Fluorosis – Symptoms of Fluorosis

Fluoride occurs in all-natural water supplies. Fluorides mainly occur in different chemical wastes from industries. Water drawn from subsurface through some geological formation may also contain a high amount of fluoride. Fluorides, present in small concentrations up to ppm, considered beneficial in water. Such water found to improve dental wellbeing and prevent dental caries. It is found that a fluoride concentration of slightly greater than 1 ppm in water causes a reduction in the cavities of teeth of young children. It also reduces the decaying and missing teeth. Excessive fluoride in drinking water may cause mottling of teeth or dental fluorosis, which results in discoloration of enamels, chipping of teeth in children in severe cases.

Bone fluorosis or crippling effects are observed in case the concentration of fluoride exceeds 1.0 mg/ L. F

,  70-100 % of districts are affected in Andhra Pradesh, Gujarat, and Rajasthan. 40-70 % districts are affected in Bihar, National Capital Territory of Dehli, Haryana, Jharkhand, Karnataka, Maharashtra, Madhya Pradesh, Orrisa, Tamilnadu, and Uttar Pradesh. 10-40% districts are affected in Assam, Jammu and Kashmir, Kerala, Chhattisgarh, and West Bengal, while the endemicity for the rest of the states is not known. fluoride occurs in all-natural water supplies. Fluorides mainly occur in different chemical wastes from industries. Water is drawn from subsurface through some geological formation may also contain a high amount of fluoride. Fluorides, present in small concentrations up to ppm, considered beneficial in water. Such water found to improve dental wellbeing and prevent dental caries. It is found that a fluoride concentration of slightly greater than 1 ppm in water causes a reduction in the cavities of teeth of young children. It also reduces the decaying and missing teeth. Excessive fluoride in drinking water may cause mottling of teeth or dental fluorosis, which results in discoloration of enamels, chipping of teeth in children in severe cases.

Fluoride can enter the body through drinking water, food, toothpaste, mouth rinses, and other dental product, drug and fluoride dust, and fumes from industries using fluoride containing salt and or hydrofluoric acid.

Source of Fluoride:

The fluoride can enter the body through the following means:

• Drinking water has more amount than 1.0 mg/L fluoride of water
• Black tea without milk.
• Tinned fish / canned food items often fluoride is used as a preservative.
• Black and red rock salt.
• Ayurvedic preparations/tablets of powders containing black rock salt.
• Dental products such as fluoride toothpaste and mouth rinses.
• Drug containing fluoride on long time treatment for disease: viz., depression, osteoporosis, otosclerosis, and any other.
• Tobacco or Supari chewing by itself.

Symptoms of Fluorosis

   The disease can affect young and old; men and women alike it can occur as Dental Fluorosis, Skelton Fluorosis, and Non- Skelton Fluorosis with the following symptoms:

• Aches and pain in the joints
• Stiffness in the joints
• The joints having the problem may be that of the neck, back, hip, shoulders, or knee joints without any obvious signs of fluid accumulation.
• Gastro-intestinal problem viz., nausea, loss of appetite, pain in the stomach, gas formation, constipation with occasional diarrhea.
• Tiredness / Fatigue
• Muscle Weakness
• Anemia / low hemoglobin
• Excessive thrust
• A tendency to urine more frequently (not having diabetes)
• Repeated abortion and stillbirth
• Infertility in the male partner, with a healthy and normal wife.
• Any individuals living in urban/rural areas and having health complaints of the above nature and if it is a persistent complaint not getting relief from any treatment/medicine, should go for the diagnosis of Fluorosis to rule out the possibility of fluoride poisoning.

Diagnosis:

Patients or any individual with the above health complaints should get the drinking water, blood, and urine tested for fluoride. A forearm X-ray should be taken to assess the calcification of ligaments.

Fluoride Testing Method:

A fluoride ion-specific electrode technology is used to get accurate results. If another method for fluoride estimation is used, the percentage error in the actual value of fluoride would be unreliable.

Treatment:

Fluoride has no treatment or medicine. This disease is diagnosed properly at an early stage can be prevented easily. The essential nutrients for combating Fluorosis are adequate intake of Calcium, Vitamin C, Vitamin E, and others, Anti-oxidants. Different recipes for adequate intake of the above nutrients are developed and field-tested with excellent results. Fluoride contaminated items should be avoided.

Dr. Abhishek Swami
Department of Environmental Science
School of Applied and Basic Sciences