Fluoridated Areas Research Articles

Effect of fluoride in drinking water on children′s intelligence in high and low fluoride areas of Delhi

Introduction: Fluoride is one of the indispensable elements for the living being. However, the intake of F above the threshold level can affect the central nervous system even before causing dental or skeletal fluorosis. Aim: The aim was to assess the effect of fluoride in drinking water on the intelligence quotient (IQ) of 8-12 years old school going children residing in high and low Fluoride (F) areas of Delhi. Materials and Methods: A total of 200 school children were selected, 100 from low F area and 100 from high F area. The IQ of the children was assessed using Ravens Standardized Progressive Matrices Test. Information for each child's sociodemographic data, mother's diet during pregnancy, duration of residency in the village, source of drinking water, and duration of drinking water from the source was entered on a specially designed proforma from mothers of children. Height and weight were also recorded for each child to assess the nutritional status. Independent t-test and Chi-square test was used to compare mean IQ scores in high and low fluoridated areas. Pearson's correlation and multivariate linear regression were used to appraise the issue of all the study variables on IQ. Results: Comparison of mean IQ of children in both high (76.20 ± 19.10) and low F (85.80 ± 18.85) areas showed a significant difference (P = 0.013). Multiple regression analysis between child IQ and all other independent variables revealed that mother's diet during pregnancy (P = 0.001) along with F in drinking water (P = 0.017) were the independent variables with the greatest explanatory power for child IQ variance (r2 = 0.417) without interaction with other variables. Conclusion: Fluoride in the drinking water was significantly related with the IQ of children. Along with fluoride, mother's diet during pregnancy was also found to be significantly related with IQ of children. Researches in the same field are further advocated with large sample size and over a large geographical area.

Concentration of Fluoride in Cow's and Buffalo's Milk in Relation to Varying Levels of Fluoride Concentration in Drinking Water of Mathura City in India- A Pilot Study.

To estimate fluoride concentration in drinking water, cow's milk and buffalo's milk and to correlate the concentration of fluoride in cow's milk and buffalo's milk with varying levels of fluoride concentration in drinking water. Ten households having both cows and buffalo's were selected by convenience in each of the 3 zones (below optimum fluoride <0.7 ppm (parts per million), optimum fluoride 0.7-1.2 ppm and above optimum fluoride areas > 1.2 ppm). From these selected households, 200 ml of fresh milk of both cows and buffaloes was collected along with 200 ml of drinking water for estimation of fluoride concentration by using a fluoride ion selective electrode method. The data was analysed using SPSS, version 11.5 for windows. The mean fluoride concentration of drinking water, cow's milk and buffalo's milk in three different fluoride zones was 0.89±0.39, 0.09±0.07, 0.09±0.08 respectively. Pearson's correlation found a statistically significant correlation between fluoride concentrations in cow's and buffalo's milk with varying levels of fluoride concentration in drinking water in zone B and zone C. However, this correlation was not statistically significant in zone A. With an increase in fluoride concentration in drinking water there was an increase in concentration of fluoride in cow's and buffalo's milk. We conclude that this association is seen in conjunction to not only a single factor but rather due to culmination of several other aspects. So, there is a need to elucidate the other factors that might be contributing to this increase and dental fluorosis.

Relationship Between Dental Fluorosis and Intelligence Quotient of School Going Children In and Around Lucknow District: A Cross-Sectional Study.

