Advertisement

Skeletal fluorosis and instant tea

      Development of skeletal fluorosis is associated with consumption of well water containing fluoride concentrations in excess of 4 parts per million (ppm).
      World Heath Organization

      U.S. Environmental Protection Agency: Ground water and drinking water— current drinking water standards. Available at: http://www.epa.gov/safewater/mcl.html. Accessed January 20, 2004

      Unprocessed foods contain insufficient fluoride to cause disease.
      Tea, however, is fluoride rich,
      • Lung S.C.
      • Hsiao P.K.
      • Chiang K.M.
      Fluoride concentrations in three types of commercially packed tea drinks in Taiwan.
      • Wei S.H.
      • Hattab F.N.
      • Mellberg J.R.
      Concentration of fluoride and selected other elements in teas.
      • Chan J.T.
      • Koh S.H.
      Fluoride content in caffeinated, decaffeinated and herbal teas.
      and skeletal fluorosis occurs in Asia where inferior quality “brick” tea comprising mature leaves, twigs, and berries of the tea plant Camellia sinensis is drunk.
      • Cao J.
      • Zhao Y.
      • Liu J.
      • et al.
      Brick tea fluoride as a main source of adult fluorosis.
      Other causes of fluorosis are rare (Table 1).
      • Krishnamachari K.A.
      Skeletal fluorosis in humans a review of recent progress in the understanding of the disease.
      • Whitford G.M.
      Acute and chronic fluoride toxicity.
      • Kuntz D.
      Fluoride therapy in osteoporosis the tide is ebbing.
      Table 1Sources of fluoride toxicity
      Fluoride therapy for osteoporosis
      Pediatric supplements
      Certain wines
      Teflon-coated pots
      “Brick” tea
      Betel nuts and leaves
      Chewing tobacco and snuff
      Pesticides
      Hydrofluoric acid
      Industrial exposure during arc welding, cryolite mining, or manufacture of aluminum, steel, or glass
      Laundry powder containing silicofluoride
      Niflumic acid (nonsteroidal anti-inflammatory)
      Fluorine vapors in laboratories, coal fumes
      Certain sparkling mineral waters
      Dentifrices, mouthwashes, toothpastes, topical dental gels
      From references.
      • Krishnamachari K.A.
      Skeletal fluorosis in humans a review of recent progress in the understanding of the disease.
      • Whitford G.M.
      Acute and chronic fluoride toxicity.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The American Journal of Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. National Academic Press, Washington, D.C1997: 288-313
        • World Heath Organization
        Guidelines For Drinking Water Quality: Volume 1. Recommendations. 2nd ed. World Health Organization, Geneva, Switzerland1993: 47
      2. U.S. Environmental Protection Agency: Ground water and drinking water— current drinking water standards. Available at: http://www.epa.gov/safewater/mcl.html. Accessed January 20, 2004

      3. National Research Council Subcommittee on Health Effects of Ingested Fluoride. National Academy Press, Washington, D.C1993
        • Lung S.C.
        • Hsiao P.K.
        • Chiang K.M.
        Fluoride concentrations in three types of commercially packed tea drinks in Taiwan.
        J Expo Anal Environ Epidemiol. 2003; 13: 66-73
        • Wei S.H.
        • Hattab F.N.
        • Mellberg J.R.
        Concentration of fluoride and selected other elements in teas.
        Nutrition. 1989; 5: 237-240
        • Chan J.T.
        • Koh S.H.
        Fluoride content in caffeinated, decaffeinated and herbal teas.
        Caries Res. 1996; 30: 88-92
        • Cao J.
        • Zhao Y.
        • Liu J.
        • et al.
        Brick tea fluoride as a main source of adult fluorosis.
        Food Chem Toxicol. 2003; 41: 535-542
        • Krishnamachari K.A.
        Skeletal fluorosis in humans.
        Prog Food Nutr Sci. 1986; 10: 279-314
        • Whitford G.M.
        Acute and chronic fluoride toxicity.
        J Dent Res. 1992; 71: 1249-1254
        • Kuntz D.
        Fluoride therapy in osteoporosis.
        Rev Rheum Engl Ed. 1999; 66: 67-69
      4. United States Department of Agriculture Economic Research Service. Food Consumption (Per Capita) Data System. Available at: http://ers.usda.gov/Data/FoodConsumption/DataSystem.asp?ERSTab=3. Accessed September 16, 2004.

        • Hollingsworth P.
        It’s tea time.
        Food Technol. 2002; 56: 16
        • Mitscher L.A.
        • Dolby V.
        The Green Tea Book. Avery Publishing Group, Garden City Park, New York1998
      5. Cresceri L.S. Greenberg A.E. Eaton A.D. Standard Methods for the Examination of Water and Wastewater. 20th ed. American Public Health Association, the American Water Works Association and the Water Environment Federation, Washington, D.C1998
        • United States Food and Drug Administration. Department of Health and Human Services
        Bottled Water. 2003; (codified at 21 CFR §165.110).
        • Gupta R.K.
        • Agarwal P.
        • Kumar S.
        • et al.
        Compressive myelopathy in fluorosis.
        Neuroradiology. 1996; 38: 338-342
        • Schnitzler C.M.
        • Wing J.R.
        • Gear K.A.
        • et al.
        Bone fragility of the peripheral skeleton during fluoride therapy for osteoporosis.
        Clin Orthop. 1990; 261: 268-275
        • Dure-Smith B.A.
        • Farley S.M.
        • Linkhart S.G.
        • et al.
        Calcium deficiency in fluoride-treated osteoporotic patients despite calcium supplementation.
        J Clin Endocrinol Metab. 1996; 81: 269-275
        • Spencer H.
        • Osis D.
        • Kramer L.
        • et al.
        Effect of calcium and phosphorus on fluoride metabolism in man.
        J Nutr. 1975; 105: 733-740
      6. Public Health Service Committee to Coordinate Environmental Health and Related Programs.
        Review of Fluoride. U.S. Department of Health and Human Services, Public Health Service, Washington, D.C1991
        • Felsenfeld A.J.
        • Roberts M.A.
        A report of fluorosis in the United States secondary to drinking well water.
        JAMA. 1991; 265: 486-488
        • Allolio B.
        • Lehmann R.
        Drinking water fluoridation and bone.
        Exp Clin Endocrinol Diabetes. 1999; 107: 12-20
        • Wu C.H.
        • Yang Y.C.
        • Yao W.J.
        • Lu F.H.
        • Wu J.S.
        • Chang C.J.
        Epidemiological evidence of increased bone mineral density in habitual tea drinkers.
        Arch Intern Med. 2002; 162: 1001-1006
        • Li Y.
        • Liang C.
        • Slemenda C.W.
        • et al.
        Effect of long-term exposure to fluoride in drinking water on risks of bone fractures.
        J Bone Miner Res. 2001; 16: 932-939
        • Kimura M.
        • Umegaki K.
        • Kasuya Y.
        • et al.
        The relation between single/double or repeated tea catechin ingestions and plasma antioxidant activity in humans.
        Eur J Clin Nutr. 2002; 56: 1186-1193
        • McKay D.L.
        • Blumberg J.B.
        The role of tea in human health.
        J Am Coll Nutr. 2002; 21: 1-13