What are the types of endemic fluorosis?
Skeletal fluorosis and dental fluorosis are the two common types. Long-term ingestion of high levels of fluoride can lead to joint pains, stiffness, and mild skeletal changes. In severe cases, it can lead to severe damage to spine and long bones and make an individual crippled for life. Besides the restricted movement of the spine, it can lead to an increased risk of fractures.
What is dental fluorosis?
Excess fluoride ingested during childhood, lead to white streaks, brown stains, and pitting on the tooth enamel. Mild cases may lead to cosmetic changes while severe cases may lead to enamel damage.
What about the occurrence of endemic fluorosis in Maharashtra?
Wherever ground water has excessive fluoride and certain geological factors such as certain rocks that have high fluoride content can lead to endemic fluorosis. This leads to elevated levels of fluoride in water. Yavatmal, Nanded, Chandrapur and Amravati have high levels of fluoride in ground water that is used for drinking purposes. Many cases in Jalgaon and Nashik districts have been affected.
How to diagnose endemic fluorosis?
Physical changes in teeth and bones can lead to the primary suspicion. Pain in joints, bones, and backaches could be early symptoms. Deformities of joints and skeletons may be seen in advanced cases. Measurement of fluoride in drinking water, urine and blood is made to confirm the diagnosis. X-rays of bones may show typical changes of
excess density
What nutritional therapy helps to reduce effects of endemic fluorosis and prevent chronic exposure to fluoride?
Calcium and Vitamin D supplements may reduce fluoride absorption and help proper bone mineralization. Administration of Vitamins C and E may help reduce the oxidative stress caused by excess fluoride, providing relief from some fluoride toxicity.
What about pharmacological interventions?
Drugs like alendronate, and chelation therapy may help in severe skeletal fluorosis. New research may bring in new molecules that can bind fluoride in the gastrointestinal tract to prevent its absorption into the body. Certain orthopedic and physiotherapy interventions may be helpful.
What are the de- fluoridation techniques useful to avoid fluorosis?
Affordable household filters that have activated alumina filters, reverse osmosis, and bone char filters are being used. Community-based De- fluoridation plants have been set up using the Nalgonda technique or reverse osmosis technology to reduce fluorine in water. NEERI has also developed a De-fluoridation technique.
Where is the maximum impact felt?
Those individuals engaged in physically strenuous activities, either agricultural or industrial are maximally affected. In some areas, these effects of endemic fluorosis are under-reported and are not fully appreciated. The available data suggests that a fluoride level in water of more than 1.5 mg/L can lead to fluorosis.