Excerpt:

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 universally present in all the areas where the fluoride content of the waterwas in the neighbourhood of or exceeded 1 part per million. The severity of the condition was in proportion to the fluoride content.

2. Deciduous teeth were also affected in areas with a high fluoride content and severe type of mottling.

3. The severe form of chronic fluorine intoxication as affecting bones, ligaments and joints was restricted to some villages situated in the three northern taluks of the Nellore district.

4. This area, which contained fluorite and fluorapatite as constituents of the rocks, showed the highest fluoride content (6 parts per million) in its water supplies.

5. A continued residence of over fifteen years in the endemic area was necessary in the case of adults to bring about symptoms of chronic intoxication.

6. The severity and site of the lesions depended to some extent on occupation.

7. A disparity in the incidence was noted in certain villages in which the ftuoride content of the water was more or less identical.

8. Economic and nutritional surveys were carried out in several representative villages. The incidence and severity of the disease had a definite relation to the economic and nutritional status of the communities.

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