Fluorosis is a disease caused due to excessive ingestion of fluoride. Fluoride are the compounds of fluorine. Fluorine is the 13th most abundant element available in the earth crust. As the surface water passes through the fluoride rich rocks it carries fluoride with it, hence most of the fluoride is found in ground water than surface water.

Permissible limit of fluoride:WHO and IS 10500 (1991) standards permit only 1.5 mg/L and 1.0 mg/L respectively as a safe limit for human consumption whereas several districts of Rajasthan India are consuming water with fluoride concentrations of up to 24 - 44 mg/l.

Krass India's Role:

The information on Fluorosis provided on this site shall be of phenomenal value in providing education and support for prevention of this disease to:

• Patients,
• Public Health Engineers and Water Chemists,
• Policy Makers and Administrators,
• Local governments, general public,
• Dentists, scientists, researchers, physicians,
• non-governmental bodies, and
• Worldwide Non-Profit organization working towards the cause.

Krass India is registered as a charitable, non-profit making organization with a objective of researching ways to deal with most endemic diseases facing our community including all aspects of Fluoride and Fluorosis to provide initiatives to mitigate the disease worldwide. We are working with government agencies in India in making them aware of our work and attract funds from overseas to carry on with its activities to benefit those in need.

We welcome all individual or philanthropist from any part of the globe who would like to support our activities by way of providing funds to the organization. Please email us if you'd like more information or click here to get more information on contributing.

Spread & Source

International Status: The following countries have been identified for the problem of Fluorosis: Pakistan, Bangladesh, Argentina, United States of America, Morocco, Middle East countries, Japan, South African Countries, New Zealand, Thailand etc.

In India: The problem has reached alarming proportions affecting at least 17 states of India. Out of those 5 are hyper endemic, where 50-100% districts are affected viz. Andhra Pradesh, Tamil Nadu, Uttar Pradesh, Gujarat, Rajasthan. In Rajasthan the Banka Patti area has been identified in Nagaur district.

Major sources of fluoride for human exposures are water, Food, Air, Medicament, and Cosmetics. It is roughly estimated that 60% of the total intake is through drinking water. In India it have been observed that Tea, Fluoridated tooth paste and high fluoride water make a major contribution for human ingestion.

Chemobiokinetics and Metabolism

Ingested fluoride is rapidly absorbed through gastrointestinal tract and lungs. The peaks are reached after 30 min in blood. The rapid excretion takes place through renal system over a period of 4 to 6 hrs. In children less than three years of age only about 50% of total absorbed amount is excreted, but in Adults and children over 3 years - about 90% is excreted. Approximately 90% of the fluoride retained in the body is deposited in the skeleton and teeth. The biological half-life of bound fluoride is several years. Fluoride also passes through the placenta and also appears in low concentrations in saliva, sweat, and milk.

Long back it was believed that Fluorosis is a problem of elderly age group but it have been found that children in the age group of 0 to 12 years are most prone to Fluorosis as their body tissues are in formative / growth stage during this period. The problem is so severe that if expectant mothers ingest high fluoride water, it can create many problems with developing fetus. It not only affects the body of a person but also renders them socially and culturally crippled.

Clinical Menifestation

Toxic effects on human beings: Fluorosis may cause Skeletal Fluorosis, Clinical Fluorosis, Dental Fluorosis, Non Skeletal manifestations, or any combination of the above and in final stages it causes premature aging.

Dental Fluorosis: White opacities, Faint yellow stain, Pitting, chipped off, Black discoloration, Enamel hypoplasia, Delayed eruption. Incidences of mottled teeth were observed even with range of 0.7-1.5 mg F/l in drinking water. The minimal daily fluoride intake in infants that may cause very mild or mild Fluorosis in human beings was estimated to be about 0.1 mg per kg body weight.

Skeletal Fluorosis: Radiological presentations: Osteosclerosis, Periosteal bone formation, Calcification of interosseous membrane, ligaments, capsules, muscular attachments, tendons. Exostoses, Osteophytosis, Associated metabolic bone disease.

Clinical presentation: Heel pain, Painful and restricted joint movements, Deformities in Limbs, Hunch back

In extreme cases: Paralysis, Mucular wasting, Premature aging

Non skeletal manifestations

1. Neurological manifestation: Nervousness & Depression, Tingling sensation in fingers and toes, Excessive thirst and tendency to urinate Frequently (Polydypsia and plyurea): The Control by brain appears to be adversely affected.
2. Muscular manifestations: Muscle Weakness & stiffness, Pain in the muscle and loss of muscle power
3. Urinary tract manifestations: Urine may be much less in volume, Yellow red in colour, Itching in the region of axilla.
4. Allergic manifestation: Very painful skin rashes, which are peri vascular inflammation. Prevalent in women and children. Pinkish red or bluish red spot, round or oval shape on the skin that fade and clear up within 7-10 days.
5. Gastro - intestinal problems: Acute abdominal pain, Diarrohea, Constipation, Blood in Stool
6. Headache
7. Edentate (Losses Teeth at an early age)
8. Red Blood cells: causes formation of echinocytes hence early destruction of the RBCs in form of ecchynocytes causes anemia.
9. Ligaments and Blood Vessel Calcification: Early calcification of blood vessels.
10. Fluoride and mental efficiency: reduce mental work capacity (MWC) and hair zinc content.
11. Fluoride and thyroid: Fluoride has inhibitory effect on iodine uptake hence causing thyroid enlargement.
12. Fluoride and Cancer: The results of the studies suggested that sodium fluoride promoted the growth of precancerous lesions of the liver.
13. Fluoride and diabetes:The study showed that chronic fluoride toxicity in humans could result in significant abnormalities in glucose tolerance, which are reversible upon removal of the excess fluoride.
14. Fluorosis and lactation: The effect of Fluorosis on lactation, lactotroph function and ultrastructure were studied in lactating rats. The results were as follows:
1. Inhibition of lactation in lactating rats
2. During chronic Fluorosis serum prolactin level was decreased.