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

Stephen J. Marx, MD
JAMA. 1978;240(15):1630-1631. doi:10.1001/jama.1978.03290150076034.
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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


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