Fluoridation of drinking water, despite being regarded as one of the top ten public health achievements of the twentieth century, has remained a much debated concept. Various studies on animals and aborted human fetuses have confirmed that excessive fluoride intake during infancy and early childhood, causes a number of irreversible structural and functional changes in the CNS leading to memory, learning and intellectual deficits. To compare the IQ levels of school children of two different locations, having different fluoride levels in water, and to establish a relationship between fluoride levels, prevalence of fluorosis and its effect on IQ levels. A cross-sectional study was conducted among 429 children aged 6 - 12 years, selected by stratified random sampling from two different areas with different levels of fluoride in drinking water in and around Lucknow district. Dental fluorosis was measured using Dean's Fluorosis Index. Intelligence Quotient was measured using Raven's Coloured Progressive Matrices (1998 edition). Majority of the fluorosis free children (76.3%) had an IQ grade 2 (definitely above the average). Majority of the children suffering from very mild and mild dental fluorosis were found to have IQ grade 3 (Intellectually average). Children with moderate cases of dental fluorosis were found to have IQ grade 4 (Definitely below average). Only 5 children with severe fluorosis were included in the study and they all were found to have an IQ grade 5. Hence, a trend of increase in the IQ grade (decrease in intellectual capacity) was observed indicating a strong correlation between fluorosis grade and IQ grade. Findings of this study suggest that the overall IQ of the children exposed to high fluoride levels in drinking water and hence suffering from dental fluorosis were significantly lower than those of the low fluoride area.

Association of Temporomandibular Joint Signs & Symptoms with Dental Fluorosis & Skeletal Manifestations in Endemic Fluoride Areas of Dungarpur District, Rajasthan, India.

Endemic fluorosis resulting from high fluoride concentration in groundwater is a major public health problem. India is among the numerous nations, where fluoride sullied groundwater is creating wellbeing issues. Safe drinking water in rural areas of India is predominantly rely on groundwater sources, which are exceptionally contaminated with fluoride. To investigate the association of temporomandibular joint Signs & Symptoms with Dental Fluorosis & Skeletal Manifestations among people living in Dad, Bokersal & Deotalab villages of Dungarpur District, Rajasthan, India. The study group consisted of 750 subjects who were born & brought up in Dad, Bokersal & Deotalab villages of Dungarpur District, Rajasthan. Temporomandibular joint & Dental fluorosis was assessed by performing type III clinical examination according to WHO guidelines (1997). For the assessment of skeletal manifestations, participants were asked to perform three diagnostic tests: (1)Touching the toes without bending the knees; (2) Touching the chest with the chin; (3) Stretching the arms sideways & folding the arms to touch the back of the head. Chi Square test & Multiple Logistic Regression were applied for statistical analysis. Among the 750 (462 males & 288 females) who participated in the study, 53% had moderate grade of dental fluorosis. The most prominent symptom suggesting Temporomandibular Joint Disorder was the clicking sound affecting 21.4% population.(p>0.001). TMJ Signs & Symptoms were prominent in the age group of 45-54 years & males were highly affected than females. Clinical examination of TMJ in Dental Fluorosis & Skeletal Fluorosis subjects showed a significant association with Dental Fluorosis & Skeletal Fluorosis.

Variation in fluorosis and caries experience among Lithuanian 12year olds exposed to more than 1ppm F in tap water.

The aim of the present study was to analyze caries experience in relation to the occurrence of fluorosis in 12 year olds in a natural fluoride area. This cross-sectional study was conducted among 12-year-old lifetime residents (n = 301) of Klaipeda, Lithuania, where the natural fluoride content is 1.7-2.2 ppm F. Data collection included a clinical dental examination and an inquiry about toothbrushing habits. Dental caries was diagnosed according to the World Health Organization criteria and described in terms of decayed, missing, and filled teeth (DMFT)/decayed, missing and filled surfaces (DMFS) indices and decayed, filled surfaces (DFS) on selected proximal surfaces. Dental fluorosis was diagnosed according to the Thylstrup-Fejerskov (TF) index and categorized as none (TF = 0), mild (TF = 1-2), moderate (TF = 3-7), or severe (TF = 8-9). The χ(2)-, Kruskal-Wallis, and Mann-Whitney tests, Pearson's correlation, and linear regression served for statistical analyses. A total of 34% of the 12 year olds studied had no signs of fluorosis, while the rest had mild (42%) or moderate (24%) fluorosis. Caries experience was negatively related to the presence of fluorosis. When present (TF > 0), the mean DMFT was 1.8 (standard deviation [SD]: 1.7) versus 2.6 (SD: 2.3) in the absence of fluorosis (TF = 0, P = 0.008). The corresponding mean DMFS values were 2.6 (SD: 3.1) versus 3.8 (SD: 4.3, P = 0.014). The presence of fluorosis associates with lesser caries experience in 12-year-old lifetime residents of an area with moderately-elevated natural fluoride.

