BACKGROUNDGround water is the major source of freshwater, hence protection of groundwater is critical for the welfare of humankind. The people living in rural areas are more exposed, since there is no centrally supplied water in these areas. The major source of fluoride in ground water is the fluoride-bearing rocks. Dental fluorosis which manifests as discolouration of teeth and skeletal fluorosis which are endemic are most early biomarkers of fluoride toxicity. Dharmapuri district in Tamilnadu is one such region where high concentration of fluoride is present in ground water. The present study was done to determine the occurrence of dental fluorosis in children belonging to Avarankattur village, Dharmapuri district and correlate to the fluoride content of the drinking water and other related factors.