High Fluoride Water Research Articles

Studies on Environmental Geology and Health Hazards with Reference to Fluoride Rich Groundwater of Nalgonda District,Telangana State, India - a Remote Sensing and G.I.S. Approach.

In the area of study the quality and quantity of groundwater are below the normal standards. In this study spatial statistical methods have been used to demarcate highly polluted zones. Especially fluoride concentrated areas in Nalgonda district. Water quality, especially excess of fluoride concentration in groundwater, is a major concern in the study area. Levels of fluoride in groundwater are considerably greater than the permissible limit especially in Nalgonda district which is known for endemic fluorosis, which is caused by intake of high fluoride water is a slow, progressively, crippling malady affecting young and old, poor and rich, rural and urban population. The area under investigation lies in between the longitude 790 0'-79o 30' E and latitude 16o 45'-17o 15' N. In as many as 1122 habitations in Ranga Reddy and Nalgonda districts, fluorosis is prevalent and they have fluoride content in excess of 1.5 mg/l drinking water. One such area where fluoride contamination in groundwater has been known for several years in parts of Nalgonda district of Telangana state. In this district, several thousands of people in various villages are suffering with advanced fluorosis. A number of studies carried out earlier established the extent of fluoride contamination in different villages. However, no attempt was made to study the spatial distribution of various quality parameters including fluoride in the groundwater of this area. With this background this investigation is planned and undertaken. The spatial variability of groundwater G.I.S techniques were presented. The fluoride variation with reference to other quality parameters was brought out. An attempt is being made to summarise and understand the factors that control the groundwater quality variation in the area of study. A detailed study on fluoride occurrence is taken up, mainly to see its relationship with various other parameters and the influence of hydrogeology and lineament pattern on fluoride occurrence.

Evaluation of groundwater contamination for fluoride and nitrate in semi-arid region of Nirmal Province, South India: A special emphasis on human health risk assessment (HHRA)

ABSTRACTThe main aim of this study was to assess the groundwater quality and human health risks of fluoride and nitrate contamination in Nirmal Province, South India, where groundwater is the primary source for drinking water. Hazard quotient (HQ) and total hazard index (THI) were calculated to estimate the non-carcinogenic risk to men, women, and children using the most substantial method recommended by United States Environmental Protection Agency (USEPA). The results of the study reveal that 26% and 20.59% of groundwater samples have significantly high nitrate and fluoride concentrations, exceeding the maximum permissible limits set by Bureau of Indian Standards (45 mg/L and 1.5 mg/L, respectively). Therefore, ingestion of high fluoride and nitrate water could be the chief reason for health risk in the study region. The total non-carcinogenic health risks for men, women, and children ranged from 2.95E−01 to 4.07E+00, 3.49E−01 to 4.80E+00, and 3.99E−01 to 5.50E+00, respectively. Moreover, 67.65%, 79.41%, and 82.35% of the total collected groundwater samples exceeded the permissible limit for acceptable total health index (THI = 1) for men, women, and children, respectively. Therefore, the health risk assessment suggests that children face higher health risk than men and women in the study region.

Curse of Fluorosis.

Fluoride was identified to have caries preventive properties and was widely used for fluoridation of water since 1940, especially in developed countries. After this there was sudden increase in the use of fluorides in food items and in oral medicinal products like toothpastes and mouth washes. Inadvertent use of above has lead to increase in fluorosis as a public health problem. In many places high fluorides are naturally present in earth crust leading to high water fluoride content increasing the risk of fluorosis. Maintaining a fine balance of fluorides in the body is mandatory for exploiting its advantages. World Health Organization (WHO) has fixed permissible limit of fluorides in water to 1.5mg/L as a preventive step to contain fluorosis. Fluorosis has three clinical components: Dental, Skeletal and Non-Skeletal Fluorosis. It occurs with increasing level of fluorides in the body. Acute toxicity due to fluorides is also known and occurs as a result of sudden exposure to high levels of fluorides, usually by ingestion. Once fluorosis occurs it is irreversible without any cure. Only symptomatic and supportive management is possible. Hence prevention is the mainstay of management. Prevention is by using alternative sources of water or its de-fluoridation. National Program for Prevention and Control of Fluorosis (NPPCF) was launched in 2008-9 to identify areas with high fluoride content of water, manage the water bodies, screen schools and community for fluorosis and comprehensive management of cases. Improving quality of drinking water as per standards and improving nutritional status of children are also important components of prevention of fluorosis.

