fluoride in dust and fumes from industries such as those manufacturing steel, aluminum, enamel, pottery, glass, bricks, phosphate fertilizer, and others involved with power, welding, water fluoridation plants, refrigeration, rust removal, oil refining, plastics, pharmaceuticals, tooth-paste, chemicals, and automobiles. The disease occurs as an endemic problem in some parts of the world and is the result of prolonged ingestion or rarely by inhalation of high amounts of fluoride. Gastrointestinal symptoms settle within 15 days. Dental fluorosis can only occur if the fluoride exposure is during the first years of life while the teeth are forming. Guissouma W, Hakamic O, Rajab AJ, Tarhounia J. 2013;4:1084–8. Clin Oral Investig, 2016; 28. Indian J Anaesth. Fluoride-rich foods such as tea, ocean fish, gelatin, skin of chicken, fluoridated salt, food contaminated with post-harvest fumigants (e.g. Skeletal fluorosis: don’t miss the diagnosis!. 2007;16:1119–28. Khairnar MR, Dodamani AS, Jadhav HC, Naik RG, Deshmukh MA. Fluoride (F) being an electronegative element, having a negative charge is attracted by positively charged ions like calcium (Ca++). sodium aluminium fluoride, Na3AlF6, which may be used on grapes). Reber JD, McKenzie GA, Broski SM. (V)Haemoglobin estimation: for detection of anaemia. However, drinking water is the most significant source. The differential diagnosis of fluorosis. (c) Better nutrition: measures to improve nutritional status (intake of calcium and vitamin C, iron,antioxidants) of affected population particulary children are an effective supplement to technical solutions mentioned above. However, the disease is easily preventable if diagnosed early and steps are taken to prevent intake of excess fluoride through provision of safe drinking water, promote nutrition and avoid foods with high fluoride content. Ingestion of excess fluoride, most commonly in drinking-water affects the teeth and bones. Gros Islet, St Lucia. Mitigation of fluorosis—a review. and numerous other drugs that contain fluoride can contribute to fluoride toxicity over time. It is also known that fluorosis, in its severe forms, is mostly restricted to a particular climate zone in the world — the areas with semi-arid tropical conditions. del Carmen Aguilar-Diaz F, Federico Morales-Corona F, Cintra-Viveiro AC, Fuente-Hernández J. London: Lewis; 1937. When there is pain and stiffness, it would not be possible to touch the back of the head. Google Scholar, Radiology Department, Orthopaedic Institute M T Kassab, University of Tunis El Manar- Faculty of Medicine of Tunis, Ksar Said, 2010, Manouba, Tunisia, Meriem Sellami, Hend Riahi, Mouna Chelli Bouaziz & Mohamed Fethi Ladeb, Rheumatology Department, Orthopaedic Institute M T Kassab, University of Tunis El Manar- Faculty of Medicine of Tunis, Manouba, Tunisia, You can also search for this author in Datta P, Datta PP. PubMed Central  Special focus is laid on updating the information for medical personnel/doctors to recognize the disease. This method is also suitable for both community and household levels. Sci Total Environ. (l) Physical tests for detection of skeletal fluorosis in endemic areas- (a)The subject is asked to lift a coin from the floor without bending the knee. 2011;96:2318–24. Chen J, Liu G, Kang Y, et al. Gastrointestinal symptoms settle within 15 days. Skeletal fluorosis is not clinically obvious and can be confused with other rheumatologic disorders. Numan Tamer M, Kale Köroğlu B, Arslan C, Akdoğan M, Köroğlu M, Çam H, et al. 2017;167:9–17. Beausejour Road North Entrance, Sensitizing the community with information on fluorosis, importance of drinking safe water and about healthy diet are important for prevention and control of fluorosis. (lll)SA/GAG test (Sialic acid / Glycosaminoglycan test) -The SA/GAG test is for early detection/diagnosIs of fluoride toxicity. Radiological features of long-standing hypoparathyroidism. PubMed  © 2020 Springer Nature Switzerland AG. Gupta N, Gupta N, Chhabra P. Image diagnosis: dental and skeletal fluorosis. Mechanism after fluoride intake: Once fluoride enters the body either through the blood vessels in the mouth or through the gastrointestinal route, it reaches the various organs and tissues in the body. Risk assessment of fluoride exposure in drinking water of Tunisia. There are similar belts in the Americas and Japan. 2013;1:117–23. 2015;44:321–38. In advanced cases, skeletal fluorosis causes painful damage to bones and joints. Eur Spine J. 2009;16:828–30. Yildiz M, Akdoğan M, Tamer N, Oral B. Simon MJ, Beil FT, Riedel C, et al. There is no treatment for severe cases of skeletal fluorosis, only efforts can be made towards reducing the disability which has occurred. 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