Abstract
A field study was undertaken to determine effects of tamarind, the use of aluminium (Al) cooking utensils, and smoking on dental and skeletal fluorosis in the randomly selected fluoride (F) endemic village of Buttlapally in the Nalgonda District, Andhra Pradesh, India, where the F level in the drinking water is 3.6 ppm. In the survey, information on the above factors was collected for all persons in the village of 46 households (HHs) with a total population of 144 adults and 83 children. The survey revealed that persons who consume tamarind daily had significantly less (p<0.01) dental mottling, bamboo spine, and genu varum/genu valgum than occasional tamarind users. The incidence of skeletal and dental fluorosis was significantly higher among smokers than nonsmokers. About 95% of the HHs used Al utensils, which aggravated the fluorosis problem in the village. When the 3.6-ppm F water was stored undisturbed for 8 and 24 hr in an Al vessel, the F level decreased to 2.58 ppm and 2.36 ppm, respectively; boiling the water for 40 min in an Al utensil decreased the F level to 2.25 ppm. In conclusion, daily consumption of tamarind correlated with less dental and skeletal fluorosis, whereas smoking and the use of Al utensils for cooking appeared to enhance the effects of fluoride toxicity.
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Association of Dietary Calcium Intake with Dental, Skeletal and Non-Skeletal Fluorosis among Women in the Ethiopian Rift Valley.
Fluorosis is a major public health problem in the Rift Valley of Ethiopia. Low calcium (Ca) intake may worsen fluorosis symptoms. We assessed the occurrence of fluorosis symptoms among women living in high-fluoride (F) communities in South Ethiopia and their associations with dietary Ca intake. Women (n = 270) from
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Epidemiological, clinical, and biochemical study of endemic dental and skeletal fluorosis in Punjab
The incidence of dental fluorosis in 46,000 children in the Punjab was assessed and compared with the fluoride content of their water supplies. Ten villages were selected for more detailed studies of skeletal as well as dental fluorosis. Factors other than the fluoride content of the drinking water which were found to influence
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Fluoride Sources, Toxicity and Fluorosis Management Techniques - A Brief Review.
Highlights Overexposure to fluoride via drinking water causes several health effects including fluorosis Endemic fluorosis is still persisted in several countries even with advancement in research Most of fluorosis management techniques suggested in the past have come with their own drawbacks Defluoridation techniques based on aluminium materials pose serious
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Association of dental and skeletal fluorosis with calcium intake and vitamin D concentrations in adolescents from a region endemic for fluorosis
Objective: Patan, is a semi urban area in Gujarat, India where fluorosis is endemic (Fluoride concentration in ground water 1.96–10.85 ppm, Patel et al., 2008). Exposure to fluoride is likely to be higher in lower socio-economic class (SEC) due to lack of access to bottled water. Calcium intake and vitamin
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Association Between Antioxidant Nutrients, Oxidative Stress-Related Gene Polymorphism and Skeletal Fluorosis in Guizhou, China.
Background: Oxidative stress plays an important role in the pathogenesis of endemic fluorosis. We analyzed associations between oxidative stress-related gene polymorphisms (PON1 rs662, CAT rs769217, rs2300182, and SOD2 rs11968525) and skeletal fluorosis, and examined potential gene–environment interactions with dietary vitamin C, vitamin E, zinc, and selenium intake. Methods: A cross-sectional study
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Skeletal Fluorosis: The Misdiagnosis Problem
It is a virtual certainty that there are individuals in the general population unknowingly suffering from some form of skeletal fluorosis as a result of a doctor's failure to consider fluoride as a cause of their symptoms. Proof that this is the case can be found in the following case reports of skeletal fluorosis written by doctors in the U.S. and other western countries. As can be seen, a consistent feature of these reports is that fluorosis patients--even those with crippling skeletal fluorosis--are misdiagnosed for years by multiple teams of doctors who routinely fail to consider fluoride as a possible cause of their disease.
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Skeletal Fluorosis & Individual Variability
One of the common fallacies in the research on skeletal fluorosis is the notion that there is a uniform level of fluoride that is safe for everyone in the population. These "safety thresholds" have been expressed in terms of (a) bone fluoride content, (b) daily dose, (c) water fluoride level, (d) urinary fluoride level, and (e) blood fluoride level. The central fallacy with each of these alleged safety thresholds, however, is that they ignore the wide range of individual susceptibility in how people respond to toxic substances, including fluoride.
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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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Mayo Clinic: Fluoridation & Bone Disease in Renal Patients
The available evidence suggests that some patients wtih long-term renal failure are being affected by drinking water with as little as 2 ppm fluoride. The finding of adverse effects in patients drinking water with 2 ppm of fluoride suggests that a few similar cases may be found in patients imbibing 1 ppm, especially if large volumes are consumed, or in heavy tea drinkers. The finding of adverse effects in patients drinking water with 2 ppm of fluoride suggests that a few similar cases may be found in patients imbibing 1 ppm, especially if large volumes are consumed, or in heavy tea drinkers and if fluoride is indeed the cause. It would seem prudent, therefore, to monitor the fluoride intake of patients with renal failure living in high fluoride areas.
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Racial Disparities in Dental Fluorosis
In 2005, the Centers for Disease Control published the results of a national survey of dental fluorosis conducted between 1999 and 2002. According to the CDC, black children in the United States have significantly higher rates of dental fluorosis than either white or Hispanic children. This was not the first time that black children were found to suffer higher rates of dental fluorosis. At least five other studies -- dating as far back as the 1960s -- have found black children in the United States are disproportionately impacted by dental fluorosis.
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