Dietary intake and bioavailability of fluoride.

After almost 40 years of water fluoridation in the United States, its effect in the food chain is now being appreciated. Current surveys indicate significant increases in the F content of infant formulas, toddler cereals, fruit juices, and popular beverages, largely because fluoridated water is used in their processing. According to the best estimates, the daily total F intake of children from foods, beverages including water, and other sources such as unintentional ingestion of dentifrices containing F is on the rise, although it is generally within the currently accepted range for this age group. It is encouraging to note that appropriate steps are now being taken by some manufacturers of infant formulas to monitor F levels and keep them within an acceptable range. Because of the increasing contribution of dietary F to total F intake, dietary F should be included in any estimate of daily total F intake in children before F supplements are prescribed, whether the children live in communities with fluoridated or nonfluoridated water. To achieve this goal, it is essential to develop a generally accepted, sensitive method for the analysis of F in foods and beverages. This should help develop the bioavailability profiles for individual foods and beverages essential for accurate assessment of dietary F intake. Fluoridated salt, used in some European countries, appears to be the only food ingredient currently in use as an alternative to water fluoridation. Attempts to utilize staple foods and beverages as vehicles for systemic F delivery have generally failed because of the decreased bioavailability of F in such products, and because it is difficult to make them available to the general population and especially to the lower socioeconomic segments of the population.