Consumer Health: Nigerian experts, regulators counter claims on fluorides in toothpastes, milk and pharmaceutical products

*The Association of Community Pharmacists of Nigeria offers crucial scientific and professional clarity on a popular pastor’s claims, asserting that fluorides, when used in approved quantities by relevant regulatory bodies, are safe and beneficial for consumers’ health

Gbenga Kayode | ConsumerConnect

The Association of Community Pharmacists of Nigeria (ACPN) has clarified that fluorides used in approved quantities by the relevant and appropriate food and drug regulatory agencies are safe for consumers.

The pharmacists’ clarification on public health implications comes on the heels of the recent claims a popular Nigerian pastor made, that fluorides in food, toothpaste, and pharmaceutical products are poisonous and carcinogenic.

ConsumerConnect learnt the clergy, in tending videos in the social media space has vigorously condemned the pharmaceutical industry for the inclusion of fluorides in various consumer products in the country.

Acknowledging the pastor’s spiritual influence, the pharmacists at the weekend, however, provided crucial scientific and professional clarity, asserting that fluorides, when used in approved quantities by regulatory bodies, are safe and beneficial for public health.

Reeling off scientific facts to buttress their points, Ambrose Ezeh, National Chairman, and Omokhafe Ashore, Secretary of ACPN, in a statement said: “We at ACPN will not attempt to tackle the pastor’s anointing in God’s Word.

“But (we) will clarify with some scientific insight and background that the pastor’s exposition on fluorides was not totally in alignment with scientific facts.”

On fluorides, regulations and public health

The pharmacists explained in the statement titled, “The ‘Use of Fluorides in Pharmaceutical Preparations and Foods”, that “fluorides used in approved quantities by the relevant and appropriate food and drug regulatory agencies are safe.

“In strictly public health interest, the ACPN wishes to posit as follows: Fluoride used in approved quantities by the relevant and appropriate Food and Drug regulatory agencies are safe.’

The ACPN stated: “While some researchers have indeed, linked fluoride with some cancers, oftentimes such incidences have been proven to be in instances where excessive amounts beyond the approved limits were used.”

The experts also clarified that, usually, fluoride use not more than 5mg/kg is safe.

In regard to the well-established benefits of fluoride in oral hygiene, the ACPN further affirmed that “fluorides enhance tooth enamel and prevent decay when added to toothpaste in approved quantities.

“This makes it both safe and effective in toothpaste.”

Food and Drug Aadministration’s take on fluorides

Fluoride has been described as a mineral that helps prevent tooth decay, is commonly found in toothpaste, fluoridated water, and some dental products, which are regulated as drugs by the US Food and Drug Administration (FDA).

A report noted that fluorides can also be added to milk or salt as a public health measure.

Fluorides are also contained in toothpaste to help in strengthening tooth enamel and prevent cavities; in water for municipal water supplies to help prevent tooth decay;  and in dental products, such as mouthwashes, gels, and varnishes for professional treatments.

Fluorides are equally added to some milk products, especially those available through school milk schemes or national nutritional programs, may be fluoridated.

In drugs, fluoride dental products are regulated as drugs in the US by the FDA.

As regard fluoride and safety, the FDA noted when used as directed, fluoride in toothpaste and fluoridated water is considered safe and effective for preventing cavities.

While fluoride is beneficial in preventing cavities, excessive fluoride intake, especially during tooth development, can lead to dental fluorosis, a condition that causes enamel defects.

On fluoride and milk, the regulatory authority said milk has a proven role in reducing the absorption of fluoride (rich in calcium which has a fluoride binding effect), according to report.

Effects of toothpaste misuse on consumers

The pharmacists also clarified that adverse effects, such as dental fluorosis, skeletal fluorosis, and thyroid complications only arise from consumers’ “prolonged excessive misuse of toothpaste.”

Addressing concerns about fluoride in dairy and non-dairy milk also, the ACPN equally noted while cow milk is typically fluoride-free, some plant-based milk might contain it as a preservative or natural component.

They, however, restated that even in such non-dairy milk as vegan milk, it is only the excessive addition of fluoride that poses any propensity to danger for consumers.

The fundamental principle of pharmacology

Underscoring the basic principle of pharmacology, the ACPN asserted that “no drug or pharmaceutical product is safe except when taken in the right quantities or measures over a timeline within the given drug regimen.

“This is why we often say all drugs are potential poisons, depending on their use and management.”

In respect of the natural occurrence of fluorides, the Association highlighted that these are naturally occurring molecules found in water, soil, salmon fish, and even some fruits and are even present in minute quantities in breast milk.

According to the pharmacists, from a holistic scientific perspective, fluorides are generally perceived as “safe for human consumption”.

Recommended fluoride intake

The ACPN informed the consumers, that the daily recommended intake of Fluoride in adults is 3.7 – 4.5mg/daily, while 0.7 – 1.3mg/daily is recommended in children.

The pharmacists explained this difference in dosage justifies the reason why pharmaceutical companies formulate age-specific toothpaste for public health.

Recognising the narrow safety window of fluoride, the Association, therefore, urged consumers to be mindful of their usage, particularly concerning children.

The statement further noted the pharmacists asked: “How intentional are consumers about the quantities of fluoride products used especially in children and paediatrics?

“Do we ensure toothpastes are not swallowed during use, especially in children?

The ACPN stated: “Since it is established that fluorides can be taken in trace amounts in form natural and other sources, how do we ensure use and consumption do not exceed daily allowance?

Any link between fluoride-containing toothpaste or milk and cancers?

The ACPN said: “Pharmacists and other scientists will continue to research the desirability of fluoride use in oral care products, and if this yields alternative drug molecules with similar benefits without the harmful effects of fluoride overdose in cost-effective settings, then a whole range of reforms may have been informed.

“In the world of science as of now, there is no credible evidence implicating fluoride-containing toothpaste or milk as causing cancers.

They averred: “Some reputable cancer associations have openly debunked claims that there is any link between fluoride and cancer after extensive research.”

The ACPN, therefore, appealed to “persons who are not health or scientific experts” to desist from advocating or positing on key subject matters, particularly those that impact public health.

According to them, this becomes important because of the potential harmful effects and consequences such carefree and misleading postings bring to bear on Nigerian consumers’ wellbeing.

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