Fluoride Intake Research Articles

Evaluation of the potential value of artificial intelligence (AI) in public health using fluoride intake as the example.

We aimed to test whether and how ChatGPT understood the epidemiological problems related to fluoride intake and whether ChatGPT could produce novel and feasible hypotheses to tackle the challenges in the research for the disorders caused by a deficient or excessive fluoride intake. We designed a set of questions to evaluate the knowledge of ChatGPT version 4o on the epidemiological problems related to fluoride intake. Three evaluators then reviewed these answers. We then requested ChatGPT4o to produce hypotheses for the eight disorders related to insufficient or excessive fluoride intake. These hypotheses were then evaluated independently by three evaluators. Finally, summaries were made through group discussions among all the authors. For the three questions on basic knowledge about the effect of fluoride on public health, the answers from ChatGPT were rated as excellent or good. For the 12 answers from ChatGPT to the epidemiological questions, 8 out of 12 answers were graded A, as excellent. Four answers were rated as B for good. The descriptions provided by ChatGPT on the effects of fluoride intake were comprehensive and well-structured. Six out of 8 answers were graded as excellent and the other 2 as good. ChatGPT proposed a hypothesis for each of the 8 disorders that are caused by either a deficiency or excess level of fluoride. Four hypotheses were rated as novel and feasible. Three hypotheses were considered relatively new and feasible. Only one hypothesis was regarded as an established hypothesis. As AI technology develops, it can assist health professionals in understanding the disorders and researchers in their work on the mechanisms behind the disorders caused by insufficient or excessive fluoride intake.

Safe use of fluoride-containing toothpastes for caries prevention in children

Relevance. Following environmental rehabilitation efforts in Chapayevsk, Samara Region, an increase in the prevalence and severity of dental caries has been observed, particularly among preschool-aged children.Objective. To evaluate the safety of fluoride use for preventing dental caries in children.Material and methods. A survey was conducted among 124 parents of children aged 5–6 years attending preschools and 361 adolescents aged 12 and 15 years, using the WHO questionnaire (2013). Responses regarding oral hygiene habits were analyzed. Fluoride ion concentrations were measured in drinking water using the potentiometric method (GOST 4386-89 S.6), in urine according to GOST 8.563-96, and in toothpastes following GOST 7983-2016. The availability and popularity of fluoride-containing toothpastes in pharmacies and supermarkets were also assessed. Statistical analysis was performed using IBM SPSS Statistics v.26 (IBM Corporation).Results. Over the past 15 years, the fluoride content in drinking water decreased from 0.78–0.91 mg/L to 0.49– 0.71 mg/L following the city’s environmental rehabilitation efforts, remaining suboptimal for caries prevention. Analysis of fluoride excretion via the kidneys indicated low overall fluoride intake from water, toothpaste, and food. A weak correlation was found between the DMFT (decayed, missing, and filled teeth) index and urinary fluoride levels (ρ = 0.35), as well as estimated systemic fluoride levels (ρ = 0.36). These results indicate low fluoride intake, eliminating concerns about toxic effects on health. An analysis of toothpaste preferences showed that the population primarily chooses fluoride-free toothpastes or those with fluoride levels below 1000 ppm. This trend is influenced by the product range available, low adherence to preventive dental care, and misinformation from online sources that often attribute negative effects to fluoridation or raise safety concerns. The actual fluoride content in toothpastes was found to be within acceptable technological limits.

Tea Polyphenols Relieve the Fluoride-Induced Oxidative Stress in the Intestinal Porcine Epithelial Cell Model

