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Aging is characterized by an age-dependent reduction in bone density. When the bone density is reduced to the level below the fracture threshold, the risk for fracture is greatly increased. Thus, in order to decrease the occurrence of new fractures, a corrective therapy is needed to stimulate bone formation. To date, fluoride is gaining acceptance as an effective agent available for the treatment of osteoporosis, a condition characterized by a reduced bone mass and increased risk of fractures. Fluoride demonstrates a positive effect on vertebral bone density and the rate of vertebral fracture in osteoporotic patient. However, it is essential that the therapeutic serum fluoride levels remain stable, and that calcium deficiency should be prevented in order to maintain the positive effect. Two major side effects of fluoride therapy, gastro- intestinal irritation and peripheral pain syndrome, can be controlled to some extent by altering the dosage of fluoride or using different galenic preparations. Despite its remarkable osteogenic action and its widespread clinical use, fluoride remains a controversial therapy for established osteoporosis. However, fluoride is the agent available that effectively increases the vertebral bone density and decreases the vertebral fracture rate, its use in the treatment of osteoporosis is strongly indicated.
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