FLOWERED-GEODBAPP: AN APPLICATION BASED ON CROWD-GENERATING DATA USING SENTINEL2 IMAGERY

Abstract. This study is part of the EU H2020 research Project FLOWERED (de-FLuoridation technologies for imprOving quality of WatEr and agRo-animal products along the East African Rift Valley in the context of aDaptation to climate change). FLOWERED project aims to develop technologies and methodologies at cross-boundary catchment scales to manage the risks associated with high Fluoride water supply in Africa, focusing on three representative test areas along the African Rift Valley (i.e. Ethiopia, Kenya and Tanzania), characterized by high fluoride contents in waters and soils, water scarcity, overexploitation of groundwater and high vulnerability to risks arising from climate change, as drought and desertification. It also is empowering local communities to take responsibility for the integrated-sustainability of the natural resources, growing national and international environmental priorities, enhancing transboundary cooperation and promoting local ownership based on a scientific and technological approach. Within the FLOWERED project, the transition from the land cover to the land use and water use maps is provided through the development of a mobile application (FLOWERED-GeoDBapp ). It is dedicated to the collection of local geo-information on land use, water uses, irrigation systems, household features, use of drinking water and the other information needful for the specific knowledge of water supply involving local communities through participative approach. This system is structured to be populated, through an action of crowd-generating data by local communities (students and people involved mainly by NGOs). The SHAREGEODBapp is proposed as an innovative tool for water management and agriculture institutions at regional and local level.

Enhanced fluoride removal performance by Ce–Zn binary metal oxide: Adsorption characteristics and mechanism

Excess fluoride in water can result in serious health problems. For this reason, we have developed a novel Ce–Zn binary metal oxide (Ce–Zn BMO) adsorbent for high-performance fluoride adsorption from drinking water. The Fourier transform infrared spectroscopy (FTIR) and X–ray photoelectron spectroscopy (XPS) results demonstrated both electrostatic interactions and ion exchange of surface hydroxyl groups of Ce–Zn BMO with fluoride ions. The Ce–Zn BMO adsorbent exhibited a good Langmuir adsorption capacity of 194mg/g at pH 7.0. The adsorbent has a wide pH range (3–7) applicability and negligible coexisting ion effect that makes it an attractive sustainable material for field applications. Column adsorption studies indicated the efficient treatable volume as ∼94-bed volume (BV) using natural water when the breakthrough point in the column was 1.5mg/L. Furthermore, six cycles reusability without much loss of adsorption capacity and effective column treatment of fluoride contaminated water indicated that Ce–Zn BMO could be developed into an efficient technology for high performance elevated fluoride water treatment.

Validating a High Performance Liquid Chromatography-Ion Chromatography (HPLC-IC) Method with Conductivity Detection After Chemical Suppression for Water Fluoride Estimation.

