Dental/skeletal fluorosis

This paper is written with the aim of providing sufficient background to help understand the mechanism of action of fluoride ion on humans. The main focus is on the effects of fluoride on dental health, in-depth discussion of skeletal fluorosis and use of fluoride for treating osteoporosis being outside the scope of this paper. Current information on the main sources of human exposure to fluoride and current recommendations for adequate intake (Al) of fluoride, as well as methods for assessing exposure, will be reviewed. 

Reliable analytical techniques are a prerequisite for accurate and precise determination of human exposure to fluoride. The goal is to monitor the intake of fluoride and maintain it at adequate levels so that optimal protection against dental caries is achieved, without excessive intake resulting in the appearance of dental or, in the worst case, skeletal fluorosis. 

Federal regulations require that fluoride not exceed a concentration of 4.0 mg L"1 in drinking water. Chronic exposure to levels above 4.0 mg L-1 may result in some cases of crippling skeletal fluorosis, a serious bone disorder. Fluoride in children s drinking water at levels of approximately 1 mg L-1 reduces the number of dental cavities. Federal law also requires that notification take place when monitoring indicates that the fluoride exceeds 2.0 mg L 1. 

Additional problems of high F occur in some groundwaters from arid areas (notably northern China, Pakistan). This creates potential additional health problems from dental and skeletal fluorosis. However, the presence of one of these elements in the Asian aquifers is not necessarily an indication of the presence of the other since As is dependent on the presence of strongly reducing conditions, whilst F occurs where Na-HCOs groundwaters dominate and where Ca concentrations are comparatively low. 

List five factors that can influence the manifestation of dental and skeletal fluorosis in animals. 

Controlling Dental Fluorosis and Skeletal Fluorosis due to Atmospheric Fluorine Pollution... 

The most important manifestation of hyperfluoric status is dental and skeletal fluorosis. In regions of volcanic activity, and in some arid zones and areas where phosphorites and apatites are mined and processed, agricultural animals and population often suffer from endemic and civilization-related fluorosis that mostly affects the teeth and skeleton. There arises the problem of reproduction and maintenance of dairy cattle (Ermakov etal. 1998, Ermakov 2001). In toxic quantities, fluorides impair the metabolism of calcium and synthesis of bone collagen by stimulating bone accretion, and speed up bone resorption and total calcium turnover in the body (Susheela and Mukher-jee 1981). 

At low-level concentrations, fluoride can reduce the risk of dental cavities. Exposure to somewhat higher amounts of fluoride can cause dental fluorosis, which, in its mildest form, can result in the discoloration of teeth. Severe dental fluorosis produces pitting and alteration of tooth enamel. Higher intake of fluoride, taken over a long period of time, can result in changes to bone and in a condition known as skeletal fluorosis. The effects of skeletal fluorosis include joint pain, restriction of mobility, and a possible increase in the risk of some bone fractures. 

Excessive intake of fluoride leads to brown discoloration of the teeth (dental fluorosis). A concentration above about 12 ppm in drinking water, as occurs naturally in some parts of the world, is associated with excessive deposition of fluoride in the bones, leading to increased fragility (skeletal fluorosis). 

The primary adverse effects associated with chronic, excess fluoride intake are skeletal, and dental or enamel, fluorosis. Other effects, including hypersensitivity reactions, renal insufficiency, immunological effects, possible association with repetitive strain injury, birth defects and cancer have been observed and discussed [17,41-45]. 

Fluoride Dental fluorosis, skeletal effects 4 Geological deposits, drinking water additive, aluminum industries... 

Fluorosis in farm animals resulting from high intakes of fluoride is characterised by dental and skeletal defects. This disorder, although naturally endemic in some areas where the drinking water contains high levels of fluoride,... 

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