Prolonged excessive intake of fluoride (F) can result in fluorosis, leading to a range of tissue oxidative damages. Therefore, mitigating the oxidative stress induced by fluorosis has become a significant research concern. Consequently, how to relieve oxidative stress caused by fluorosis is an urgent matter. In the present study, intestinal porcine epithelial (IPEC-J2) cells were chosen to explore the underlying mechanism of tea polyphenols (TPs) on F-induced oxidative stress. The results show that the cytotoxicity of IPEC-J2 cells induced by F presented a dose-dependent manner according to cell viability. Additionally, F treatment inhibited the activity of T-SOD, CAT, and GSH-Px as well as their transcription levels, increased the reactive oxygen (ROS) formation and cell damage rates, and then promoted cell apoptosis through the results of TUNEL and mitochondrial membrane potential detection when compared with the IPEC-J2 cells from the control group. As the main antioxidant ingredient in tea, TPs alleviated F-induced cell oxidation and apoptosis via blocking F-induced ROS generation and LDH’s release, as well as promoting the transcription of tight junction (TJ) proteins and the activities of antioxidant enzymes in IPEC-J2 cells. These results provide a new treatment strategy for F-induced intestinal oxidative impairment.

Urinary Fluoride Levels Among Youth in the National Health and Nutrition Examination Survey (NHANES) 2015-2016: Potential Differences According to Race.

Urinary fluoride (UF) is the most well-established biomarker for fluoride exposure, and understanding its distribution can inform risk assessment for potential adverse systemic health effects. To our knowledge, this study is the first to report distributions of UF among youth according to sociodemographic factors in a nationally representative United States (US) sample. The study included 1191 children aged 6-11 years and 1217 adolescents aged 12-19 years from the National Health and Nutrition Examination Survey (NHANES) 2015-2016. We examined UF according to sociodemographic variables as well as Spearman correlations between UF and plasma fluoride. Survey-weighted quantile regression examined associations between tap water fluoride and UF levels adjusted for covariates. The average age of participants was 12.5 years. The median (IQR) UF and water fluoride concentrations were 0.52 (0.50) mg/L and 0.39 (0.54) mg/L, respectively. Children had higher UF levels than adolescents and males had higher UF levels than females. UF differed according to race/ethnicity among both children and adolescents. Specifically, non-Hispanic Black youth tended to have higher UF levels than all participants except for those classified as other race/multiracial. UF and plasma fluoride were moderately correlated for children and adolescents. Higher water fluoride levels were associated with higher UF levels, and the magnitudes of association were larger at higher quantiles of UF (β = 0.14, p < 0.001; β = 0.20, p< 0.001 at the 25th and 50th quantiles, respectively). The magnitude of association between water fluoride and UF was the largest for non-Hispanic Black participants (predictive margin = 0.3, p < 0.001). Non-Hispanic Black youth in the US may have greater fluoride exposure and receive more of their fluoride intake from tap water than youth of other races/ethnicities. Factors contributing to potential racial/ethnic disparities in fluoride exposure within the US warrant further investigation so that they can be mitigated to reduce the potential for harm.

Broad-based targeted lipidomic analysis of dental fluorosis population in an adult population.

Dental fluorosis, as a common chronic fluoride toxicity oral disease, is mainly caused by long-term excessive intake of fluoride, which seriously affects the aesthetics and function of patients' teeth. In recent years, with the rapid development of metabolomics technology, lipidomics, as an important means to study the changes in lipid metabolism in organisms, has shown great potential in revealing the mechanisms of disease development. As a major component of cell membranes and a signaling molecule, metabolic disorders of lipids are closely related to a variety of diseases, but the specific mechanism of action in dental fluorosis is still unclear. Therefore, the present study aimed to systematically analyze the differences in lipid profiles between dental fluorosis patients and healthy populations by using broad-based targeted lipidomics technology to provide new perspectives on the pathogenesis of dental fluorosis. To this end, the researchers compared the salivary lipidome of healthy participants with the salivary micro lipidome of dental fluorosis patients. Their saliva samples were collected, and advanced broad-based targeted lipidomics technology, combined with a high-performance liquid chromatography-mass spectrometry (LC-MS) system, was used to comprehensively detect and quantify the lipids in the samples. The lipid data were processed and analyzed by bioinformatics to identify the unique patterns of changes in the lipid profiles of dental fluorosis patients and to verify the significance of these changes using statistical methods. Several glycerophospholipids, fatty acyls, and sphingolipids exhibited marked alterations in dental Among these, glycocholic acid, LPA (18:4), taurolithocholic acid-3-sulfate, lithocholic acid-3-sulfate, and taurochenodeoxycholic acid-3-sulfate were observed between dental fluorosis patients and healthy controls. taurochenodeoxycholic acid was significantly decreased, while PA (12:0_12:0) levels were significantly elevated. These findings suggest that These findings suggest that disturbances in lipid metabolism play a crucial role in developing dental fluorosis.