Recovery of high specific area silica and sodium fluoride from sodium hexafluorosilicate

Sodium fluoride and high specific area silica were synthesized by using sodium hexafluorosilicate (Na2SiF6) and sodium carbonate decahydrate (Na2CO3·10H2O). The influencing factors of react temperature, contact time, sodium dodecyl sulfate (SDS) and molar ratio of Na2SiF6 to Na2CO3·10H2O were investigated. The optimum process involves the reaction of 0.075 mol Na2SiF6 and 150 mL, 0.225 mol Na2CO3·10H2O (molar ratio of 1:3) at 85 °C for 90 min, and 2.0×10−3 mol sodium dodecyl sulfate (SDS) as additive. The results show that the purities of SiO2 and NaF at extraction yields of 96.5% and 98.0% are 91.0% and 98.6%, respectively. The obtained SiO2 were characterized by X-ray diffraction (XRD), scanning electron microscope (SEM), Fourier transform infrared ray (FTIR), differential scanning calorimetry and thermogravimetric analysis (DSC-TGA), N2 absorption/desorption (BET) and laser particle size analyzer. The result demonstrates that SiO2 particles have a high BET surface area of 103 m2/g, and a mean grain size of 985 nm.

Prevention of early childhood caries (ECC) through parental toothbrushing training and fluoride varnish application: A 24-month randomized controlled trial

ObjectivesTo investigate the effectiveness of hands-on training in parental toothbrushing, with or without semi-annual applications of 5% sodium fluoride varnish in preventing ECC. MethodsStudy was conducted in Hong Kong where water is optimally fluoridated. Children aged 8–23 months were recruited and randomly allocated to one of three groups: Gp 1 – control, one-off oral health education talk to parents; Gp 2 – oral health education talk and parental toothbrushing training, reinforced every 6 months; Gp 3 – semi-annual application of fluoride varnish onto child's teeth in addition to the intervention provided to Gp 2. Clinical examinations of the children and interviews were conducted at baseline and after 24 months to assess the children's dental caries status and toothbrushing behaviour. ResultsOut of the 450 child–parent dyads recruited at baseline, 415 (92%) remained after 24 months. At baseline, 2% of the children had non-cavitated enamel caries lesions and the mean dmft score was 0.03±0.24. Most of the children did not have daily parental toothbrushing (65–73%) and self toothbrushing (86–90%). At 24-month follow-up, including both non-cavitated and cavitated carious lesions, the incidences of ECC in Gp 1 to Gp 3 were 11.9%, 11.8%, and 17.5%, respectively (p>0.05); and the mean new dmft scores in Gp 1 to Gp 3 were 0.3, 0.2, and 0.3, respectively (p>0.05). Proportions of parents who practiced parental toothbrushing twice daily were 62.7%, 60.4%, and 65.7% in Gp 1 to Gp 3, respectively (p>0.05). ConclusionsIn a water fluoridated area, hands-on training in parental toothbrushing, with or without semi-annual application of 5% sodium fluoride varnish may not have additional effect on preventing ECC in young children with low risk of dental caries compared to provision of oral health education to parents. Clinical significanceIn a water fluoridated area, provision of individual oral health education to parents may be sufficient for preventing ECC in young children below age 3. Supplemental training in parental toothbrushing and semi-annual applications of fluoride varnish may not have additional caries prevention effect in young children with low risk of dental caries.

Evaluation of fresh and stored rainwater quality in fluoride and arsenic endemic area of Thar Desert, Pakistan.

