Neurology of endemic skeletal fluorosis

Reddy, D. Raja

doi:10.4103/0028-3886.48793

Cited by 71 publications

(68 citation statements)

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“…Patients with SF are advised to keep away from fluoride intake. Fluoride mobilized from the skeleton gets excreted very slowly through urine and feces, 10 and patients with SF will excrete large amounts of flouride for years. v…”

Section: Discussionmentioning

confidence: 99%

Image Diagnosis: Dental and Skeletal Fluorosis

Gupta

Chhabra

2016

TPJ

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A 45-year-old man presented to the Department of Medicine at our institution with 1 year of noninflammatory pain in multiple joints. The pain had begun in both knee joints, followed by low-back ache and neck, wrist, and foot pain. There was no associated fever or swelling of any joint. The patient did not report any history of addiction or illness but did report using fluoridated toothpaste. The patient also lived in a region of India where the problem of fluorosis is endemic. On examination, we found his teeth had brown strains and rough, pitted enamel ( Figure 1). There was diffuse tenderness at the cervical spine, the lumbosacral spine, and elbow, wrist, knee, and ankle joints. There was no swelling or restriction of movement in any of these areas. There were no neurologic deficits, and the rest of the physical examination was normal. X-ray scans showed osteosclerosis of the knee (Figure 2), ankle, wrist, pelvis, and vertebral column, and calcification of the sacrotuberous ligament (Figure 3) and the posterior longitudinal ligament (Figure 4). Twenty-four-hour urinary fluoride levels were elevated (18 ppm). The patient was advised to avoid fluoridated water, fluoridated toothpaste, and foods containing fluoride. He was kept under close follow-up and was educated about the potential development of neurologic symptoms and signs.Nishtha Gupta, MDS, is a Student in the

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Section: Discussionmentioning

confidence: 99%

Image Diagnosis: Dental and Skeletal Fluorosis

Gupta

Chhabra

2016

TPJ

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“…As a result, the consumption of fluoride by humans became uncontrolled and unpredictable often exceeding its therapeutic window. An excessive fluoride consumption has been linked to development of fluorosis, a slow degenerative disease, affecting teeth and bone tissues, as well as inducing neurological defects, infertility, and mental retardation [8][9][10][11][12]. Endemic fluorosis is a serious national problem occurring in many counties all over the world and affecting many millions of people using groundwater with high fluoride content for their daily needs [3,13].…”

Section: Introductionmentioning

confidence: 99%

Molecular Mechanisms of Cytotoxicity and Apoptosis Induced by Inorganic Fluoride

2012

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Fluoride (F) is ubiquitous natural substance and widespread industrial pollutant. Although low fluoride concentrations are beneficial for normal tooth and bone development, acute or chronic exposure to high fluoride doses results in adverse health effects. The molecular mechanisms underlying fluoride toxicity are different by nature. Fluoride is able to stimulate G-proteins with subsequent activation of downstream signal transduction pathways such as PKA-, PKC-, PI3-kinase-, Ca 2+ -, and MAPK-dependent systems. G-protein-independent routes include tyrosine phosphorylation and protein phosphatase inhibition. Along with other toxic effects, fluoride was shown to induce oxidative stress leading to excessive generation of ROS, lipid peroxidation, decrease in the GSH/GSSH ratio, and alterations in activities of antioxidant enzymes, as well as to inhibit glycolysis thus causing the depletion of cellular ATP and disturbances in cellular metabolism. Fluoride triggers the disruption of mitochondria outer membrane and release of cytochrome c into cytosol, what activates caspases-9 and -3 (intrinsic) apoptotic pathway. Extrinsic (death receptor) Fas/FasL-caspase-8 and -3 pathway was also described to be implicated in fluoride-induced apoptosis. Fluoride decreases the ratio of antiapoptotic/proapoptotic Bcl-2 family proteins and upregulates the expression of p53 protein. Finally, fluoride changes the expression profile of apoptosis-related genes and causes endoplasmic reticulum stress leading to inhibition of protein synthesis.

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“…Nearly 73% of the children had detectable dental fluorosis. Since there is a linear relationship between urinary fluoride levels and fluoride intake and intake varies widely with diet and certain beverages (especially tea), as well as with volume of water consumed, such variations are generally regarded as physiological [12,13]. Even so, the fact that urine fluoride levels could be measured in only 33 children may be a limitation of our study.…”

Section: Discussionmentioning

confidence: 70%

High prevalence of dental fluorosis among schoolchildren in three villages in Vavuniya District: an observational study

Rajapakse

Jayawardhane²,

Lokubandara³

et al. 2017

Ceylon Med. J.

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Background Studies of groundwater sources in Sri Lanka show that in the entire Northern, North Central, Uva and Eastern Provinces, and also in a large area of the North Western Province, groundwater fluoride content is within the range 1.0 mg/l and 3.0 mg/l. The WHO recommended safe upper limit of fluoride for drinking water is 1.5 mg/l.Objective Our objective was to determine the prevalence and degree of dental fluorosis in a cohort of schoolchildren in Sinnasippikulam in Vavuniya District, the fluoride content in their serum and urine, and fluoride levels in drinking water in dug wells of the area.Methods Invitations in Tamil and Sinhala were sent to all households by courier. Demographic information and oral hygiene practices of 307 responsive children were recorded by interviewing children and their mothers. Detailed clinical examinations were performed according to WHO basic methods, with some modifications. Assessment of dental fluorosis in the children was done according to Dean's Index codes and criteria. Conclusions Our results show that harmful levels of fluoride are extremely common in groundwater sources in the study area, and consequently, dental fluorosis is highly endemic (72.9%) among resident schoolchildren.

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Neurology of endemic skeletal fluorosis

Cited by 71 publications

References 1 publication

Image Diagnosis: Dental and Skeletal Fluorosis

Image Diagnosis: Dental and Skeletal Fluorosis

Molecular Mechanisms of Cytotoxicity and Apoptosis Induced by Inorganic Fluoride

High prevalence of dental fluorosis among schoolchildren in three villages in Vavuniya District: an observational study

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