Abstract
1. A case of osteosclerosis, exhibiting in addition mottled enamel, severe anemia showing no response to anti-anemic therapy, and bilateral renal lesions is reported.
2. The diagnosis of fluoride osteosclerosis was proved by the history of a long residence in areas of endemic fluorosis and by fluorine analysis of the patient’s bones and teeth.
3. Osteosclerosis may be a dangerous sequel to the chronic ingestion of fluorine-containing water supplies, since it may give rise to a secondary anemia due to encroachment upon the blood-forming marrow. There is also the possibility of kidney damage due to the chronic fluoremia.
4. Areas in the United States in which dental fluorosis exists and where the fluorine content of the drinking water is over three parts per million should be systematically studied by the public health authorities to determine how widespread the condition of osteosclerosis is.
5. Al patients with dental fluorosis and anemia and/or signs of renal impairment should have radiographic examinations of the skeletal system to rule out the existence of fluoride osteosclerosis.