- Chronic excess dietary fluoride intake contributes to degenerative joint disease.
- Species differences in lesion location largely explained by biomechanics of gait.
- Irrespective of bone fluoride, koalas show higher baseline prevalence of DJD.
- Increasing bone fluoride associated with prevalence of moderate and severe lesions.
- Inconsistencies in relationship explained by the effect of selective survival bias.
One of the manifestations of chronic fluoride toxicosis in mammals is skeletal fluorosis, which can include lesions of degenerative joint disease (DJD). Although DJD lesions have been less commonly studied than bone or dental lesions in relation to the pathology and epidemiology of fluoride toxicosis, there have been multiple independent studies in various species that have concluded that there appears to be an effect. The mechanisms by which fluoride affects the joints are not clear, but our data provide evidence that chronic excess dietary fluoride intake contributes to DJD. Our study is the first to specifically address the association between fluoride exposure and DJD in multiple species of free-ranging mammals. We describe levels of DJD in six marsupial species (Macropus giganteus, Notamacropus rufogriseus, Wallabia bicolor, Phascolarctos cinereus, Trichosurus vulpecula and Pseudocheirus peregrinus) inhabiting high and low fluoride environments. Lesions occurred to varying extents in all species, and lesion distribution varied with biomechanical differences in gait. In addition, we show an association (independent of age) between increasing bone fluoride concentration (as a measure of fluoride exposure) and increasing prevalence of moderate and severe DJD in five species of marsupial, which we propose does not persist at the highest levels of fluoride exposure due to selective survival bias.
Occupational skeletal fluorosis
Conclusion Four cases of skeletal fluorosis are described in individuals who had been working in an aluminum plant for periods up to 12 yens. Two patients exhibited radiological changes indicative of the first stage of the disease and two of the second stage. All patients exhibited backache, pains in arms and
Early diagnosis and complete recovery from fluorosis through practice of interventions
OBJECTIVES: The objective of this communication is to disseminate scientific and technical information for early diagnosis of Fluorosis; recent developments in care and management of patients of Fluorosis. Material and Methods: Body fluids collected from patients suspected of Fluorosis referred by hospitals, samples of drinking water used by them are the
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
On the association of fluorosis with degenerative-dystrophic lesions of the skeleton in workers engaged in electrolytic departments of aluminum plants
Workers of electrolytic departments at the Novokuznetsk aluminum plant were found to suffer not only from fluorosis (28.2) per cent), but also from degenerative-dystrophic affection of the skeleton (87.7 per cent). The workers of a control group who were not exposed to a chronic action of fluorine compounds the degenerative-dystrophic
Clinical symptoms of dental and skeletal fluorosis in Gadag and Bagalkot Districts of Karnataka.
An investigation was undertaken in six endemic villages of Mundargi taluk of Gadag district and two of Hungund taluk of Bagalkot district to assess the clinical symptoms of both dental and skeletal fluorosis and in turn to find out the severity of the disease. A check list developed with the help of
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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.
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.
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.
Similarities between Skeletal Fluorosis and Renal Osteodystrophy
It is quite possible, and indeed likely, that some kidney patients diagnosed with renal osteodystrophy are either suffering from skeletal fluorosis or their condition is being complicated/exacerbated by fluoride exposure.
A highly significant relationship of exposure to fluoride was established with the frequency of back and neck surgery, fractures, symptoms of musculoskeletal disease and past history of diseases of bones and joints in the absence of the typical findings of skeletal fluorosis. Monitoring exposed workers for the early manifestations of "musculoskeletal fluorosis" is recommended prior to the development of destructive and degenerative changes of the skeleton.
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