Clinical Information

Fluoride induces bone formation by stimulating osteoblasts. Because fluorides increase bone density, they are used in dental preparations and as an antiosteoporotic agent. However, prolonged high exposure to fluoride produces changes in bone morphology consistent with osteomalacia, including prolonged mineralization lag time and increased osteoid thickness. The adverse skeletal effects of fluoride are associated with plasma fluoride greater than 4 mcmol/L. Chronic fluorosis may produce osteosclerosis, periostitis, calcification of ligaments and tendons, and crippling deformities.

Prolonged exposure to the fluoride-containing antifungal agent voriconazole can produce high plasma fluoride concentrations and bone changes (periostitis). Several other medicines also contain fluoride are used for treating skin diseases (eg, flucytosine, an antifungal) and some cancers (eg, fluorouracil, an antimetabolite).