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Controlling the Fluoride Dose in a Patient with Compromised Salivary Function: A Case Report



F Eichmiller, Naomi Eidelman, Clifton M. Carey


ckground: High concentration topical fluorides are commonly used to prevent caries in patients with compromised salivary function due to radiation and chemotherapy. Case Description: A cancer patient using tray-applied topical fluoride gel complained fo gastric symptoms, difficulty in swallowing, leg muscle sorness, and knee joint sorness. CT scan revealed thickening of the esophagus walls. Upper endoscopy found abnormal motility. The motility test indicated high amplitude peristalsis and hypertensive LES, and urine testing indicated high levels of systemic fluoride. The patient's fluoride regimen was altered until urinary fluoride levels returned to normal levels and symptoms resolved within a short period of time. Clinical Implications: Clinicans prescribing home-applied high concentration fluorides need to be cognizant of the symptoms of fluoride toxicity, to monitor patient, and to adjust the dose or mode of application and control the total ingested dose.
Journal of the American Dental Association


caries, dose fluoride, toxicity, treatment xerostomia


Eichmiller, F. , Eidelman, N. and Carey, C. (2005), Controlling the Fluoride Dose in a Patient with Compromised Salivary Function: A Case Report, Journal of the American Dental Association, [online], (Accessed May 26, 2024)


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Created January 1, 2005, Updated February 17, 2017