Hypocalcemia and hypoglycemia are frequent laboratory findings. The signs may be delayed for several hours. Pain in various muscle groups may occur. The blood pressure falls, presumably due to central vasomotor depression as well as a direct toxic action on cardiac muscle. The respiratory center is first stimulated and later depressed.
Death usually results from either respiratory paralysis or cardiac failure.
In children as little as 500 mg of sodium fluoride may be fatal. The net result is osteomalacia and increased bone resorption which may negate any beneficial effect that fluoride may have on bone formation. The effect of fluoride alone on bone is well known. Stimulation of osteoblastic bone formation occurs but in the absence of additional calcium, the bone is incompletely mineralized. Recalcification of the focus is the indication to reduce the dosage to a maintenance level, while continued or increased activity as shown by polytomography, positive Schwartze sign and neurosensorial loss progression are the indications to continue treatment or to increase the dosage.