There has been a growing concern over the occurrence of fluoride (F−) in groundwater and the impact of F− exposure on human health issues over the past decades. So, this study conducted a regional–scale assessment of the occurrence and trend of groundwater F− distribution [2014–2018] integrated with locally field–based investigations on F− exposure to a few selected families (10 households and 35 respondents) and reason behind their consumption of F− containing water (n = 18). In the local study, water samples were collected from multiple sources around the selected households by dividing them into consumptive and non–consumptive use. Results revealed that across the state of Andhra Pradesh, the occurrence of F− is more than the permissible limit in groundwater, and it has been increasing over the years (2014–2018) (average SD is 0.55), and the local study showed that the groundwater had an average of 1.5 mg/L F−, while other sourced water had an average of <1 mg/L F−. Most interestingly, nine families are consuming non–F− containing water (<0.52 mg F−/day) which is commercially available, while only one family is consuming F− containing groundwater and being exposed to >3 mg F−/day. This disparity in fluoride exposure is dependent on economic stability and health exposure policies.
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