Abstract
A cross-sectional survey of 18,621 adults of both sexes living in rural tribal areas of the Dungarpur and Udaipur districts of Rajasthan, India was conducted to correlate the prevalence of osteo-dental fluorosis with nutritional status, living habits, and occupation. The mean fluoride (F) concentration in drinking water sources ranged from 1.0 to 6.1 ppm. Among subjects with poor nutrition, the prevalence of dental fluorosis rose to 61.6% and skeletal fluorosis to 23.9%. A high incidence of fluorosis was also observed in subjects using substances such as alcohol, betel nuts, citrus fruits, edible ghee or fat, tea, and tobacco. The highest incidence of dental (90.1%) and skeletal ( 60.8%) fluorosis was observed in alcohol or beverage users and the lowest (30.8% an d 8.9%) in the citrus fruits users, respectively. Subjects with different occupations exhibited a variable incidence of dental and skeletal fluorosis. Labourers showed the highest incidence of dental and skeletal fluorosis (63.1% and 26.2%), followed by farmers (61.2% and 21.8%), housewives (57.1% and 13.2%), businessmen (54.2% and 14.4%), students (54.2% and 9.5%), and servicemen (51.5% and 15.9% ), respectively. These data pertaining to the relationship of osteo-dental fluorosis with nutritional status, living habits, and occupation were statistically analysed and found to exhibit highly positive correlations. Possible causes for differences in the incidence of fluorosis in relation to nutritional status, habits , and occupation are discussed.
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Epidemiological, clinical, and biochemical study of endemic dental and skeletal fluorosis in Punjab
The incidence of dental fluorosis in 46,000 children in the Punjab was assessed and compared with the fluoride content of their water supplies. Ten villages were selected for more detailed studies of skeletal as well as dental fluorosis. Factors other than the fluoride content of the drinking water which were found to influence
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Skeletal fluorosis among Indians of the American Southwest
Presented are 20 cases of Southwestern American Indians having characteristic sclerotic bone changes caused by the ingestion of drinking water containing excessively great quantities of fluoride salts. The changes of skeletal fluorosis are described, and it is pointed out that the degree of change does not seem to correlate well
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The spectrum of radiographic bone changes in children with fluorosis
Painful, crippling deformities in Tanzanian children from an area of endemic fluorosis are reported. Excessive fluoride ingestion in pregnant women may possibly poison and alter enzyme and hormonal systems in the fetus causing disturbances to osteoid formation and mineralization. Knock-knees, bowlegs, and saber shins develop when walking begins. Combinations of osteomalacia, osteoporosis,
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Non-Endemic Skeletal Fluorosis: Causes And Associated Secondary Hyperparathyroidism (Case Report and Literature Review).
Highlights Fluorocarbon “huffing” is an under-appreciated cause of skeletal fluorosis (SF) We present a SF case with hyperparathyroidism, osteosclerosis, and osteomalacia SF may go undetected due to variation in symptoms, radiology, and biochemistry Dietary calcium, prior bone health, and skeletal F exposure influence SF features SF is common in
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Effect of combined therapy with sodium fluoride, vitamin D and calcium in osteoporosis
Fluoride administration in both man and animals has been shown to stimulate new bone formation. However, the bone is poorly mineralized, and osteomalacia and secondary hyperparathyroidism frequently occur. In this study we investigated the effect of variable levels of fluoride and calcium intake, accompanied by vitamin D, on osteoporosis in
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Fluoridation, Dialysis & Osteomalacia
In the 1960s and 1970s, doctors discovered that patients receiving kidney dialysis were accumulating very high levels of fluoride in their bones and blood, and that this exposure was associated with severe forms of osteomalacia, a bone-softening disease that leads to weak bones and often excruciating bone pain. Based on
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Mayo Clinic: Fluoridation & Bone Disease in Renal Patients
The available evidence suggests that some patients wtih long-term renal failure are being affected by drinking water with as little as 2 ppm fluoride. The finding of adverse effects in patients drinking water with 2 ppm of fluoride suggests that a few similar cases may be found in patients imbibing 1 ppm, especially if large volumes are consumed, or in heavy tea drinkers. The finding of adverse effects in patients drinking water with 2 ppm of fluoride suggests that a few similar cases may be found in patients imbibing 1 ppm, especially if large volumes are consumed, or in heavy tea drinkers and if fluoride is indeed the cause. It would seem prudent, therefore, to monitor the fluoride intake of patients with renal failure living in high fluoride areas.
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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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"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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Skeletal Fluorosis & Individual Variability
One of the common fallacies in the research on skeletal fluorosis is the notion that there is a uniform level of fluoride that is safe for everyone in the population. These "safety thresholds" have been expressed in terms of (a) bone fluoride content, (b) daily dose, (c) water fluoride level, (d) urinary fluoride level, and (e) blood fluoride level. The central fallacy with each of these alleged safety thresholds, however, is that they ignore the wide range of individual susceptibility in how people respond to toxic substances, including fluoride.
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