In the current study, the chemistry of fresh and stored rainwater of Thar Desert, Pakistan, was estimated during two consecutive monsoon periods. The present research deals with the variation in physicochemical parameters, total arsenic (As(t)), inorganic arsenic species (As(i), As(V), As(III)), and fluoride (F(-)) in stored rainwater (SRW) at different time intervals (1week to 3months). The pH of fresh rainwater (FRW) samples showed slightly acidic to neutral in nature (6.08-7.06) which were inconsistent with the reference pH value (5.6) of rainwater. The resulted data indicated that As(t) and F(-) levels in SRW were enhanced with time duration. The levels of As(t) and F(-) in SRW after different time intervals were found in the range of 194-683μg/L and 10-35.4mg/L, respectively. The values of As(t) and F(-) were 20-70 and 7-24 times higher than those of WHO permissible limits, 10μg/L and 1.5mg/L, respectively. The As(III) was dominant species in SRW, which corresponds to >60% of As(i). The characteristics of the SRW revealed an unacceptable quality to consume for drinking and agricultural purposes in the studied area.

A reappraisal of the quantitative relationship between sugar intake and dental caries: the need for new criteria for developing goals for sugar intake.

BackgroundThere is a clear relation between sugars and caries. However, no analysis has yet been made of the lifetime burden of caries induced by sugar to see whether the WHO goal of 10% level is optimum and compatible with low levels of caries. The objective of this study was to re-examine the dose-response and quantitative relationship between sugar intake and the incidence of dental caries and to see whether the WHO goal for sugar intake of 10% of energy intake (E) is optimum for low levels of caries in children and adults.MethodsAnalyses focused on countries where sugar intakes changed because of wartime restrictions or as part of the nutritional transition. A re-analysis of the dose-response relation between dietary sugar and caries incidence in teeth with different levels of susceptibility to dental caries in nationally representative samples of Japanese children. The impact of fluoride on levels of caries was also assessed.ResultsMeticulous Japanese data on caries incidence in two types of teeth show robust log-linear relationships to sugar intakes from 0%E to 10%E sugar with a 10 fold increase in caries if caries is assessed over several years’ exposure to sugar rather than only for the first year after tooth eruption. Adults aged 65 years and older living in water fluoridated areas where high proportions of people used fluoridated toothpastes, had nearly half of all tooth surfaces affected by caries. This more extensive burden of disease in adults does not occur if sugar intakes are limited to <3% energy intake.ConclusionsThere is a robust log-linear relationship of caries to sugar intakes from 0%E to 10%E sugar. A 10%E sugar intake induces a costly burden of caries. These findings imply that public health goals need to set sugar intakes ideally <3%E with <5%E as a pragmatic goal, even when fluoride is widely used. Adult as well as children’s caries burdens should define the new criteria for developing goals for sugar intake.

Physiologic and Metabolic Benefits of Formulated Diets and Mangifera indica in Fluoride Toxicity

ABSTRACTFluorosis is a major health problem affecting normal physiological and metabolic functions in people living in endemic fluoride areas. The present work was aimed at investigating the role of basal, high carbohydrate low protein (HCLP) and high protein low carbohydrate (HPLC) diets and Mangifera indica fruit powder as a food supplement in fluoride-induced metabolic toxicity. Exposure to fluoride resulted in elevation of plasma glucose levels, ACP, ALP, SGPT, SGOT, and hepatic G-6-Pase activities, plasma and hepatic lipid profiles with decreased plasma protein, HDL-C, hepatic glycogen content and hexokinase activity in basal, HCLP and HPLC diet fed albino rats. However among the three diets tested, HPLC diet was found to be relatively, a better metabolic regulator. All the three formulated diets (basal, HCLP and HPLC) supplemented with mango fruit powder (5 and 10 g), decreased plasma glucose content, ACP, ALP, SGPT, SGOT and hepatic G-6-Pase activities and plasma as well as hepatic lipid profiles. These diets also elevated the hepatic glycogen content and hexokinase activities. These effects however, were prominent with the HPLC diet supplemented with mango fruit powder and, among the two doses of mango fruit powder, the higher dose (10 g) yielded more promising results. It is surmised that the micronutrients and phytochemicals present in the diets and the mango fruit could be responsible for attenuation of fluoride-induced metabolic toxicity.

