Restraint in Use of High-Dose Fluorides To Treat Skeletal Disorders

There is presently no treatment generally recognized as completely satisfactory for involutional osteoporosis, a condition that may be found in more than 50% of women past age 60 years and in a lesser percent of men in the same age group.¹ This disorder is associated with appreciable morbidity manifested most strikingly as femoral neck fractures or vertebral compression. Many drugs are currently being investigated in an effort to find a useful treatment. Among these drugs are several preparations of inorganic fluoride. Fluorides have also been used for treatment of otospongiosis (otosclerosis), a disorder with osteopenia of the bony capsule of the inner ear.² We suspect that in certain settings high-dose fluoride is being used for treatment of involutional osteoporosis and other osteopenic disorders without systematic monitoring for either efficacy or complications of long-term treatment. The purpose of this editorial is to emphasize that fluoride treatment for skeletal disorders