And now:Ish <[EMAIL PROTECTED]> writes:



DENTAL FLUOROSIS is a diffuse symmetric hypomineralization (irregular 
calcification) disorder of ameloblasts (enamel-forming cells). Fuorosis is 
irreversible and only occurs with exposure to fluoride when enamel is 

•the secondary incisor teeth start forming as a baby (3-6 months old);
•molars are developed at six to eight years of age; and,
•wisdom teeth are formed by 12 years of age.

Instead of being a normal creamy-white translucent color, fluorosed enamel is 
porous (objectionable secondary staining often occurs) and opaque; teeth can 
resemble a ghastly-white chalk color (light refractivity is greatly reduced 
because the enamel’s prism structure is defective). Cloudy striated (lines of 
demarcation) enamel, white specks or blotches, "snow-capping", 
yellowish-brown spots, or brown pits on teeth are all characteristic of 
fluorosis. In its more severe form, fluorosed enamel is structurally weak 
(brittle) and prone to erosion and breakage, especially when drilled and 
filled. Even in the milder forms, there is increased enamel attrition. 
Fluorotic lesions are not just confined to enamel, but can be seen by 
microscope in dentin as well (dentin is the calcareous tissue beneath 
enamel). Because fluoride is a powerful bone and tooth seeking element, it 
also deposits bone or bone-like material externally on the roots of teeth, 
and internally in the tooth’s pulp chamber; the calcified material narrows 
the pulp chamber, and thereby interferes with tooth nutrition. The reigning 
paradigm in public health and dental circles has been to dismiss the 
significance of dental fluorosis by labelling it a cosmetic effect. However, 
fluorosis is a toxic manifestation of chronic (low-dose, long-term) fluoride 
intake. In other words, fluorosis means fluoride poisoning (see Webster's 
dictionary). Just as a blue-black line appearing on gums signifies chronic 
lead poisoning, fluorosis is the first visible sign that the whole body has 
been poisoned by too much fluoride. To prevent fluorosis from occurring in 
the ten or so most prominent and/or most susceptible teeth, the most critical 
time to avoid fluoride exposure is the first 3 to 6 years of a child’s life. 
See flteeth.htm for peer-reviewed abstracts.



SKELETAL FLUOROSIS is an abnormal increase in bone density.

"Endemic skeletal fluorosis is a chronic metabolic bone and joint disease 
caused by ingesting large amounts of fluoride either through water or rarely 
from foods of endemic areas. Fluoride is a cumulative toxin which can alter 
accretion and resorption of bone tissue. It also affects the homeostasis of 
bone mineral metabolism. The total quantity of ingested fluoride is the 
single most important factor which determines the clinical course of the 
disease which is characterized by immobilization of joints of the axial 
skeleton and of the major joints of the extremities. A combination of 
osteosclerosis, osteomalacia and osteoporosis of varying degrees as well as 
exostosis formation characterizes the bone lesions. In a proportion of cases 
secondary hyperparathyroidism is observed with associated characteristic bone 
changes. Contrary to earlier thinking, severe crippling forms of skeletal 
fluorosis are seen in paediatric age group too. Increased metabolic turnover 
of the bone, impaired bone collagen synthesis and increased avidity for 
calcium are features in fluoride toxicity. Osteosclerotic picture is evident 
when small doses of fluoride are ingested over a long period of time during 
which calcium intakes are apparently normal while osteoporotic forms are 
common in paediatric age group and with higher body load of the element. 
Alterations in hormones concerned with bone mineral metabolism are seen in 
fluorosis. Kidney is the primary organ of excretion for fluorides. Age, sex, 
calcium intake in the diet, dose and duration of fluoride intake and renal 
efficiency in fluoride handling are the factors which influence the outcome. 
Serum parameters rarely help in the diagnosis. Elevated urinary fluoride and 
increased bone fluoride content are indicators of fluoride toxicity. 
Fluorosis is a preventable crippling disease. No effective therapeutic agent 
is available which can cure fluorosis. Industrial fluorosis is on the 
increase on a global basis. Bone density measurement is a tool for early 
Source: Krishnamachari KA, Skeletal fluorosis in humans: a review of recent 
progress in the understanding of the disease, Prog Food Nutr Sci, 1986, 10 
(3-4): 279-314

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