Skeletal fluorosis

Skeletal fluorosis is a chronic invasive systemic bone disease caused by long-term excess fluoride intake and fluorosis involving bone; fluorosis affecting the teeth is called dental fluorosis. In 1901 Eaqer first reported dental fluorosis, and in 1932 the Danes Motlev and Gudijonsson named it fluorosis, believing it accompanied by osteosclerosis.

Common Symptoms

Diarrhea; osteomalacia; osteoporosis; spinal cord compression; osteosclerosis; persistent pain; nausea; muscle atrophy

Causes

For example spring water, especially hot spring water, has too high fluoride; drinking water below 1x10-6 is safe, and long-term use above 1x10-6 can cause chronic fluorosis; residents saving fuel cook rice, boil soup, brew tea, defeather poultry and blanch vegetables with hot spring water, all causing contamination. Fluoride stimulates bone growth and is used to treat osteoporosis, increasing BMD, drawing pharmaceutical attention, though its use is controversial: ① although BMD increases, it is not proven to reduce fractures; ② the new bone formed by fluoride mineralizes abnormally, worse with low calcium intake and not fully prevented even with calcium and vitamin D; ③ the imbalance from bone matrix production with delayed mineralization (osteomalacia) causes lower-limb pain and may even increase fractures. Coal and some industrial raw materials contain fluoride, polluting air during smelting. Pathogenesis: after entering via the digestive or respiratory tract, fluoride spreads through blood circulation causing various changes. 1. Binding calcium and magnesium ions in plasma lowers blood calcium and magnesium, causing tetany, muscle spasm and pain; enzymes dependent on calcium or magnesium are inhibited, affecting many metabolic processes. 2. Effect of fluoride ion: it is toxic to cytoplasm, affects cell function, and acts on bone apatite, replacing hydroxyl groups, affecting bone metabolism and causing osteoporosis, osteosclerosis or a mixed type, with bone pain, fracture and deformity; teeth during growth are susceptible, causing dental fluorosis.

Treatment

Prosthodontic treatment, supportive treatment

Prevention

Skeletal fluorosis is mainly due to high fluoride in drinking water, so switching to low-fluoride water or removing fluoride can fully prevent and treat it; after reducing fluoride intake, the kidney still excretes fluoride strongly, and as blood fluoride falls, excess stored in bone and teeth is released and excreted, improving symptoms. Thus lowering drinking-water fluoride is both necessary and feasible. Avoid high-fluoride water: residents in high-fluoride areas should seek low-fluoride sources such as deep well water, tap water, rain or snow water, and test water regularly. Chemical defluoridation includes: 1. Aluminum sulfate plus lime precipitates aluminum hydroxide, adsorbing fluoride. 2. Activated alumina has large surface area and strong ion exchange, adsorbing fluoride. 3. Basic aluminum chloride added to water forms a colloidal polymer with fluoride precipitating, leaving low-fluoride supernatant. These methods are imperfect and costly, hard to maintain long-term. 4. Eat clean water and food, avoid high-fluoride water and fluorine-contaminated food; strengthen education; in the south, where hot spring water is used, deep wells for non-high-fluoride water are important; improve grain storage and cooking habits to avoid fluorine-contaminated food.

Recommended Department

It is recommended to visit the stomatology department; before the visit you may first book an appointment and connect with experts through this platform.

Warm reminder: The above information is provided for health education reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek care at a regular hospital in time.