Excerpt

The first account of mottled enamel in human beings was given in 1902 by Eager of the United States Public Health Service who noticed its frequency among Italian emigrants from Naples. Black and McKay (1916) found it occurring in various parts of the U.S.A. and described it more fully in 1916. Since then, cases have been reported from every continent, but although popular belief associated the condition with drinking water, it was not till 1932 that fluorine contained in it was established experimentally by Smith and her associates, as the aetiological factor. Its recognition in India is more recent. In 1936 the health authorities noted a peculiar disease in the Nellore district in Madras Presidency, which was characterized by stiffness and pain in the spinal region and in various joints. A preliminary survey revealed the presence of fluorine in the drinking eater of the district and a heavy incidence of mottled enamel in the teeth of school children, and subsequent investigation showed that both these conditions were present in several other districts as well.

… Endemic dental fluorosis occurs in many parts of the world, but cases with skeletal changes seem to be comparatively rare. They were first observed by Flemming Moller and Gudjonsson (1932) in cryolite workers near Copenhagen, who had been exposed to fluorine for long periods. Cryolite, a double fluoride of sodium and aluminium containing as much as 54 per cent of fluorine, is used in the manufacture of aluminium. Besides showing some anaemia and dyspeptic symptoms, many of these workers had restricted mobility of the spine, and in severe cases almost complete rigidity. Radiography showed a progressive schlerosis of the bones, especially of the vertebrae, pelvis and ribs, with calcification of the costal cartilages…