A variety of methods, including the Ion Selective Electrode (ISE), have been used for estimation of fluoride levels in drinking water. But as these methods suffer many drawbacks, the newer method of IC has replaced many of these methods. The study aimed at (1) validating IC for estimation of fluoride levels in drinking water and (2) to assess drinking water fluoride levels of villages in and around Vellore district using IC. Forty nine paired drinking water samples were measured using ISE and IC method (Metrohm). Water samples from 165 randomly selected villages in and around Vellore district were collected for fluoride estimation over 1year. Standardization of IC method showed good within run precision, linearity and coefficient of variance with correlation coefficient R2=0.998. The limit of detection was 0.027ppm and limit of quantification was 0.083ppm. Among 165 villages, 46.1% of the villages recorded water fluoride levels >1.00ppm from which 19.4% had levels ranging from 1 to 1.5ppm, 10.9% had recorded levels 1.5-2ppm and about 12.7% had levels of 2.0-3.0ppm. Three percent of villages had more than 3.0 ppm fluoride in the water tested. Most (44.42%) of these villages belonged to Jolarpet taluk with moderate to high (0.86-3.56ppm) water fluoride levels. Ion Chromatography method has been validated and is therefore a reliable method in assessment of fluoride levels in the drinking water. While the residents of Jolarpet taluk (Vellore distict) are found to be at a high risk of developing dental and skeletal fluorosis.

Assessment of the Impact of Groundwater Fluoride on Human Health: A Case Study of Makindu District in Kenya

Assessment of human exposure to the naturally occurring fluoride in groundwater in Kenya has not being exhaustive. This study investigated the extent of human exposure to fluoride and its impact on human health in Makindu District, and evaluated the potential risk of using ground water contaminated by fluoride ion (F-). The study used an ex post facto design and the data collection tools used were interviews, questionnaires, key informants and observation. Water from three boreholes and a spring in the study areas was analysed for pH, Total Alkalinity, Total Hardness, and concentrations of Fluoride, Chloride, Sulfate, Iron, Calcium, Magnesium, Sodium and Potassium. The collected data was analyzed using the Ms-Excel and Statistical Package for Social Sciences (SPSS). The results show that majority of the respondents relied on tap water from springs. Raw water from Makindu Spring, the main source of drinking water for Makindu Town, had fluoride concentration of 1.1 mg/L, which is below the WHO maximum allowable value of 1.5 mg/L. All the three boreholes covered during the study had fluoride concentration above the WHO maximum allowable value. This implied that the population that relied on boreholes as a source of water was exposed to health risk associated with high fluoride. 38.4% and 33.3% of the respondents, respectively from Kiboko Location and Makindu Location, had moderately to severely mottled enamel, an indication of the impact of fluoride in water. It is recommended that defluoridation systems should be introduced and that alternative sources of water be developed to mitigate the impacts of high fluoride water to the local communities.

Enzymatic Activity of Glutathione S-Transferase and Dental Fluorosis Among Children Receiving Two Different Levels of Naturally Fluoridated Water.

This study was conducted to measure the activity of the enzyme glutathione S-transferase (GST) in saliva and to compare the activity of this enzyme in children with and without dental fluorosis in communities with different concentrations of naturally fluoridated water. A total of 141 schoolchildren participated in this cross-sectional study. Children were selected from two communities: one with a low (0.4ppm) and the other with a high (1.8ppm) water fluoride concentration. Dental fluorosis was evaluated by applying the Thylstrup and Fejerskov Index (TFI) criteria. Stimulated saliva was obtained, and fluoride concentration and GST activity were measured. The GST activity was compared among children with different levels of dental fluorosis using multinomial logistic regression models and odds ratios (OR). The mean age of the children was 10.6 (±1.03) years. Approximately half of the children showed dental fluorosis (52.5%). The average GST activity was 0.5678 (±0.1959) nmol/min/μg. A higher concentration of fluoride in the saliva was detected in children with a higher GST activity (p=0.039). A multinomial logistic regression model used to evaluate the GST activity and the dental fluorosis score identified a strong association between TFI=2-3 (OR=15.44, p=0.007) and TFI≥4 (OR=55.40, p=0.026) and the GST activity level, compared with children showing TFI=0-1, adjusted for age and sex. Schoolchildren with higher levels of dental fluorosis and a higher fluoride concentration in the saliva showed greater GST activity. The increased GST activity most likely was the result of the body's need to inactivate free radicals produced by exposure to fluoride.