Association between ESR1 and COL1A1 gene polymorphisms and skeletal fluorosis in Tibetan, Kazakh, Mongolian and Russian populations, China.

Skeletal fluorosis is a chronic metabolic bone disease caused by excessive accumulation of fluoride in the bones. Previous studies have found that when the intake of tea fluoride is similar, the prevalence of skeletal fluorosis varies greatly among different ethnic groups, which may be related to different genetic backgrounds. Single nucleotide polymorphisms (SNPs) of estrogen receptor 1 (ESR1) and collagen type 1 α1 (COL1A1) were strongly associated with bone metabolism as well as bone growth and development, but their association with the risk of skeletal fluorosis has not been reported. To explore the incidence of skeletal fluorosis in different nationalities in the endemic fluorosis area of brick-tea type. To study the relationship between 4 SNPS of ESR1 and COL1A1 gene and skeletal fluorosis METHODS: A cross-sectional study was conducted in Inner Mongolia, Qinghai and Xinjiang. By including exclusion criteria, a total of 989 people were included in the study, demographic data were collected, and physical examinations and laboratory biochemical tests were performed. The X-ray of the participants were diagnosed according to the diagnostic criteria of Chinese endemic skeletal fluorosis (WS192-2008). Fluoride levels in tea or urine were measured using fluoride ion electrodes. SNP was evaluated using Sequenom-MassARRAY system. The prevalence of skeletal fluorosis varies among different nationalities. Binary logistic regression found that carried the ESR1 Rs9340799 G allele played a protective role in brick-tea-type fluorosis (OR=0.673[95% CI, 0.495,0.914]). Russians carried the COL1A1 Rs1800012 T allele had a significantly higher risk of developing skeletal fluorosis (OR=6.370 [95% CI, 1.413,28.715]). When stratified by sex, carriage of the T allele in COL1A1 Rs1800012 significantly increased the risk of developing skeletal fluorosis in Russian men. At the same time, changes in tea fluoride intake and older age can affect the effect of genetic background differences on the risk of skeletal fluorosis. Our data suggested that there may be a genetic component to the risk of skeletal fluorosis in participants of different ethnicities and that this difference could modified by tea fluoride intake, sex or age.

Abnormal methylation of Mill1 gene regulates osteogenic differentiation involved in various phenotypes of skeletal fluorosis in rats and methionine intervention.

Excessive fluoride intake can lead to skeletal fluorosis. Nutritional differences in the same fluoride-exposed environment result in osteosclerosis, osteoporosis, and osteomalacia. DNA methylation has been found to be involved in skeletal fluorosis and is influenced by environment and nutrition. In a previous study, we screened eight genes with differential methylation associated with various phenotypes of skeletal fluorosis. By combining gene functions, Mill1 gene was selected for subsequent experiments. First, we found that the Mill1 gene was hypomethylated and upregulated in osteosclerosis skeletal fluorosis, whereas it was hypermethylated and downregulated in osteoporosis/osteomalacia skeletal fluorosis. Similar results were obtained in the cell experiments. Subsequently, we validated the regulation of Mill1 gene methylation using DNMT1 and TET2 enzyme inhibitors. Furthermore, we knockdown and overexpression experiments confirmed its downregulation inhibited osteogenic differentiation, whereas osteogenic differentiation was promoted by its overexpression. These findings imply that abnormal methylation of the Mill1 gene triggered by fluoride under diverse nutritional conditions, regulates its expression and participates in osteogenic differentiation, potentially resulting in various phenotypes of skeletal fluorosis. Eventually, we use methionine for interventions both in vivo and in vitro. The results indicated that under normal nutrition and fluoride exposure followed by methionine intervention, the methylation levels of the Mill1 gene increased, whereas its high expression and enhanced osteogenic differentiation were restrained. This study offers a theoretical foundation for understanding the mechanism behind the various phenotypes of skeletal fluorosis through the perspective of DNA methylation and for employing nutrients to intervene in skeletal fluorosis.

