Fluoride Action Network


The objectives of the present study were to highlight (i) how to diagnose fluorosis, due to fluoride ion (F) toxicity, in out-patient departments, by retrieving the history and through tests and (ii) the interventions available for recovery. In patients suspected of fluorosis, the F levels were investigated in samples of drinking water and body fluids (serum and urine), and forearm X-ray radiographs taken to assess the presence of interosseous membrane calcification. The haemoglobin (Hb) was tested for monitoring purposes. With the results obtained and the history retrieved, a correct diagnosis of fluorosis was arrived at. The meaning of any deviations in the results are discussed in three case studies. Recovery was obtained through two corrective measures: (i) diet editing and (ii) diet counselling. In diet editing F ingestion from all sources was withdrawn and in diet counselling an adequate consumption of essential nutrients, vitamins, antioxidants, and micronutrients through dietary sources was promoted. Pharmaceutical products were not recommended as recovery with them is slow. The first reassessment, scheduled at 4–6 weeks post-intervention, was a confidence building exercise for the patient. The disappearance of the health complaints and the subsequent recovery were related to the reduction in the F levels in the urine and a rise in the Hb. The study provides an overview of the clinical manifestations of fluorosis, diagnostic tests, differential diagnosis, interventions practised, monitoring, and recovery from the disease. The report highlights that kidney failure may occur in F toxicity and that diagnostic tests for fluorosis are helpful in the understanding of the occurrence of renal failure in association with fluorosis.