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Incidence of fluorosis and urinary fluoride concentration are not always positively correlated with drinking water fluoride level.

Excerpts Though the concentration of fluoride in drinking water in Noapara was much higher than that in Kamdebpur, Chalk Atla and Junidpur, the urinary fluoride concentration in subjects of Noapara did not differ much. The predominance of severe skeletal and dental fluorosis in subjects of Noapara can probably be linked to high fluoride exposure but relatively less excretion (as evident from urinary fluoride levels). Interestingly, despite low fluoride (within the permissible limit) levels in d