Abstract
For the past 45 years, there has been a great deal of debate regarding the health issues surrounding the fluoridation of public water supplies. In order to assess the association between fluoridation and hip fracture, we identified 129 counties across the United States considered to be exposed to public water fluoridation and 194 counties without exposure. Data from the Health Care Financing Administration and the Department of Veterans Affairs were used to calculate the incidence of hip fracture among white persons, aged 65 years or older, in fluoridated and nonfluoridated counties. There was a small statistically significant positive association between fracture rates and fluoridation. The relative risk (95% confidence interval) of fracture in fluoridated counties compared to nonfluoridated counties was 1.08 (1.06 to 1.10) for women and 1.17 (1.13 to 1.22) for men. As comparisons were made at the grouped level, it may be inappropriate at this time to draw inferences at the individual level. The relationship observed at the county level needs to be duplicated at the individual level with more precise measures of fluoride exposure.
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Fluoride-induced fractures: relation to osteogenic effect
The possible effects of fluoride in inducing fractures were studied in 61 patients treated with sodium fluoride (NaF), 40-60 mg daily in combination with calcium and vitamin D. Nine patients developed the fluoride-(F) related lower extremity pain syndrome. Four other patients had stress fractures associated with trauma. Seven of the
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Bone resorption marker and ultrasound measurements in adults residing in an endemic fluorosis area of Turkey
The purpose of this prospective study was to investigate the quantity and quality of bone by quantitative ultrasound (QUS) measurements and to assess bone resorption by urinary excretion measurement of C-terminal telopeptide of type I collagen (CTX) in an adult Turkish population living in an endemic fluorosis area and consuming
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Fluoride in diet, drinking water and urine in relation to bone mineral density and incidence of fractures.
Background: Randomized controlled trials have shown that high fluoride doses increases both bone mineral density and skeletal fragility. The consequences of long-term low dose exposure to fluoride, primarily via drinking water, on bone health among the general public is however not clear. In the present study, we assessed associations of
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Hip fractures and fluoridation in Utah's elderly population
OBJECTIVE: To test the effect of water fluoridated to 1 ppm on the incidence of hip fractures in the elderly. DESIGN: Ecological cohort. SETTING: The incidence of femoral neck fractures in patients 65 years of age or older was compared in three communities in Utah, one with and two without water fluoridated
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A prospective study of bone mineral content and fracture in communities with differential fluoride exposure
In 1983/1984, a study of bone mass and fractures was begun in 827 women aged 20-80 years in three rural Iowa communities selected for the fluoride and calcium content of their community water supplies. The control community's water had a calcium content of 67 mg/liter and a fluoride content of
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Clinical Trials: Fluoride Treatment & Bone Fracture in Osteoporosis Patients
Due to its ability to increase bone mass, fluoride has been used as an experimental treatment for osteoporosis. The results, however, have generally been disastrous. Rather than prevent bone fractures in osteoporosis patients, fluoride therapy (at doses of 20-34 mg/day) was repeatedly found to increase fracture rates. One of the most
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Fluoride Reduces Bone Strength in Animals
Most animal studies investigating how fluoride effects bone strength have found either a detrimental effect, or no effect. Few animal studies have found a beneficial effect. In fact, one of the few studies that found a beneficial effect was unable to be repeated by the same authors in a later
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"Pre-Skeletal" Fluorosis
As demonstrated by the studies below, skeletal fluorosis may produce adverse symptoms, including arthritic pains, clinical osteoarthritis, gastrointestinal disturbances, and bone fragility, before the classic bone change of fluorosis (i.e., osteosclerosis in the spine and pelvis) is detectable by x-ray. Relying on x-rays, therefore, to diagnosis skeletal fluorosis will invariably fail to protect those individuals who are suffering from the pre-skeletal phase of the disease. Moreover, some individuals with clinical skeletal fluorosis will not develop an increase in bone density, let alone osteosclerosis, of the spine. Thus, relying on unusual increases in spinal bone density will under-detect the rate of skeletal fluoride poisoning in a population.
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Mechanisms by which fluoride may reduce bone strength
Based on a large body of animal and human research, it is now known that fluoride ingestion can reduce bone strength and increase the rate of fracture. There are several plausible mechanisms by which fluoride can reduce bone strength. As discussed below, these mechanisms include: Reduction in Cortical Bone Density De-bonding of
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Fluoride in Water & Bone Fracture
Current epidemiological evidence indicates that the margin of safety between the level of fluoride in water that does, and does not, increase the risk of fracture is insufficiently large to protect all members of society from fluoride-induced damage to bone.
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