Utilization of marble waste powder as a novel adsorbent for removal of fluoride ions from aqueous solution

Developing products and processes to reduce waste and to facilitate reuse is the key to sustainable waste minimization. A novel adsorbent was prepared for removal of fluoride ions from aqueous solution utilizing marble waste powder (MWP) which is an environmental concern polluting soil/water resources. Characterization of MWP was done using Fourier transform infrared spectroscopy (FTIR), X-ray powder diffraction (XRD), thermogravimetric and differential thermal analysis (TG-DTA), scanning electron microscopy (SEM)/energy-dispersive X-ray spectroscopy (EDS) and transmission electron microscopy (TEM) which gave an insight to the compositional, micro-structural and thermal decomposition behavior of the adsorbent. The specific surface area of the adsorbent used was 7.18m2/g. The effect of various factors such as pH, contact time, initial fluoride concentration, dosage and presence of other ions on fluoride removal was also evaluated. The results showed that the adsorption capacity of the waste powder was 1.20mg/g at pH 7 with a contact time of 3h. The mechanism of adsorption was studied, and it was found that Freundlich isotherm fitted best to the experimental data, while the kinetic studies revealed that the process followed pseudo-second order model. MWP was found to be an effective adsorbent for defluoridation of high fluoride water by reducing excess fluoride ions (>1.5mg/L) and simultaneously utilizing the disposed marble waste into a valuable product.

Prevalence of dental fluorosis among primary school children in association with different water fluoride levels in Mysore district, Karnataka.

Fluoride intake at optimal level decreases the incidence of dental caries. However, excessive intake, especially during developmental stages can cause adverse effects such as dental and skeletal fluorosis. To assess the prevalence and severity of dental fluorosis in primary school children born and raised in three villages of Mysore District. The three selected villages have different water fluoride concentrations. Three villages namely, Nerale (water fluoride 2.0 ppm), Belavadi (1.2 ppm) and Naganahally (0.4 ppm) were selected for the study. Then, a total of 405 children, 10-12-year-old (204 [50.4%] males and 201 [49.60%] females) were selected from three schools of the villages. Dean's fluorosis index recommended by World Health Organization was used to evaluate fluorosis among the study population. The overall prevalence of dental fluorosis was found to be 41.73%. An increase in the community fluorosis index (CFI) was higher among those living in high water fluoride area. A significantly positive correlation was found between CFI and water fluoride concentration in drinking water.

The prevalence of dental fluorosis and its associated factors in Salem district.

Context:There are various regions in India that have high levels of fluoride in drinking water sources. Many people residing in such places suffer from dental fluorosis (DF).Aims:To evaluate the prevalence of DF in children residing in Salem and also to find any correlation between DF and other related factors.Materials and Methods:One school from each block of Salem (total 21 blocks) was selected for the study. A single examiner had evaluated untreated caries, lesions, and DF (for permanent anterior teeth and molars) using the Dean's fluorosis index, in all children. Water fluoride level determination at each school was done using the Tamil Nadu Water Fluoridation and Drainage Board field kit. Other factors that may have contributed to DF were assessed using a questionnaire, which was provided to each student. The data obtained were statistically analyzed using the SPSS software version 11.5.Statistical Analysis:Chi-square test was used for statistical analysis.Results:DF was present in 56.9% of the children examined. It was mostly seen in 9 years old (72%) and male (59%) children. A positive correlation was found between the occurrence of DF and the duration of residence in a place with high water fluoride content, consumption of borewell water (64%), the parts per million of fluoride in drinking water, consumption of black tea (59%). However, no correlation was found between DF, dental caries, consumption of milk, or consumption of foods cooked in aluminum vessels.Conclusion:There was a correlation between DF and factors such as male gender, bore well water consumption, black tea consumption and the duration of residence in a place with high water fluoride content.

