Abstract

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 rats were given commercially available spring water with 100 ppm fluoride (N = 8), or without addition (N = 8) for 18 weeks. At 16 weeks of age, four female rats and one male rat were kept in a cage for 5 days; all females were successfully impregnated. BMD was measured at 16 weeks of age, on the first day postpartum, and at the end of lactation. Spinal BMD was significantly higher in fluoride-exposed rats than control (P < 0.05), but there were no differences in femoral BMD (P = 0.670). During pregnancy, spinal BMD and femoral BMD were not significantly changed in fluoride-exposed rats, whereas BMD of the spine was significantly decreased in the control rats (P = 0.013), but not in the femur. During lactation, BMD was significantly decreased at the two regions compared to initial values (P < 0.05) in both groups. This study shows that pregnancy has no effect on bone, but lactation has a decreasing effect on BMD in fluoride-exposed rats.

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    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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    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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