Early Childhood Exposures to Fluorides and Cognitive Neurodevelopment: A Population-Based Longitudinal Study.

It is important to maintain confidence in the risk and benefit balance of major caries-preventive programs using fluoride. The ongoing debate about potential effects of early-life exposures to fluoride on cognitive neurodevelopment requires high-quality scientific evidence. This study aimed to investigate the potential effects of fluoride exposure on cognitive neurodevelopment assessed with the Wechsler Adult Intelligence Scale 4th edition (WAIS-IV) in an Australian population-based sample. The sample was selected from the National Child Oral Health Study (NCOHS) 2012-2014. NCOHS collected data on socioeconomic factors, oral health behaviors, and residential history to estimate percentage lifetime exposure to fluoridated water during the first 5 y of life (%LEFW). NCOHS children were also examined by trained and calibrated examiners to assess dental fluorosis (a reliable and valid individual biomarker of total fluoride intake during early childhood). The sample was followed up in 2022-2023 to collect data on cognitive neurodevelopment (intelligence quotient [IQ]) using the WAIS-IV, which was administered by trained and calibrated qualified psychologists. Multivariable regression models were generated to investigate associations between the 2 exposure measurements (%LEFW and dental fluorosis) with full-scale IQ (FSIQ) scores, controlling for important confounding effects. Hypotheses of noninferiority were also tested, contrasting different levels of exposure to fluoride. Some 357 participants aged 16 to 26 y completed the WAIS-IV, with a mean FSIQ score of 109.2 (95% confidence interval [CI]: 107.8-110.5). The estimates of the multivariable regression models demonstrated slightly higher FSIQ scores among the exposed than the nonexposed. The adjusted β of 100%LEFW versus 0%LEFW was 1.07 (95% CI: -2.86, 5.01) and of having dental fluorosis versus no fluorosis was 0.28 (95% CI: -3.00, 3.57). The hypothesis of noninferiority tests found that FSIQ scores of those exposed and nonexposed to fluoride were equivalent. The study provided consistent evidence that early childhood exposure to fluoride does not have effects on cognitive neurodevelopment.

Health Implications of Proinflammatory Cytokine Activity at Different Levels of Fluoride Exposure: A Systematic Review.

The chronic intake of excessive fluoride (F-) (> 1.5 mg/L) affects several tissues, organs, and systems. This represents a worldwide issue due to the presence of the compound in nature, with drinking water being the main source of exposure. The underlying mechanisms by which F- is toxic are not completely understood, but proinflammatory cytokine activity is implicated in these events. The aim of this study was to perform a systematic review of the health implications of proinflammatory cytokine activity at different levels of F- exposure. The search for original studies in which the activity of proinflammatory cytokines was assessed under exposure to F- was performed using the PubMed, Scopus, Springer, EBSCO, and Google Scholar databases by applying the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The study protocol was registered with PROSPERO (CRD42024546726). Sixteen studies were analyzed in the present review. Tumor necrosis factor-alpha (TNF-α), interleukin (IL)-1 beta (β), IL-6, IL-2, IL-12, IL-17, IL-18, C-reactive protein, and transforming growth factor-β (TGF-β) were the proinflammatory cytokines identified in the included reports. Alterations in cytokine activity were observed in response to varying levels of F- exposure, implicating an increased risk of toxicity and damage to the evaluated structures by highlighting the role of inflammation in the progression of these processes. Hence, the activity of proinflammatory cytokines at different levels of F- exposure has important implications for health, where inflammation plays a relevant role in the underlying mechanisms related to the resulting toxicity.

