Abstract
Recent ecological comparison studies have suggested a positive association between fluoridation and hip fracture. Using data from the Rochester Epidemiology Project, we found the incidence of hip fracture for the 10 years before the fluoridation of the Rochester, Minn, public water supply was 484 per 100,000, compared with 450 per 100,000 in the following 10 years. When the effects of calendar time and age were controlled for, the relative risk associated with fluoridation was 0.63. These ecologic trend data suggest that the fluoridation of public water supplies is not associated with an immediate increase in rates of hip fracture. Further studies of this association at the individual level are clearly required before public policy decisions can be made.
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Effect of slow-release sodium fluoride on cancellous bone histology and connectivity in osteoporosis
We have previously demonstrated that a treatment regimen of slow-release sodium fluoride (SRNaF) and continuous calcium citrate increases lumbar bone mass, improves cancellous bone material quality, and significantly reduces vertebral fracture rate in osteoporotic patients. In order to assess whether such treatment also improves trabecular structure, we quantitated cancellous bone
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Marked decrease in trabecular bone quality after five years of sodium fluoride therapy--assessed by biomechanical testing of iliac crest bone biopsies in osteoporotic patients
Sodium fluoride has for more than 2 decades been a commonly used therapeutic agent for established osteoporosis because of a repeatedly documented anabolic effect on trabecular bone mass. Recently, however, three controlled trials have failed to demonstrate any therapeutic advantage of NaF over placebo with respect to vertebral fracture rate.
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Summary of workshop on drinking water fluoride influence on hip fracture on bone health. (National Institutes of Health, 10 April, 1991)
An ecologic study [22] compared fracture rates in 216 counties with natural fluoride levels greater than 0.7 ppm with rates in 95 counties with naturally low fluoride (less than 0.4 PPM) in the drinking water (Dose Ecology Study). Hip fracture ratios used as a denominator the hip fracture rates
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Insights into material and structural basis of bone fragility from diseases associated with fractures: how determinants of the biomechanical properties of bone are compromised by disease.
Minimal trauma fractures in bone diseases are the result of bone fragility. Rather than considering bone fragility as being the result of a reduced amount of bone, we recognize that bone fragility is the result of changes in the material and structural properties of bone. A better understanding of the
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Elevated serum fluoride concentrations in women are not related to fractures and bone mineral density.
Epidemiologic studies of the relations between drinking-water fluoride levels and bone mineral density (BMD) and fracture are characterized by disparate conclusions and an absence of information about individual circulating fluoride levels. This study relates serum fluoride concentrations, which reflect individual fluoride exposures, to BMD and bone fractures. Data are from
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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 Reduces Bone Strength in Animals
Most animal studies investigating how fluoride effects bone strength have found either a detrimental effect, or no effect. Few animal studies have found a beneficial effect. In fact, one of the few studies that found a beneficial effect was unable to be repeated by the same authors in a later
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The Relationship Between Fluoride, Bone Density, and Bone Strength
Although fluoride has generally been found to reduce the bone density of cortical bone, it is well documented that fluoride can increase the density of trabecular bone (aka cancellous bone). Trabecular bone is the primary bone of the spine, whereas cortical bone is the primary bone of the legs and arms. While increases in
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In Vitro Studies on Fluoride & Bone Strength
The "in vitro" research on fluoride and bone strength confirms what has repeatedly been found in animal and human studies: the more fluoride a bone has, the weaker the bone becomes. In an in vitro bone study, the researcher directly exposes a human or animal bone to a fluoride solution
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Fluoride in Water & Bone Fracture
Current epidemiological evidence indicates that the margin of safety between the level of fluoride in water that does, and does not, increase the risk of fracture is insufficiently large to protect all members of society from fluoride-induced damage to bone.
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