Dental Survey for Adolescent at Anseong-si as Water Fluoridated Area

Dental Survey for Adolescent at Anseong-si as Water Fluoridated Area

Dental Survey at Okcheon County as Water Fluoridated Area

Dental Survey at Okcheon County as Water Fluoridated Area

Effects of Life-long Fluoride Intake on Bone Measures of Adolescents

Controversy persists concerning the impact of community water fluoridation on bone health in adults, and few studies have assessed relationships with bone at younger ages. Ecological studies of fluoride’s effects showed some increase in bone mineral density of adolescents and young adults in areas with fluoridated water compared with non-fluoridated areas. However, none had individual fluoride exposure measures. To avoid ecological fallacy and reduce bias, we assessed associations of average daily fluoride intake from birth to age 15 yr for Iowa Bone Development Study cohort members with age 15 yr dual-energy x-ray absorptiometry (DXA) bone outcomes (whole body, lumbar spine, and hip), controlling for known determinants (including daily calcium intake, average daily time spent in moderate-to-vigorous intensity physical activity, and physical maturity). Mean (SD) daily fluoride intake was 0.66 mg (0.24) for females and 0.78 mg (0.30) for males. We found no significant relationships between daily fluoride intake and adolescents’ bone measures in adjusted models (for 183 females, all p values ≥ .10 and all partial R2 ≤ 0.02; for 175 males, all p values ≥ .34 and all partial R2 ≤ 0.01). The findings suggest that fluoride exposures at the typical levels for most US adolescents in fluoridated areas do not have significant effects on bone mineral measures.

A comparative study of fluoride ingestion levels, serum thyroid hormone &amp; TSH level derangements, dental fluorosis status among school children from endemic and non-endemic fluorosis areas

The study was undertaken to determine serum/urinary fluoride status and comparison of free T4, free T3 and thyroid stimulating hormone levels of 8 to 15 years old children with and without dental fluorosis living in an endemic and non-endemic fluorosis area. A sample group of 60 male and female school children, with or without dental fluorosis, consuming fluoride-contaminated water in endemic fluoride area of Udaipur district, Rajasthan were selected through a school dental fluorosis survey. The sample of 10 children of same age and socio-economic status residing in non endemic areas who did not have dental fluorosis form controls. Fluoride determination in drinking water, urine and blood was done with Ion 85 Ion Analyzer Radiometer with Hall et al. method. The thyroid gland functional test was done by Immonu Chemiluminiscence Micropartical Assay with Bayer Centaur Autoanalyzer.The significantly altered FT3, FT4 and TSH hormones level in both group1A and 1B school children were noted. The serum and urine fluoride levels were found to be increased in both the groups. A significant relationship of water fluoride to urine and serum fluoride concentration was seen. The serum fluoride concentration also had significant relationship with thyroid hormone (FT3/FT4) and TSH concentrations. The testing of drinking water and body fluids for fluoride content, along with FT3, FT4, and TSH in children with dental fluorosis is desirable for recognizing underlying thyroid derangements and its impact on fluorosis.

Dental Fluorosis and Dental Caries Prevalence among 12 and 15-Year-Old School Children in Nalgonda District, Andhra Pradesh, India.