Comparative Analysis of Fluoride Removal Efficacy of Drinking Water with Moringa Oleifera Seeds, Leaves and its Barks as Economic and Cost-Effective Bioadsorbents

ABSTRACT Background: Fluorides are the most important pollutants present in the effluents from various industrial and groundwater sources. These are very poisonous to living beings and have a dangerous effect on their health. Fluoride in drinking water within permissible limits of 0.5-1.0 mg/L is useful for the production and of maintenance healthy, teeth and bones as extreme intake of fluoride causes dental and skeletal fluorosis. Thus the removal of fluoride using adsorbents is a main step towards the protection of environment. Methods: The water samples are collected from wells of Salem district. Previous to sampling, the water is left to run from the source for few minutes. The study for presence of fluoride in groundwater samples is carried out as per APHA standard methods. Fluoride concentration be determined with SPADNS method spectrometric ally by use zirconyl-SPADNS (sodium 2-(parasulphophenylazo)-1, 8-dihydroxy-3, 6-naphthalene-disulphonate) reagents. Results: The significant difference in average score is tested through the analysis of variance after testing the normality test and it shows there is highly significant difference is found in the Fluoride Removal with respect to Moringaoleifera seeds, Moringaoleifera leaves, Moringaoleifera barks since the p value is less than 0.01. Conclusion: Drinking water is an essential basic need. The use of adsorbents is simple, cheap, non-toxic and environmentally friendly, its adoption for the defluoridation of drinking water. Based on the results of this study, it can be concluded that the low-cost adsorbents are effective in removal of fluoride from water.

Synergistic effects of vitamin C mitigates sodium fluoride-induced dental fluorosis and allergic immune responses in mice

Fluoride consumption through food and drinking water above permissible levels poses serious health risks. Managing fluoride intake from community water sources is a considerable challenge. This study aimed to understand the synergistic effect of vitamin C supplementation in a mouse model exposed to sodium fluoride (NaF) and ovalbumin (OVA) allergen. In brief, Balb/c mice received 100 ppm NaF daily in drinking water and intragastrical administration of 5 mg OVA as a food allergen. Further, OVA-specific IgE and IgG1 humoral immune responses, leukocytes infiltration, and histopathological alterations in tissues of the liver, kidney, thymus and spleen were analysed by ELISA and microscopic examination. Results showed that NaF and OVA administration developed clinical symptoms of food allergy, followed by dental fluorosis in the lower incisors, evidenced by Thylstrup-Fejerskov index in mice. Besides, Vitamin C supplementation, as a potential antioxidant and anti-allergic molecule effectively reduced the symptoms of food allergy, dental fluorosis, eosinophils infiltration, and histological alterations in mice which exposed to sodium fluoride and OVA allergen. In conclusion, the study provides compelling evidence that vitamin C might be a potential therapeutic drug for mitigating both dental fluorosis and food allergy induced by excessive fluoride intake through food and water.

The influence of dental fluorosis on shear bond strength: a systematic review protocol

Dental fluorosis, a condition characterized by enamel hypoplasia caused by excessive fluoride intake, can potentially affect the adhesion of dental materials. This systematic review aimed to assess the influence of dental fluorosis on shear bond strength (SBS) and to provide clinical recommendations. A comprehensive search of electronic databases was conducted, followed by a rigorous selection process to include relevant in vitro studies. The quality of the included studies was assessed and data were extracted for analysis. Based on these findings, it is recommended to consider alternative bonding techniques or to use specific dental materials for fluorosis-affected teeth. Further research is needed to elucidate the mechanisms underlying the potential impact of dental fluorosis on shear bond strength and develop more targeted clinical strategies.

Exposure and probable ingestion of fluoride through non-dietary edible items from Panipat (NCR), India.

The present study revealed that various non-dietary items like pan masala, chewing tobacco, betel nuts, and toothpaste may contribute to the fluoride burden of the human body. In this line, an attempt was made to analyze the fluoride content of non-dietary items collected from Panipat City of Haryana. The study depicts that intake of pan masala, chewing tobacco, betel nuts, and toothpaste expose the consumers to 21.0 to 56.80, 18.00 to 36.20, 7.45 to 77.40, and 21.10 to 1118.20µg fluoride/g respectively. The demand for these non-essential edible items is increasing daily, and people are unaware of the detrimental health effects of these products. The people of the study area are advised to prohibit these products as they contain an appreciable amount of fluoride.