Removal of fluoride by nature diatomite from high-fluorine water: An appropriate pretreatment for nanofiltration process

Nanofiltration (NF) is an effective technology for fluoride rejection in drinking water which has characteristics of high water flux, high water recovery rate and low operation pressure, etc. However, high fluoride concentration severely influences the quality of its product water. Herein, nature diatomite was chosen to adsorb fluoride prior to NF process. The characterization of diatomite was investigated by SEM and XRD, and the feasibility was studied by XPS and FT–IR. The influences of diatomite dosage, pH, ionic strength and anions concentration were researched by batches of adsorption experiments. The presence of HA enhanced the adsorption of fluoride at pH<5 while reduced fluoride adsorption at pH>5. The adsorption process fitted the Langmuir isotherm and the adsorption kinetics fitted the pseudo-second-order rate equation. In addition, the combination of adsorption process and NF treatment was studied, which confirmed that the nature diatomite can ensure the permeate water of the NF system to meet the standard. Results of this study demonstrated that the nature diatomite was viable and effective to be used as the pretreatment adsorbent for NF system to defluorinate high fluoride water.

Comparing activated alumina with indigenous laterite and bauxite as potential sorbents for removing fluoride from drinking water in Ghana

Fluoride is considered beneficial to teeth and bones when consumed in low concentrations, but at elevated concentrations it can cause dental and skeletal fluorosis. Most fluoride-related health problems occur in poor, rural communities of the developing world where groundwater fluoride concentrations are high and the primary sources of drinking water are from community hand-pump borehole drilled wells. One solution to drinking high fluoride water is to attach a simple de-fluoridation filter to the hand-pump; and indigenous materials have been recommended as low-cost sorbents for use in these filters. In an effort to develop an effective, inexpensive, and low-maintenance de-fluoridation filter for a high fluoride region in rural northern Ghana, this study conducted batch fluoride adsorption experiments and potentiometric titrations to investigate the effectiveness of indigenous laterite and bauxite as sorbents for fluoride removal. It also determined the physical and chemical properties of each sorbent. Their properties and the experimental results, including fluoride adsorption capacity, were then compared to those of activated alumina, which has been identified as a good sorbent for removing fluoride from drinking water. The results indicate that, of the three sorbents, bauxite has the highest fluoride adsorption capacity per unit area, but is limited by a low specific surface area. When considering fluoride adsorption per unit weight, activated alumina has the highest fluoride adsorption capacity because of its high specific surface area. Activated alumina also adsorbs fluoride well in a wider pH range than bauxite, and particularly laterite. The differences in adsorption capacity are largely due to surface area, pore size, and mineralogy of the sorbent.

A cross-sectional study to assess the intelligence quotient (IQ) of school going children aged 10-12 years in villages of Mysore district, India with different fluoride levels.

Besides dental and skeletal fluorosis, excessive fluoride intake can also affect the central nervous system without first causing the physical deformities associated with skeletal fluorosis. With the existence of widespread endemic fluorosis in India, the possible adverse effect of elevated fluoride in drinking water on the Intelligence Quotient (IQ) level of children is a potentially serious public health problem. This study assessed the Intelligence Quotient (IQ) of school going children aged 10-12 years in villages of Mysore district with different fluoride levels. In this cross-sectional study, 405 school children aged 10-12 years were selected from three villages in Mysore district with normal fluoride (1.20 mg F/l), low fluoride (0.40 mg F/l) and high fluoride (2.20 mg F/l) in their water supplies. A pre designed questionnaire was used to collect the required data for the survey which included socio demographic details, oral hygiene practices, diet history, body mass index and dental fluorosis. Intelligence Quotient was assessed using Raven's colored Progressive Matrices Test. In bivariate analysis, significant relationships were found between water fluoride levels and Intelligence Quotient of school children (P < 0.05). In the high fluoride village, the proportion of children with IQ below 90, i.e. below average IQ was larger compared to normal and low fluoride village. Age, gender, parent education level and family income had no significant association with IQ. School children residing in area with higher than normal water fluoride level demonstrated more impaired development of intelligence when compared to school children residing in areas with normal and low water fluoride levels. Thus, children's intelligence can be affected by high water fluoride levels.

