Abstract
Presented are 20 cases of Southwestern American Indians having characteristic sclerotic bone changes caused by the ingestion of drinking water containing excessively great quantities of fluoride salts. The changes of skeletal fluorosis are described, and it is pointed out that the degree of change does not seem to correlate well with the concentration of fluoride in the bone. It remains an enigma that there is such variability in the degree of the manifestations among people exposed to the same supply of drinking water,m but it is pointed out that factors such as climate, nutritional status, and habit variations may be responsible. It is concluded that skeletal fluorosis produces no demonstrable physiologic adversities, but it is important to differentiate from serious pathologic conditions which it may stimulate.
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Skeletal fluorosis in relation to drinking water, nutritional status and living habits in rural areas of Maharashtra, India
The present study was carried out during May 2010 to December 2011 in three villages which were randomly selected from Warora tehsil of Chandrapur district which is one of the endemic district of Maharashtra. . . . All the presently available ground water samples were collected and the mean fluoride concentration
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Endemic genu valgum and other bone deformities in two villages of Mandla district in central India
An epidemiological investigation was undertaken in the villages of Tilaipani and Hirapur located in Mandla District of Central India to determine the cause and extent of a peculiar skeletal deformity characterised by knock knee (genu valgum) occurring mainly among children. In Tilaipani, 74.4% of children and adolescents below age 20
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Osteo-dental fluorosis in relation to nutritional status, living habits, and occupation in rural tribal areas of Rajasthan, India
A cross-sectional survey of 18,621 adults of both sexes living in rural tribal areas of the Dungarpur and Udaipur districts of Rajasthan, India was conducted to correlate the prevalence of osteo-dental fluorosis with nutritional status, living habits, and occupation. The mean fluoride (F) concentration in drinking water sources ranged from
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Endemic fluorosis: a study of the factors involved in the production of mottled enamel in children and severe bone manifestations in adults
Summary and Conclusions A detailed study of the factors involved in the production of "mottled enamel" in children and severe bone manifestations in adults; as a result of the ingestion of fluorides in drinking water, has been made during the last three years. This study revealed: 1. "Mottled enamel" in children was
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Nutritional and metabolic rickets
Nutritional rickets is caused by vitamin D deficiency due to lack of exposure to sunlight. Neonatal rickets occurs only in infants born to mothers with very severe osteomalacia. Calcium deficiency alone does not cause mineralisation defects. It only causes osteoporosis and secondary hyperparathyroidism with raised plasma, 1,25 (OH)2D and osteocalcin.
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Factors which increase the risk for skeletal fluorosis
The risk for developing skeletal fluorosis, and the course the disease will take, is not solely dependent on the dose of fluoride ingested. Indeed, people exposed to similar doses of fluoride may experience markedly different effects. While the wide range in individual response to fluoride is not yet fully understood, the following are some of the factors that are believed to play a role.
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Nutrient Deficiencies Enhance Fluoride Toxicity
It has been known since the 1930s that poor nutrition enhances the toxicity of fluoride. As discussed below, nutrient deficiencies have been specifically linked to increased susceptibility to fluoride-induced tooth damage (dental fluorosis), bone damage (osteomalacia), neurotoxicity (reduced intelligence), and mutagenicity. The nutrients of primary importance appear to be calcium,
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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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Fluoridation, Dialysis & Osteomalacia
In the 1960s and 1970s, doctors discovered that patients receiving kidney dialysis were accumulating very high levels of fluoride in their bones and blood, and that this exposure was associated with severe forms of osteomalacia, a bone-softening disease that leads to weak bones and often excruciating bone pain. Based on
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Kidney Patients Are at Increased Risk of Fluoride Poisoning
It is well established that individuals with kidney disease are susceptible to suffering bone damage and other ill effects from low levels of fluoride exposure. Kidney patients are at elevated risk because when kidneys are damaged they are unable to efficiently excrete fluoride from the body. As a result, kidney patients
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