Risk Factors Associated with the Prevalence of Fluorosis in the Endemic Area of Punjab (Bathinda District)

Abstract

Aim: To assess the risk factors associated with the prevalence of fluorosis in the endemic area of Punjab.
 Study Design: The fluorosis endemic area of Punjab state was purposively selected for assessment of risk factors associated with it.
 Place and Duration of Study: The study was conducted in rural and urban areas of Bathinda district during January 2021 to March 2021
 Methodology: A sample of 140 subjects were selected randomly consisting of 70 males and 70 females each from both the rural and urban area of Bathinda district. An interview schedule cum questionnaire was designed to collect general, dietary and clinical information of the respondents. The degree of dental fluorosis was assessed using ICMR index [1].
 Results: It was revealed that among the rural subjects, majority of respondents were suffering from grade 1 fluorosis (38.57%) followed by grade 0 (37.14%), grade 2 (18.57%) and grade 3 (5.71%). Whereas among urban subjects, majority of respondents were free from fluorosis (58.57%) followed by grade 2(34.28%), grade 1 (21.42%) and grade 3 (5.71%). Age and the duration of stay in the endemic area were found to be positively correlated with the incidence of fluorosis. The higher number of subjects having heavy or moderate lifestyle were suffering from grade 2 and grade 3 of fluorosis, whereas majority of sedentary respondents were free from fluorosis and suffering from grade 1 of fluorosis. A negative correlation was observed with the per capita income of the selected subjects, i.e., with the increasing income the prevalence of fluorosis decreased. Excessive intake of tea and alcohol was also associated with the severity of fluorosis. Among various micro nutrients, the intake of Calcium, phosphorus, magnesium and ascorbic acid was found to be significantly (P<0.05) different in the subjects with various grades of fluorosis.
 Conclusion: Water is the primary source of fluorine intake by humans, but there are many predisposing factors that aggravate the condition for fluorosis, which can be avoided by taking diet rich in calcium and anti-oxidants in addition to water with permissible level of fluorine. The higher prevalence in the rural area as compared to urban area might be due to more consumption of tea and alcohol by respondents belonging to rural area.