MAHARSHI DAYANAND SARASWATI UNIVERSITY
COMMUNITY NUTRITION
TOPIC:Fluorosis
FLUOROSIS
INCIDENCE
Fluorosis is prevalent in certain parts of India, China, Tanzania,
South Africa.
In India, an estimated 62 million people, 2million children in 17
states are affected with endemic fluorosis.
The survey revealed that the major source of drinking Water was
bore wells, which had fluoride levels ranging from 0.5-6.6 Ppm.
Dental mottling was in the range of 17-36 per cent. The
prevalence was relatively higher among the children of 10-14
years (30 to 67 per cent) in all the district surveyed.
The overall prevalence of skeletal fluorosis in population of all age
groups was found to be less than 1 per cent.The heavy deposits
of fluoride bearing minerals in the rock are mainly responsible for
endemic fluorosis in India. The fluoride content of drinking water
varies between 0.5-0.25 mg/l in different parts of India
Its presence in water >2-3 ppm leads to fluorosis. Fluoride toxicity
manifests in two major forms and skeletal fluorosis and dental
fluorises.
SIGNS AND SYMPTOMS
The severity and duration of symptoms of flourises depends on a
person's age, nutritional status, environment, kidney function,
amount of fluoride ingested, genetic background, tendency to
allergies etc.
Fluorosis usually begins with dental flurosis and constant
excessive fluoride consumption later result in skeletal fluorises.
Dental Fluorosis :Occurs where the fluoride content of water is
high (>3-5).mottling of permanent teeth is common.
.-The enamel losses its luster and become rough.
- Symptoms may range from tiny white streaks to dark brown
strains and rough, pitted enamel. Incisors of the upper jaw are
more affected.
- Occurs in children who are exposed to high floride levels before
completion of mineralization of teeth.
Severity of dental fluorisis rated using following categories :-
Questionable:Enamel shows slight changes ranging from few
white flecks to occasional white spots.
Very mild :Small opaque paper white areas are scattered over
less than 25%of tooth surface.
Mild :White opaque areas on the less than 50%of the surface.
Moderate :White opaque areas affect more than 50% of the
enamel surface.
Severe : All enamel surfaces are affected. The teeth also have
pitting.
Skeletal Fluorosis : This disease exhibits very slow progression
- Patients develops stiffness, joint pain and deformities of the
spine.
- Clinical manifestation of fluorosis is called genu valgum (knock
knees.
- Genu valgum results when fluoride intake is higher than
2-16 mg/l.
- Bones are hardened and thus less elastic resulting in an
increased frequency of fracture.
High fluoride level may also interfere with iodine Metabolism,
causing hypothyroidism. The hormones of bone Metabolism like
Parathyroid and growth hormone level in serum are elevated.
It may also cause vitamin D vitamin deficiencies which cause
causes deformities in young children.
CAUSES
Caused by excessive intake of fluoride from multiple sources like
food, water, air and excessive use of toothpastes.
Drinking water is the most significant source.
Moderate level chronic exposure is more common. Acute high
level exposure is rare and usually occurs due to contamination of
water sources.
High levels of fluoride content are mostly found at the foot of high
mountains or in areas where geologic deposits are collected in
TREATMENT
- In severe cases, whitening of b the teeth, veneers or other
dentistry techniques can be used to correct any permanent
discolouration.
- supplementation of Vitamin C alleviate the symptoms of
endemic flurosis.
- Tamarind increases urinary excretion of fluoride hence delays
progression of flurosis.
PREVENTION
- Creating awareness through health education and
discouraging consuming water from high fluoride sources.
- Administrators should be sensitize for identifying sources with,
more than permissible amount of fluoride b in drinking water.
- Supplementation of affected population with micronutrients
like Ca, Vit. D and C.
- Propagation and supply of domestic defluoridators.
- Avoiding fluoride rich food such as tea, tobacco and fluoride
rich toothpaste and encouraging consumption of food touch
in Ca, vitamin C, D, and protein.
- Make efforts to dig bore wells in fluoride zones.
THANK YOU
