Assessment of skeletal and non-skeletal fluorosis in endemic fluoridated areas of Vidharbha Region, India: A survey

Abstract

Objectives:To evaluate skeletal and non-skeletal fluorosis in patients living at endemic fluoridated areas and also the morphological changes in red blood cells (R.B.C.’s).Materials and Methods:The cross-sectional study was conducted at Vidharbha region of Maharashtra, India. An ethical clearance was obtained from the concerned authorities. Fifty families were screened and 204 subjects who had dental/skeletal fluorosis were included in the study. The aims and objectives were explained to the study subjects of the village and biochemical, hematological and radiological assessment was done. The main source of drinking water in this area was tube well. The concentrations of fluoride in two different areas of same village were 4 and 4.5 ppm.Results:Prevalence of skeletal fluorosis and non-skeletal fluorosis in male patients was 56.87% (116) and in female patients (88) it was 43.13%. RBC count in male patients was 5.03 ± 0.49 while in female patients it was 4.70 ± 0.47. With significant difference between male and female patients, P value was 0.003. Hb% in male patients was 12.44 ± 1.76 and in female patients it was 11.31± 1.34, showing significant difference between male and female patients P value 0.038. Alkaline phosphate level in male patients was 289.68 ± 149.09 and in female patients it was 276.68 ± 164.97. ESR count in male patients was found 11.41 ± 8.75 and in female patients it was 13.29 ±7.37. Radiological finding of fluorosis patients shows thickening of inner and outer tables of skull bone in 83.92% of patients and only 7.84% of the patients were suffering from barrowing of long bone.

Correlation between fluorosis and dental caries in endemic areas of Wardha district

“…Another study conducted by Bawaskar and Bawaskar in 2006 in a villages of Maharashtra had found the prevalence of dental fluorosis as 43%. [18] In Maharashtra, a study conducted by SudhirRawlani [6] in 2010 mentioned that the prevalence of dental fluorosis in Vidharbha area ranging from 43.13% to 56.87%. [7] Another study conducted by Rawlani in 2011 suggested that the prevalence of dental fluorosis in Wardha district of Maharashtra is 16.5%.…”

“…In higher age group (>40 years) at a fluoride concentration of 2.8 ppm or higher, deformities such as crippling, kyphosis, and genu varum were observed. [7] In Maharashtra, a study conducted by Rawlani in 2010 [6] mentioned that the prevalence of dental fluorosis in Vidharbha area ranges from 43.13% to 56.87%.…”

“…As the affected teeth lose their normal, creamy, white translucent color and become rough, opaque, and chalky white. [6] This study is to measure the prevalence of dental fluorosis and dental caries in the population residing in an area with International Journal of Medical Science and Public Health 2 2017 | Vol 6 | Issue 12 (Online First) a high and normal level of fluoride in drinking water and to find whether high fluoride level in drinking water is more protective for dental caries or a risk factor for dental fluorosis. The water supply of endemic area in Wardha district selected for the study reported that the level of fluoride is more than 1.5 mg/l.…”

Autophagy may protect MC3T3-E1 cells from fluoride-induced apoptosis

“…Excessive exposure to fluoride in drinking water, or in combination with exposure to fluoride from other sources, may give rise to a number of adverse effects, including dental fluorosis, skeletal fluorosis and vascular calcification (2)(3)(4). However, the cellular mechanisms underlying fluoride-induced cytotoxicity in osteoblasts remain to be fully elucidated.…”

Craniofacial Manifestations of Systemic Disorders: CT and MR Imaging Findings and Imaging Approach

“…The skull and tubular bones are less often affected. Some studies have demonstrated increased marrow spaces in the jaw and thickening of both the inner and outer tables of the skull (84).…”