ФЛЮОРОЗ ВРЕМЕННЫХ ЗУБОВ: ОБЗОР ЛИТЕРАТУРЫ

Subject. Foreign and domestic studies on fluorosis of primary teeth. Dental fluorosis is a malformation in which the structure of hard dental tissues of the teeth changes during their formation due to excessive fluoride intake. There are many studies on fluorosis of permanent teeth. Problems associated with fluorosis of primary teeth are covered much less frequently. An analysis of such studies is presented in this review. Objectives. Analysis of foreign and domestic studies on fluorosis of primary teeth. Methodology. The search for publications was carried out on the PubMed platform, in the eLibrary electronic library and in the MEDLINE databases, according to the specified keywords. In the course of the research, an independent search and analysis of scientific articles was carried out, as well as their systematization and ordering in the reference lists of literature. Results. During the analysis of literary sources it was revealed that fluorosis also occurs in prinary teeth, the prevalence of the disease in some countries was determined, the features of fluorosis in prinary teeth and the factors of its occurrence were identified. The main problems have been identified in the form of a lack of data on methods of prevention of caries of primary teeth and features of its treatment in children living in the endemic zone of fluorosis. Conclusion. The analysis of the available literature sources shows that the topic of fluorosis of primary teeth is insufficiently covered. In foci of endemic fluorosis, along with fluorosis of permanent teeth, fluorosis of temporary teeth is also found. In primary teeth, a mild and very mild degree of fluorosis is more often observed. The most pronounced changes are visualized on the teeth of the chewing group, especially on the primary second molars, which are formed at later stages of development. This pattern may indicate that fluorosis of primary teeth is mainly due to postnatal exposure to fluoride. Fluorosis of primary teeth can be a predictor of fluorosis of permanent teeth. Dental fluorosis is an important medical and social problem that requires further study and updating of treatment and preventive measures.

Spatial distribution of groundwater quality and risk indices evaluation via consumption

Groundwater is a valuable source for drinking and irrigation use and is the primary concern of developing countries. Therefore, the current study investigated groundwater in the Mirpur District of Azad Jammu and Kashmir, Pakistan, for drinking and irrigation purposes. Groundwater was sampled from the Jatlan, Mirpur, and Dadyal towns of studied district and analyzed for physicochemical parameters. Groundwater results revealed that the WHO's upper limits were not surpassed for physiochemical parameters, except for pH value (11.7% samples). Groundwater was evaluated for various quality and risk indices. Based on the water quality index (WQI), groundwater was categorized as excellent to good for drinking use. For irrigation uses, 11.7% of Mirpur and 5.8% of Dadyal water were unsuitable, and the rest was found in the good category as evaluated by sodium adsorption ratio and sodium hazards. The groundwater was classified as calcium sulfate (CaSO4), and mixed types and hydrogeochemistry were predominantly influenced by surrounding rock weathering. The groundwater showed a maximum level of hazard quotient of 0.20 ± 0.05 via fluoride intake in the Dadyal town. Based on studied parameters and risk indices, groundwater is recommended for drinking, domestic, and agricultural purposes.

Evaluation of some anions in groundwater in Riyadh, Saudi Arabia, and human health risk assessment of nitrate and fluoride.

Groundwater is a vital source of water for human and agricultural use in many parts of the world. The purpose of this research was to establish the quality of groundwater in Riyadh, Saudi Arabia, as well as the human health concerns associated with it. We collected and examined groundwater samples for pH, EC, TDS, CaCO3, fluoride (F-), chloride (Cl-), sulfate (SO42-), and nitrate (NO3-). The ion chromatography conductometric detection method was constructed to determine fluoride, chloride, sulfate, and nitrate in groundwater. The suggested method worked well for the anions that were being studied; it had a high coefficient of determination (r2 > 0.998) and average recoveries for all analytes that were between 97.5% and 99.0%, with a range of error of 0.77 to 2.37%. Fluoride concentrations were detected between 0.001 and 0.14mg/L, which are within the acceptable limit by several organizations. Chloride was measured in the range of 17.1 to 966.5mg/L, with some samples above the limits. The influence on sulfate ranged from 2.0 to 1136.0mg/L, with several samples exceeding the limits. In contrast, with nitrate levels ranging from 1.4 to 5.0mg/L, the majority of the samples fall within the acceptable range. The overall intake of fluoride, chloride, sulfate, and nitrate is 0.00605, 138.911, 65.515, and 1.19, respectively, which is lower than the recommended daily consumption except for chloride. The groundwater sample contains fluoride and nitrate with HQ values less than one: 0.000064-0.0641 and 0.033654-0.120192. Humans in Riyadh, Saudi Arabia, do not pose a health risk when digesting or absorbing groundwater fluoride or nitrate.