Environmental Distribution of Fluoride in Drinking Waters of Kaltungo Area, North-Eastern Nigeria

This study focus on the distribution of fluoride in natural drinking water sources in Kaltungo area North-Eastern Nigeria. Forty five water samples were analyzed to determine the concentration levels of fluoride using Atomic Absorption Spectrometer. The result revealed that fluoride ranges from 0.52 to 4.4 mg/L in surface waters and from 0.1 to 3.95 mg/L in ground waters, while in plant tissue the fluoride content ranges from 1.2 to 1.96 mg/L. The average value of fluoride is 2.8 mg/L in both surface and ground waters. This results indicates that inhabitants of Kaltungo area at high risk of high fluoride exposure. Ingestion of high fluoride water results in manifestation of dental fluorosis in some of the inhabitants.

Development of Network Pressure-Superposed Secondary Water Purification

Secondary water supply equipment was designed based on the current water supply source and municipal pipe network. The combination between Water purification and pressure-superposed water supply could guarantee the drinking water security, fully exploit the municipal pipe network pressure, and effectively save the energy. Catalytic oxidation of ozone, complex adsorption, and microbial degradation collaborated to treat the micro-polluted water. Activated alumina was employed for the high fluoride water purification with HCl/NaOH deep regeneration. For the brackish water, membrane treatment was adopted. A collaborative technology of ozone oxidation, contact oxidation, and biological oxidation was used for the iron/manganese-rich water. The results showed that all the effluents could meet the requirement of "Sanitary standard for drinking water" (GB5749-2006) and "Water quality standards for fine drinking water" (CJ94-2005).

High fluoride water in Bondo-Rarieda area of Siaya County, Kenya: a hydro-geological implication on public health in the Lake Victoria Basin.

BackgroundOnly a few studies to evaluate groundwater fluoride in Eastern Africa have been undertaken outside the volcanic belt of the Great Eastern Africa Rift Valley. The extent and impact of water fluoride outside these regions therefore remain unclear. The current study evaluated fluoride levels in household water sources in Bondo-Rarieda Area in the Kenyan part of the Lake Victoria Basin (LVB) and highlighted the risk posed by water fluoride to the resident communities. The results, it was anticipated, will contribute to in-depth understanding of the fluoride problem in the region.MethodsA total of 128 water samples were collected from different water sources from the entire study area and analyzed for fluoride content using ion-selective electrodes.ResultsLake Victoria was the main water source in the area but dams and open pans (39.5%), boreholes and shallow wells (23.5%), and streams (18.5%) were the principal water sources outside walking distances from the lake. The overall mean fluoride content of the water exceeded recommended limits for drinking water. The mean water fluoride was highest in Uyoma (1.39±0.84 ppm), Nyang’oma (1.00±0.59 ppm) and Asembo (0.92±0.46 ppm) and lowest in Maranda Division (0.69±0.42 ppm). Ponds (1.41±0.82 ppm), springs (1.25±0.43 ppm), dams and open pans (0.96±0.79 ppm), and streams (0.95±0.41 ppm) had highest fluoride levels but lake and river water did not have elevated fluoride levels. Groundwater fluoride decreased with increasing distance from the lake indicating that water fluoride may have hydro-geologically been translocated into the region from geochemical sources outside the area.ConclusionsLake Victoria was the main water source for the residents of Bondo-Rarieda Area. Majority of in-land residents however used water from dams, open pans, boreholes, shallow wells, ponds and streams, which was generally saline and fluoridated. It was estimated that 36% of children living in this area, who consume water from ground sources from the area could be at the risk of dental fluorosis.

