present, so you should get your water tested, even when it is not supplied municipally. Click here to find out how to have your water tested. Other sources are foods and beverages prepared with fluoridated water. The foods highest in fluoride are tea, raisins, blue claw crab, shrimp, fries, potato chips, gravy, popsicles, oatmeal, broth, and raisin bran. 3 The amount in tea can reach six times the amount in fluoridated water. 4

Fluorosis in teeth

 Dental fluorosis is caused by fluoride damage to the cells (ameloblasts) that produce tooth enamel during tooth formation. It is the first sign of trouble and easy to spot. Today, dental fluorosis has been trivialized, yet 8 to 51% of children in fluoridated communities suffer from dental fluorosis, and 3 to 26% of children in non-fluoridated communities suffer from dental fluorosis due to its presence in much of our food supply. In 2010, the Centers for Disease Control reported 41 % of American adolescents now have dental fluorosis. 5

Childhood rapid bone growth removes fluoride from the bloodstream, possibly reducing the risk of dental fluorosis by lowering serum fluoride levels. However, once fluoride is in the skeleton, it stays there for years and can manifest as brittle bones that are fracture-prone later in life. Additionally, deficiencies in calcium, magnesium, and aluminum will increase the chances of fluorosis. 2 Researchers have noted a 400% increase in fluorosis from the time fluoridation began.

Stages of fluorosis 6


Normal

No signs of enamel malformation.

Stage One-Questionable

Some evidence of white spots.

Stage Two-Very Mild

Small opaque white spots that cover less than 25% of the tooth.

Stage Three-Mild

Similar to mild, but the spots cover 50% of the tooth.

Stage Four-Moderate

White and a few brown stains covering more than 50% of the tooth.

Stage Five-Severe

White and brown stains cover the tooth's entire surface, and pitting is present.

Skeletal fluorosis

High amounts of fluoride also deposit in bones, causing them to be more brittle and tend to lead to more fractures. As a result, the cervical vertebrae and the pelvis are the two areas mainly affected. Hip fracture rates are substantially higher in people residing in fluoridated communities. 7 The most common early symptoms of skeletal fluorosis are lower back pain, stiffness and joint pain, weaker bones, and growth lines on bones. Unfortunately, the condition mimics other problems like arthritis, and for that reason, it is frequently misdiagnosed. 8 Because bones remodel so slowly, the half-life of fluoride is eight years. Therefore, once skeletal fluorosis is diagnosed, the only treatment is removing the source of the fluoride and monitoring the condition. 9 

Calcified Pineal Gland Fluorosis

The pineal gland is critical for our sleep cycles, hormone balance, and immune system. It releases melatonin that influences our biological clock and helps protect the body from cell damage caused by free radicals. Recently, scientists have discovered that the pineal gland is the master regulator of the body. It works with the hypothalamus and behaves as a bridge between the nervous and hormone systems. It also works with the limbic system to balance emotions and other rhythms throughout the body. Unfortunately, fluoride causes the pineal gland to calcify and malfunction. Once the pineal gland calcifies, daily sleep and wake cycles can suffer. It has also been linked to early puberty, breast cancer, oxidative stress, Alzheimer's disease, and other neurodegenerative diseases. 10 

Intelligence and Fluorosis

Seventy-four studies have investigated the relationship between fluoride and human intelligence and concluded that elevated fluoride exposure is associated with reduced IQ. 11 Accordingly, the Lancet recommended that fluoride be classified as a developmental neurotoxin with lead, mercury, arsenic, PCBs, and toluene. 12

Hypothyroidism and Fluorosis

The thyroid gland uses iodine to help produce thyroid hormone, which regulates energy and much more. Fluoride displaces the iodine and prevents the thyroid from producing adequate thyroid hormone. One study found that hypothyroidism was twice as likely in areas with higher fluoride. 13 The signs of hypothyroidism in children are different than adults and include poor growth, resulting in short stature, delayed development of permanent teeth, delayed puberty, and poor mental development. 

What You Can Do

The first step is to avoid the major sources of fluoride; fluoridated drinking water, fluoridated toothpaste, and fluoride supplements. If your water is fluoridated, drink and cook with bottled water. Filters are available that can remove fluoride from well and municipal water. Next, avoid foods with fluoride, especially tea. Do not use non-stick pans as they shed fluoride. Lastly, try to avoid medications that contain fluorides such as Lipitor, Crestor, Vytorin, Zetia/Ezetimibe, fluticasone propionate, Celebrex, Prevacid, Lexapro, Risperdal, and Levaquin. 

Detoxing can take many years because the bones take many years to remodel completely, so be patient. The best thing you can do is eat a nutrient-dense diet, pay special attention to your mineral intake, stay away from processed carbohydrates and vegetable oils, exercise, sleep right, minimize the damage from stress, and get some sun. Additionally, this lifestyle precludes the use of fluoride to prevent decay, because tooth decay is extremely rare on paleo/primal/keto-type diets. For a more comprehensive guide, click here.