Associations between Dietary Patterns, Fluoride Intake and Excretion in Women Exposed to Fluoridated Salt: A Preliminary Study

Abundant information exists on fluoride intake and excretion in populations exposed to fluoridated water, but not fluoridated salt, where fluoride is eaten through a combination of foods and beverages. This study assessed associations between dietary patterns, fluoride intake and excretion in Mexican women exposed to fluoridated salt. We estimated dietary fluoride intake and excretion (mg/day) from 31 women using 24-h recalls (ASA24) and 24-h urine collections (HDMS diffusion method) and assessed agreement among both estimates of exposure with a Bland-Altman plot. Dietary patterns among the sample were explored by Principal Component Analysis and associations between these patterns and both fluoride intake and excretion were estimated. using Quantile Regressions. Median dietary fluoride intake and excretion were 0.95 and 0.90 mg/day, respectively, with better agreement at values below 1.5 mg/day. We identified three dietary patterns: “Urban Convenience”, “Plant-based” and “Egg-based”. The “Urban Convenience” pattern, characterized by dairy and convenience foods was associated with an increase of 0.25 mg and 0.34 mg of F in the 25th and 50th percentiles of intake respectively, (p &lt; 0.01), and a marginal 0.22 mg decrease in urinary fluoride (p = 0.06). In conclusion, in this sample of Mexican women, a dietary pattern rich in dairy and convenience foods, was associated with both fluoride intake and excretion.

Fluoride Ingestion Induces Formation of Unusual Macromolecular Complexes in Gut Lumen Which Retard Absorption of Essential Minerals and Trace Elements by Chelation.

This study investigates the impact of chronic fluoride exposure on the absorption of essential minerals in the gut and explores the mechanisms underlying mineral deficiencies due to fluoride ingestion. Male Wistar rats were randomly assigned to three groups: group 1 (G-1) served as the control (non-fluoride exposed), while group 2 (G-2) and group 3 (G-3) received human equivalent doses (HED) of fluoride (50 and 100ppm ad libitum, corresponding to 5 and 10ppm in humans, respectively) for 75days. Serum fluoride concentrations were measured, and the levels of essential minerals and trace elements in blood and stool were analyzed using ICP-MS. X-ray diffraction (XRD) analysis was performed on stool samples to identify chemical compounds. The chemical compounds and macromolecular complexes containing fluoride and essential minerals were identified and quantified using Match3 software. Results indicated that the blood concentrations of essential minerals were significantly lower (p ≤ 0.05) in the fluoride-exposed groups compared to the control, while excretion of essential elements in stool was significantly higher (p ≤ 0.05) in the fluoride-administered groups. XRD analysis revealed the formation of unusual macromolecular chemical complexes in the stool of fluoride-treated groups, with the types and concentrations of these compounds increasing with higher fluoride doses. The study concludes that fluoride in the stomach chelates minerals, reducing their absorption, and induces the formation of unusual high molecular weight macromolecular chelation complexes, which alter the chemical species in the gut and further impair the absorption of essential minerals.