Background:Fluoride is a double edged sword. The assessment of dental caries and fluorosis in endemic fluoride areas will facilitate in assessing the relation between fluoride concentrations in water with dental caries, dental fluorosis simultaneously.Aim:The objective of the following study is to assess the dental caries and dental fluorosis prevalence among 12 and 15-year-old school children in Nalgonda district, Andhra Pradesh, India.Subjects and Methods:This was a cross-sectional study. Two stage cluster sampling technique was employed to select 20 schools from Nalgonda district. The oral examination of available 12 and 15-year-old children fulfilling the inclusion and exclusion criteria was carried out to assess dental caries and fluorosis. The examination was conducted by a single trained and calibrated examiner using the mouth mirror and community periodontal index probe under natural daylight. These areas were divided into four categories, low, medium, high and very high fluoride areas based on the fluoride concentration at the time of statistical analysis. The data was analyzed using Statistical Package for the Social Sciences version 16 (IBM, Chicago, USA).Results:The caries prevalence was less among 12-year-old children (39.9% [369/924]) compared with 15-years-old children (46.7% [444/951]). The prevalence was more among females (50.4% [492/977]) than males (35.8% [321/898]). The prevalence was more in low fluoride area (60.5% [300/496]) followed by very high fluoride area (54.8% [201/367]), high fluoride area (32.4% [293/904]) and medium fluoride area (17.6% [19/108]) in the descending order. The fluorosis prevalence increased with increasing fluoride concentration with no difference in gender and age distribution.Conclusion:Low fluoride areas require fluoridation or alternate sources of fluoride, whereas high fluoride areas require defluoridation. Defluoridation of water is an immediate requirement in areas with fluoride concentration of 4 parts per million and above as dental fluorosis is a public health problem in these areas with 100% prevalence.

Fluoride intake of infants living in non-fluoridated and fluoridated areas

Data on fluoride exposure of infants are sparse. This study aimed to estimate total daily fluoride intake (TDFI) of infants aged 1-12 months, living in non-fluoridated and fluoridated areas in north-east England. Daily dietary fluoride intake was assessed using a three-day food diary coupled with analysis of fluoride content of food/drink consumed, using a F-ISE and diffusion method. A questionnaire with an interview was used to collect information on toothbrushing habits. TDFI was estimated from diet, plus fluoride supplements and dentifrice ingestion where used. Thirty-eight infants completed the study; 19 receiving fluoridated water (mean 0.97 mgF/l) and 19 receiving non-fluoridated water (mean 0.19 mgF/l). Mean (SD) TDFI for the infants living in fluoridated and non-fluoridated areas was 0.107 (0.054) and 0.024 (0.015) mg/kg body weight per day, respectively. Diet was the only fluoride source for 87% of infants and none used fluoride supplements. For infants for whom mouth/teeth cleaning was undertaken, dentifrice contribution to TDFI ranged from 24 to 78%. Infants living in fluoridated areas, in general, may receive a fluoride intake, from diet only, of more than the suggested optimal range for TDFI. This emphasises the importance of estimating TDFI at an individual level when recommendations for fluoride use are being considered.

Summary of: Fluoride intake of infants living in non-fluoridated and fluoridated areas

Data on fluoride exposure of infants are sparse. This study aimed to estimate total daily fluoride intake (TDFI) of infants aged 1-12 months, living in non-fluoridated and fluoridated areas in north-east England. Daily dietary fluoride intake was assessed using a three-day food diary coupled with analysis of fluoride content of food/drink consumed, using a F-ISE and diffusion method. A questionnaire with an interview was used to collect information on toothbrushing habits. TDFI was estimated from diet, plus fluoride supplements and dentifrice ingestion where used. Thirty-eight infants completed the study; 19 receiving fluoridated water (mean 0.97 mgF/l) and 19 receiving non-fluoridated water (mean 0.19 mgF/l). Mean (SD) TDFI for the infants living in fluoridated and non-fluoridated areas was 0.107 (0.054) and 0.024 (0.015) mg/kg body weight per day, respectively. Diet was the only fluoride source for 87% of infants and none used fluoride supplements. For infants for whom mouth/teeth cleaning was undertaken, dentifrice contribution to TDFI ranged from 24 to 78%. Infants living in fluoridated areas, in general, may receive a fluoride intake, from diet only, of more than the suggested optimal range for TDFI. This emphasises the importance of estimating TDFI at an individual level when recommendations for fluoride use are being considered.

