Between 2016 and 2018, the level of fluoride in Gurugram’s groundwater rose by 17%, as per data with the district public health engineering department. Medical practitioners said this could be a reason for the high prevalence of oral health issues, such as dental fluorosis, in the region, especially in rural areas, where people rely on groundwater.
According to the data, the highest concentration of fluoride in the groundwater in 2016 was 4.7 mg/litre which rose to 5.5 mg/litre in 2018. The acceptable level for flouride in water, according to the Bureau of Indian Standards (BIS) is 1-1.5 mg /l. It is believed that levels above this could cause dental decay.
A 2015 publication by the Geological Survey of India (GSI) states that many parts of Haryana including Gurugram, Rewari, Mahendragarh, Hisar and Faridabad had a fluoride content as high as 7 to 8 mg/litre.
The fluoride toxicity is taking on a toll on residents of the district, particularly children, said doctors in these areas.
“There has been a sharp rise in the number of people coming in with yellow teeth in areas such as Sohna, Manesar and Farrukhnagar. Children are reporting pain and discolouration in their teeth. The problem has particularly risen in the past three to four years,” said Dr Anita Kumar, a medical practitioner with a local non-governmental organisation that routinely conducts dental check-up camps in the areas.
Fluoride is the second-most common pollutant of drinking water in India, according to the National Health Portal. Intake of excess fluoride affects the teeth and bones, and can even cause arthritis, cancer, infertility in women, brain damage and Alzheimer’s disease, according to doctors.
A 2017 study of children in government schools in rural Gurugram by the SGT University in Chandu-Budhera found that 22.5% children below the age of five had dental fluorosis. It also found 76.04% children between the age of five and 12 suffered from the disease.
According to doctors, the prevalence of dental fluorosis is high among the rural population due to their dependence on tubewells and borewells for drinking water, whereas the urban population relies on treated canal water and water filtration systems. “Hospitals in urban parts rarely see cases of dental fluorosis as the population here uses drinking water filters,” said Dr Vinay Singh, a dental surgeon in the city, adding that another reason why cases of dental fluorosis are underreported is the lack of awareness about the disease. “There has to be a massive campaign to raise awareness in affected areas. People think there is nothing wrong with the water they drink and, therefore, continue drinking it,” he said.
Dr Madhu Mahla, senior dentist at Civil Hospital, Civil Lines, said the health department conducts frequent drives to educate people about the disease. “People in rural areas don’t know what fluoride is. Health workers are aiming to educate them and are asking them to go for water filters,” she said.
However, according to Dr Kumar, most people in rural areas can’t afford water filtration systems. “What is needed is identification of contaminated tubewells by authorities and sealing them off. The effect of fluoride can be reduced by including drumstick or moringa plants in the diet,” she said, adding that a diet rich in calcium and Vitamin C also helps.