7002 Building Poor Bone, A Rare Presentation Of Skeletal Fluorosis

Abstract Disclosure: C. Pham: None. J.S. Lopresti: None. Skeletal fluorosis is a rare disease associated with osteosclerosis and fractures. Case: 26 year old male presented with a history of multiple traumatic fractures but no childhood or family history of fractures. Initial labs revealed a corrected calcium of 8.1 mg/dL (8.5-10.3), ALP 1,504 U/L (40-129), PTH 131 pg/ml (15-65), 25-OH D 14 ng/ml (30-100), PO4 3.7 mg/dl (2.5-4.5) and normal creatinine. X-Rays demonstrated osteosclerosis and cortical expansion of bone and nuclear bone scan demonstrated diffuse increased uptake. Further history revealed huffing of computer inhalants (10 cans daily) for years. Due to these findings, urine fluoride 16.88 mg/L (0.20-3.20 mg/L) and serum fluoride 0.40 mg/L (&amp;lt;0.05 mg/L) were obtained and vitamin D was started. 4 months later, his vitamin D level improved to 21 while calcium levels normalized despite ongoing inhalant use. ALP (878) and PTH (92) continued to be elevated albeit at improved levels. Conclusion: Exposure to fluoride leads to a rare condition called skeletal fluorosis causing accelerated osteogenesis and bone turnover leading to weak bone. Symptoms include bony pain, fractures, and osteosclerosis on radiographs. Differential diagnosis includes other conditions associated with osteosclerosis such as Paget’s disease and myelofibrosis. However, diffuse osteosclerosis and vertebral osteophytosis are noted only in skeletal fluorosis compared to other potential causes, though our patient did not have a CT spine done to assess for osteophytes. Biochemical studies can include hypocalcemia and hyperparathyroidism. It is thought that low calcium intake contributes to the hyperparathyroidism. Elevated serum and urine fluoride levels are also diagnostic and can persist for months after cessation of fluoride intake. Sodium fluoride has been posited as a treatment for osteoporosis due to its tremendous ability to build bone; however, the quality of bone made is poor leading to unacceptable fracture rates. Skeletal fluorosis should be suspected in any patient with history of diffuse osteosclerosis and hyperparathyroidism; and vitamin D supplementation should be initiated. In our case, hypocalcemia and PTH levels were improved despite active inhalant use after vitamin D supplementation. This suggests that Vitamin D deficiency and fluoride may be two independent driving factors in hyperparathyroidism in patients with fluorosis. Increased calcium absorption with vitamin D provides therapeutic benefit in both cases. Presentation: 6/1/2024

Fluoride Concentration in Selected Water Sources of Ngamiland and Boteti Districts: Risk of Dental Fluorosis

Fluoride is well-known for its role in preventing dental issues and promoting strong teeth and bones. It is commonly found in water, tea, and fluoridated toothpaste. The World Health Organisation recommends fluoride concentrations between 0.5 mg/L to 1.50 mg/L in water. Excessive fluoride intake can lead to dental fluorosis which affects tooth enamel. This study aimed to investigate fluoride levels in different water sources within selected villages of Ngamiland and Central Boteti districts and assess dental fluorosis prevalence among the residents. Our objectives were to measure fluoride concentrations in various water sources, evaluate the impact of pH and salinity on fluoride levels, and determine the link between fluoride concentration and dental fluorosis prevalence. Water samples were analyzed for fluoride concentration, pH, and salinity using ion chromatograph, pH meter, and conductivity meter, respectively. Interviews were conducted in Maun, Tsau, Toteng, and Motopi regarding dental fluorosis prevalence. Results showed that groundwater in Motopi and Tsau had fluoride concentrations ranging from 2.81 – 17.05 mg/L, while Toteng tap and standpipe water had fluoride concentrations of 0.78 and 0.83 mg/L. Maun tap and standpipe water, as well as Motopi surface water, yielded fluoride concentrations ranging from 0.16 – 0.37 mg/L. Salinity and pH showed no significant relationship with fluoride concentration, with correlation coefficients of 0.09 and 0.46, respectively. In conclusion, Tsau boreholes had the highest fluoride concentration, linked to dental fluorosis in individuals aged 30 years and above. Maun tap and standpipe water, alongside Motopi tap and surface water, exhibited low fluoride concentrations, while Toteng tap, and standpipe water revealed appropriate fluoride levels. The study revealed that Salinity and pH do not influence fluoride concentration in water.