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Treatment of osteoporosis with sodium fluoride: An appraisal.

Crippling fluorosis… is characterized by dense bones, exostoses, neurologic complications due to bony overgrowth, osteoarthritis, and ligamentous calcification.

… new bone formed under the stimulus of fluoride administration may exhibit various degrees of osteosclerosis, osteoporosis, osteomalacia, and architectural disorganization. Of these manifestations, only osteosclerosis increases bone strength. When fluoride is used therapeutically, therefore, it is obvious that conditions must be carefully chosen so as to maximize the development of osteosclerosis and to minimize the undesirable manifestations of osteoporosis and osteomalacia.

… The dramatic increase in the predominant trabecular bone of the axial skeleton during fluoride therapy is not accompanied by a corresponding increase in the predominantly cortical bone of the appendicular skeleton. Bone remodeling in cortical bone is increased during fluoride therapy (35); however, positive coupling does not occur, and formation and resorption remain in relative balance. Indeed, several investigators have reported that cortical bone decreases significantly during treatment…

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