Bone Density, Fluorosis and Fluoride Concentration in Drinking Water

Objectives: To examine the relationship amongst the degree of fluorosis, bone density and drinking water fluoride levels of life-long residents. Methods: This study included children aged 10–15 years, with similar nutritional, dietary habits and similar ethnic and socioeconomic status, from three areas with different drinking water fluoride levels (0.19; 0.48 and 3.00 ppm F). The degree of fluorosis (Dean's Index), the fluoride concentration in the drinking water (potentiometrically) and the bone density (photon absorptiometer) were determined. The distal 1/3 of the left radius was measured for bone mineral content, bone width and bone density. Results: No relationships were found between fluorosis and bone width or between fluorosis and bone density in any of the three areas. However, statistical significant differences (p<0.05; Kruskal - Wallis Test) were found in the fluorosis levels between the three different areas. In a comparison between the different fluoride areas for the bone density at a specific age, differences were found (p < 0.05; Kruskal-Wallis). Only extremely weak relationships (p > 0.10) were found amongst different ages (10 to 15 years) and ABMD for Kuboes (0.48 ppm F) and Leeu Gamka (3.00 ppm F), but a highly significant (p<0.02) negative correlation was found for the low fluoride area (0.19 ppm F). Conclusions: This study indicated that even low drinking water fluoride levels were reflected in the bone density of children, but the lowest fluoride area (0.19 ppm) showed a negative correlation in bone density with age.