OBJECTIVE: To test the effect of water fluoridated to 1 ppm on the incidence of hip fractures in the elderly.
DESIGN: Ecological cohort.
SETTING: The incidence of femoral neck fractures in patients 65 years of age or older was compared in three communities in Utah, one with and two without water fluoridated to 1 ppm.
PATIENTS: All patients with hip fractures who were 65 years of age and older over a 7-year period in the three communities, excluding (1) those with revisions of hip fractures, (2) those in whom the hip fracture was anything but a first diagnosis, (3) those in whom metastatic disease was present, or (4) those in whom the fracture was a second fracture (n = 246).
OUTCOME MEASURE: Rate of hospital discharge for hip fracture.
RESULTS: The relative risk for hip fracture for women in the fluoridated area was 1.27 (95% confidence interval [CI] = 1.08 to 1.46) and for men was 1.41 (95% CI = 1.00 to 1.81) relative to the nonfluoridated areas.
CONCLUSIONS: We found a small but significant increase in the risk of hip fracture in both men and women exposed to artificial fluoridation at 1 ppm, suggesting that low levels of fluoride may increase the risk of hip fracture in the elderly.
Denser but Not Stronger? Fluoride-Induced Bone Growth and Increased Risk of Hip Fractures.
Abstract Since the mid-1940s, fluoride has been added to toothpaste and (in some countries) tap water, table salt, or milk to reduce dental cavities.1 Although low-level fluoride supplementation prevents cavities, higher levels cause white mottling of the teeth.2 What is more, some studies suggest fluoride in drinking water may increase the
Environmental Fluoride 1977 by Rose & Marier
The Associate Committee on Scientific Criteria for Environmental Quality was established by the National Research Council of Canada in response to a mandate provided by the Federal Government to develop scientific guidelines for defining the quality of the environment. The concern of the NRC Associate Committee is strictly with scientific
Bone resorption and quantitative ultrasound in an endemic fluorosis area of Turkey.
The purpose of this prospective study was to investigate the quantity and quality of bone by quantitative ultrasound (QUS) measurements and to assess bone resorption by urinary excretion measurement of C-terminal telopeptide of type I collagen (CTX) in an adult Turkish population living in an endemic fluorosis area and consuming
The effects of fluoridation on degenerative joint disease (DJD) and hip fractures
Fluoride strengthens bone, yet makes it more susceptible to fracture. If mechanical factors are important in DJD, an increased risk for DJD in communities where fluoride is consumed is also expected. Hip fractures and knee DJD joint replacements among those >65 years for 1991-1996 were compared between one community with
Exposure to natural fluoride in well water and hip fracture: a cohort analysis in Finland
In the retrospective cohort study based on record linkage, the authors studied a cohort of persons born in 1900-1930 (n = 144,627), who had lived in the same rural location at least from 1967 to 1980. Estimates for fluoride concentrations (median, 0.1 mg/liter; maximum, 2.4 mg/liter) in well water in
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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.
Fluoride & Spontaneous Hip Fractures in Osteoporosis Patients
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Based on a large body of animal and human research, it is now known that fluoride ingestion can reduce bone strength and increase the rate of fracture. There are several plausible mechanisms by which fluoride can reduce bone strength. As discussed below, these mechanisms include: Reduction in Cortical Bone Density De-bonding of
Fluoride Content of Bone Impairs Bone Quality
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