Tissue necrosis after subgingival irrigation with fluoride solution

Irrigation of periodontal pockets with fluoride solution after scaling and root planing is occasionally recommended to inhibit the growth of pathogeni c bacteria in the periodontal pocket. At the same time, irrigation enables mechanical removal of loosely adhering plaque and debris. Due to its toxici ty, fluoride solution deposited in the periodontium may lead to tissue dama ge. We report in this paper, a case of extensive periodontal tissue necrosi s and permanent loss of alveolar bone after irrigation of periodontal pocke ts with stannous fluoride solution. The literature on the toxic effects of fluoride on the local tissues is briefly reviewed and arguments for a re-ev aluation of the use of stannous fluoride for pocket irrigation are provided .