Prevalence of malocclusion among 15-year-old school children using dental aesthetic index in Nalgonda district, Andhra Pradesh, India: A cross-sectional study

Background: The available literature on the prevalence of malocclusion among school children in endemic fluoride areas in India is scanty. Objectives: The objective was to assess the prevalence of malocclusion using dental aesthetic index (DAI) and its association with gender, area of residence, and fluoride concentration among 15-year-old school children. Materials and Methods: This cross-sectional study was conducted among 15-year-old school children in the rural and urban areas of Nalgonda district, Andhra Pradesh, India. Two-stage cluster sampling was used for selecting the eligible children. Six out of 59 mandals in Nalgonda district were selected by simple random sampling technique. All the secondary schools in rural and urban areas of these mandals were listed and subsequently, four schools from each of these mandals were selected using random sampling. All eligible children aged 15 years were selected and assessed for malocclusion using Dentofacial anomalies with criteria of DAI by three trained and calibrated dentists. The DAI in relation to gender and area of residence were compared and analyzed using SPSS 16. Student's t-test and one-way ANOVA were used for comparing the mean values between groups. The qualitative data were analyzed using the Chi-square test. Results: A total of 1484 children was examined. The prevalence of malocclusion was 17.9%. The prevalence was significantly higher (P = 0.001) among females (23.6%) compared to males (13%). The prevalence was significantly higher (P = 0.001) in urban areas (22.2%) compared to rural areas (15%). The prevalence was significantly less (P = 0.001) in optimal (13%) and above optimal areas (8%) compared to below optimal areas (23%). Conclusion: The prevalence and severity of malocclusion were more among females, urban, and below optimal fluoride areas.

Chronic Alcohol Consumption and the Development of Skeletal Fluorosis in a Fluoride Endemic Area of the Ethiopian Rift Valley

This study compared the occurrence of skeletal fluorosis in chronic consumers of locally brewed alcoholic beverages and their matched controls in the Ethiopian Rift Valley. The study revealed that chronic alcohol consumers developed severe forms of crippling skeletal fluorosis quite early in life. The controls were either symptom-free or exhibited mild forms of the fluorosis. The study showed that crippling skeletal fluorosis was directly associated with the large volumes of the locally brewed beer and honey-mead consumption on a daily basis. Chemical analysis of the alcoholic beverages showed that high concentration of fluoride which was much higher than the fluoride in the water was used for the brewing process. From this study one would conclude that in communities residing in high fluoride areas, there should be awareness creation campaigns to point out the relationship of excessive consumption of locally brewed alcoholic drinks and skeletal fluorosis. Regulations should also be put in place to require producers of local alcoholic beverages to use low fluoride water for brewing.

Co-relation of body mass index, dental caries and periodontal status with fluorosis in different high fluoridated areas of Haryana state, India.

The aim of the present study is to compare the effect of corticotomy versus prostaglandin E1 injection in human subjects on rate of tooth movement, anchorage loss and their effect on crest bone height and root length. Clinical interventional study. Split mouth design was used. Study was done on 32 regular orthodontic patients. A volume of 100 mcg of prostaglandin E1 was injected on the right side once in 2 weeks and on the left side corticotomy was performed, and canine retraction was started on both sides simultaneously. The rate of space closure and anchorage loss was assessed with casts. The root length and crestal bone height changes were assed with IOPAs. The comparison of rate of tooth movement, anchorage loss, crestal bone height and root length changes between the sides were statistically analyzed using paired t-test. The average rate of space closure on right side was 0.36 mm/week with a standard deviation of 0.05 mm/week and on the left side average rate of space closure was 0.40 mm/week with a standard deviation of 0.04 mm/week. The difference between the rate of closure between the right side and left where found to be statistically significant (P=0.003). The anchorage loss, the crestal bone height changes and root length changes were not statistically significant. The rate of tooth movement was significantly more with corticotomies when compared with given dose of prostaglandin injection.