Fluorosis and periodontium: A report of our institutional studies

Fluorosis is a world-wide prevalent endemic disease due to high-fluoride water intake, especially in the developing countries. Among the various environmental etiological factors, the influence of high-fluoride water intake on the periodontium is still unexplored. With this background, we conducted a group of epidemiological and in vitro studies in a single group of the population residing in high-fluoride water areas (1.5-3.0 ppm) of Davangere district, Karnataka, India. The studies not only explored an epidemiological association between fluorosis and periodontal disease, but also the influence of fluorosis on periodontal structures along with the comparison of influence of periodontal treatment on fluorosed and nonfluorosed teeth. These preliminary studies conducted in our institution are hereby elaborately presented and discussed in this article along with their important conclusions. The results of these studies necessitate further exploration of the influence of high-fluoride water intake on the periodontium in other affected populations of the world.

Comparative assessment of fluorosed and nonfluorosed fibroblast attachment on fluorosed and nonfluorosed teeth after scaling and root planning and ethylenediaminetetraacetic acid root biomodification

Background and Objectives: Fluorosis causes mineralization changes in the tooth and can lead to morphological alterations of fibroblasts. To evaluate the effect of fluorosis on periodontal healing, the initial step while healing such as, fibroblast attachment onto the root surface requires to be evaluated on the fluorosed and nonfluorosed tooth using nonfluorosed as well as fluorosed fibroblasts originated from the subjects influenced by high-water fluoride. Hence, the objective of the current study was to study and compare the attachment of nonfluorosed and fluorosed fibroblasts on the fluorosed and nonfluorosed root fragments. Materials and Methods: A total of 112 fluorosed and nonfluorosed, periodontally healthy and diseased tooth roots were obtained and allotted to eight groups : f0 luorosed healthy (FH) and non-FH (NFH) controls, fluorosed diseased (FD) and non-FD (NFD) controls, fluorosed and nonfluorosed teeth treated with scaling and root planning (SRP) (FD SRP and NFD SRP) and similar groups treated with SRP and ethylenediaminetetraacetic acid (EDTA) (FD SRP + EDTA and NFD SRP + EDTA) burnishing treatment with 24% EDTA gel for 2 min. After the respective treatment half of the root fragments in each group were incubated in the human periodontal ligament fibroblast cells obtained and cultured from freshly extracted FH and NFH human premolar tooth root. The nonfluorosed fibroblasts are elongated, flat cells thus they show increased attachment to root the surface. Results: When comparison was carried out between the attachment of fluorosed and nonfluorosed fibroblasts on NFD groups treated with scaling and EDTA, significant results were obtained with increased attachment seen on the group incubated with nonfluorosed fibroblasts (P = 0.029). While on comparison between the attachment of fluorosed and nonfluorosed fibroblasts on NFH group, NFD group treated with SRP and NFD group, no significant results were obtained (P > 0.05). On comparison between the attachment of fluorosed and nonfluorosed fibroblasts on FD group treated with SRP, highly significant results were obtained with increased attachment seen in the group incubated with nonfluorosed fibroblasts (P = 0.001). While the comparison of attachment of fluorosed and nonfluorosed fibroblasts on FH group, FD group treated with SRP + EDTA and FD group revealed no significant results (P > 0.05). Interpretation and Conclusion: SRP proves yet to be a standard requirement for fibroblast attachment to occur both in fluorosed and nonfluorosed teeth. Although, there is no significant difference in attachment between SRP and SRP + EDTA among fluorosed teeth, EDTA does not seem to be a promising agent for root biomodification in fluorosed teeth in given concentration and time of treatment.

Spinal Cord Compression Revealing Fluorosis

Bone fluorosis due to high water fluoride contents is endemic in North Africa. Neurological complications as spinal cord compression at dorsal level are rare and unusual. Its outcome depends on early diagnosis and surgical treatment. The authors report a new case of spinal cord compression due to ossification of the yellow vertebral ligament in a patient with previously unknown bone fluorosis.