Abstract
Radiological investigation of skeletal fluorosis was carried out among the inhabitants from two areas where the fluoride content of water was high, using both conventional radiography and radiographic measurements of bone mineral content (BMC). Of 139 cases in the first group, 68 presented bone abnormalities while 21 of 54 cases in the second group showed a similar change. Four essential types of bony lesion were classified. Osteoporosis, especially in the long bones, was the earliest change to be observed. The results of measurements at the distal end of the ulna indicated the presence of a low BMC even among inhabitants with a good nutritional status. It is concluded that osteoporosis towards the ends of long bones is an early radiographic sign of endemic fluorosis especially in an individual under the age of 40 years.
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Radiological spectrum of endemic fluorosis: relationship with calcium intake
Skeletal fluorosis continues to be endemic in many parts of India. Osteosclerosis and interosseous membrane calcification have long been regarded as hallmarks of this disease. Our study showed in addition a wide variety of radiological patterns: coarse trabecular pattern, axial osteosclerosis with distal osteopenia and diffuse osteopenia. Subjects with osteopenic changes had
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The effect of pregnancy and lactation on bone mineral density in fluoride-exposed rats
Fluoride increases metabolic turnover of the bone in favour of bone formation. Excessive intake of fluoride may lead to pathological changes in teeth and bones: dental and skeletal fluorosis. In this study, we investigated the effect of pregnancy and lactation on bone mineral density (BMD) in fluoride-exposed rats. Female Wistar
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Fluoride exposure and bone status in patients with chronic intestinal failure who are receiving home parenteral nutrition
BACKGROUND AND OBJECTIVE: Metabolic bone disease is frequent in chronic intestinal failure. Because fluoride has a major effect on bones, the status of both fluoride and bone was studied in long-term home parenteral nutrition (HPN) patients. DESIGN: We studied 31 adults aged (x +/- SD) 56.3 +/- 15.1 y, mainly
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Effects of fluoridated drinking water on bone mass and fractures: the study of osteoporotic fractures
To determine if optimal fluoridation of public water supplies influences bone mass and fractures, we studied 2076 non-black women, all aged > or = 65 years recruited into the Study of Osteoporotic Fractures at the Pittsburgh clinic. Information on fluoride exposure was limited to community water supplies. The variable used
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The effects of fluoride on the bones and teeth from ICR-derived glomerulonephritis (ICGN) mice and ICR mice after subacute exposure
Dental fluorosis and osteofluorosis from using drinking water contaminated with the fluoride ion (F) have been reported from many countries including the People’s Republic of China and India. Because fluoride is excreted by the kidney and the toxic effects of F are more severe when renal failure is present, Imprinting
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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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Fluoride & Osteoarthritis
While the osteoarthritic effects that occurred from fluoride exposure were once considered to be limited to those with skeletal fluorosis, recent research shows that fluoride can cause osteoarthritis in the absence of traditionally defined fluorosis. Conventional methods used for detecting skeletal fluorosis, therefore, will fail to detect the full range of people suffering from fluoride-induced osteoarthritis.
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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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Variability in Radiographic Appearance of Skeletal Fluorosis
Osteosclerosis (dense bone) is the bone change typically associated with skeletal fluorosis, particularly in the axial skeleton (spine, pelvis, and ribs). Research shows, however, that skeletal fluorosis produces a spectrum of bone changes, including osteomalacia, osteoporosis, exostoses, changes resulting from secondary hyperparathyroidism, and combinations thereof. Although the reason for this radiographic variability is not yet fully understood, it is believed to relate to the dose of fluoride consumed, the individual's nutritional status, exposure to aluminum, genetic susceptibility, presence of kidney disease, and area of the skeleton examined.
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Symposium on the non-skeletal phase of chronic fluorosis: The Joints
Of 300 patients with endemic skeletal fluorosis 187 (110 children and 77 adults) showed evidence of arthritis. The spine, especially its cervical portion, appeared to be mainly involved; elbow, hip and knee joints followed next in order.
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