FLUOROSE POR INGESTÃO VOLUNTÁRIA DE PASTA FLUORETADA APÓS OS 5 ANOS DE IDADE: RELATO DE CASO E DISCUSSÃO DA IMPORTÂNCIA DA EDUCAÇÃO EM SAÚDE BUCAL NA 1A INFÂNCIA

Abstract

Introduction: Concerns about children’s intake of fluoride toothpaste are limited
to infancy due to the risk of fluorosis in the permanent anterior teeth, but the
educational process to ensure safety for the entire dentition has been neglected.
Objective: To report a case of dental fluorosis in canine, premolar and 2nd molar
teeth caused by voluntary ingestion of fluoride toothpaste. Case report: A 12-
year-old patient, 65 kg, search dental care due to dissatisfaction with the color of
the posterior teeth. It was diagnosticated that the superior and inferior canine,
premolar and second molar teeth had fluorotic opacities, and the other teeth are
sound. Among the possible causes, the main one was the way the child started
brushing their teeth after 5 years of age. It was reported that she voluntarily
brushed her teeth 6x/day without spitting. Analyzes of the fluoride concentration
in the water consumed by the patient and in the toothpastes used were performed.
A urinary fluoride excretion test by the patient, requesting her to brush her teeth
by spitting out or swallowing all the toothpaste in use, was made. Results: Fluoride
concentration in the water was 0.74 mg F/L and 1,357 and 1,426 mg F/kg in the
toothpastes pastes used. In urine test, 0.90 and 1.35 mg F were found, respectively,
spitting or swallowing the toothpaste after brushing. It was estimated that from 5
years of age, the child was submitted a dose of 0.17 mg F/day/kg of body weight,
which is 2.4 times the upper limit for an acceptable fluorosis. Conclusion: The
reported case suggests that it is a consequence of the failure of the health education
process in early childhood regarding the rational use of fluoride toothpaste.