Review of acute and chronic biomarkers of fluoride exposure and their significance for public health.

Abstract

Fluoride, a trace element, plays a crucial role in dental health, primarily by preventing dental caries and promoting enamel remineralization. However, excessive exposure to fluoride can result in adverse health effects, including dental and skeletal fluorosis. This review provides a critical analysis of the clinical manifestations of fluorosis, highlighting the physiological signs associated with chronic fluoride exposure, such as osteocondensation, cortical thickening, and skeletal deformities. The review places particular emphasis on the significance of various biomarkers for assessing fluoride exposure, categorizing them into acute and chronic indicators. Acute biomarkers, such as plasma and urine, offer insights into recent fluoride exposure, capturing short-term fluctuations. Conversely, chronic biomarkers, including hair and nails, provide retrospective assessments of long-term fluoride accumulation. Hair serves as a valuable non-invasive biomarker, effectively reflecting environmental and dietary fluoride exposure over extended periods. Similarly, nails show promise as a non-invasive biomarker due to their ability to reflect fluoride accumulation over time. The review underscores the critical need to monitor fluoride levels in drinking water and other sources to mitigate health risks, particularly in regions where fluorosis is endemic. By synthesizing current research, this paper aims to inform public health strategies and establish guidelines for safe fluoride exposure, ensuring the benefits of fluoride for dental health are maximized while minimizing the risks associated with overconsumption.