Skip to main content

Dental fluorosis and urinary fluoride concentration as a reflection of fluoride exposure and its impact on IQ level and BMI of children of Laxmisagar, Simlapal Block of Bankura District, W.B., India

Abstract

There has been growing public concern about intellectual performance of children at high levels of fluoride exposure. A cross-sectional study was conducted in Simlapal Block of Bankura District, West Bengal, to find out the relationship between fluoride (F) exposure as exposure dose (ED) with dental fluorosis (DF), urinary fluoride concentration (UF), intelligence quotient (IQ) and body mass index (BMI). Fifty groundwater samples were collected from the target area. One hundred forty-nine children belonging to age group 6 to 18 years were considered for this study. Experimental results reveal that mean F concentration of that area is 2.11 mg/L (±SD 1.64). On the basis of F concentration in groundwater and water consumption pattern, ED was calculated to explore the impact of F on DF, UF, IQ, and BMI. Paired t test results suggest that exposure rate of F does not show any significant differences (<0.05) among the children of 12 different places. As a result of F exposure, DF cases are mostly found in the order of moderate > severe > mild > very mild > questionable > normal conditions. The highest UF concentration was recorded as 17 mg/L, but the status of DF in the affected children was recorded as moderate. The results also reveal that ED has a positive correlation with DF (r = 0.299, P < 0.01) and UF (r = 0.513, P < 0.01) and a negative correlation with IQ (r = −0.343, P < 0.01) along with BMI (r = 0.083, non-significant). Therefore, from this study, it may be concluded that UF and DF concentration could act as a biomarker of fluoride toxicity.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9

References

  • American Public Health Association (APHA), 2005. Standard methods for the examination of water and Wastewater, 21st Ed, Washington DC

  • Arvind, A. B., Isaac, A., Murthy, N. S., Shivaraj, N. S., Suryanarayana, S. P., & Pruthvish, S. (2012). Prevalence and severity of dental fluorosis and genu valgum among school children in rural field practice area of a medical college. Asian Pacific Journal of Tropical Disease, 2(6), 465–469.

    Article  Google Scholar 

  • Beltrán-Aguilar, E. D., Barker, L. K., Canto, M. T., Dye, B. A., Gooch, B. F., Griffin, S. O., Hyman, J., Jaramillo, F., Kingman, A., Nowjack-Raymer, R., Selwitz, R. H. & Wo, T. (2005). Surveillance for dental caries, dental sealants, tooth retention, edentulism, and enamel fluorosis – United States, 1988–1994 and 1999–2002. In: Morbidity and Mortality Weekly Report, 54(03). Centers for Disease Control and Prevention, 1–44.

  • Cao, J., Zhao, Y., Liu, J., Xirao, R., Danzeng, S., & Daji, D. (2003). Brick tea fluoride as a main source of adult fluorosis. Food and Chemical Toxicology, 41, 535–542.

    CAS  Article  Google Scholar 

  • Cerklawski, F. L., & Ridlington, J. W. (1987). Influence of type and level of dietary calcium on fluoride bioavailability in the rat. Nutrition Research, 7, 1073–1083.

    Article  Google Scholar 

  • Chatterjee, A., Roy, R. K., Ghosh, U. C., Pramanik, T., Kabi, S. P., & Biswas, K. (2008). Fluoride in water in parts of Raniganj Coalfield, West Bengal. Current Science, 94(3), 309–311.

    CAS  Google Scholar 

  • Chen, Y. X., Han, F. L., Zhou, Z. L., Zhang, H., Jiao, X., Zhang, S., Huang, M., Chang, T., & Dong, Y. (2008). Research on the intellectual development of children in high fluoride areas. Fluoride, 41, 120–124.

    Google Scholar 

  • Das, K., Dey, U., Roy, P., Pal, K. C., & Mondal, N. K. (2013). Dental fluorosis among children in Laxmisagar Village, Bankura District, West Bengal, India. Fluoride, 46(4), 230–233.

    Google Scholar 

  • Dean, H. T. (1942). The investigation of physiological effects by the epidemiological method. In R. F. Moulton (Ed.), Fluoride and dental health (pp. 23–31). Washington DC: American Association for Advancement of Science.

    Google Scholar 

  • Dean, H. T., & Elvove, E. (1935). Studies on the minimal threshold of the dental signs of chronic endemic dental fluorosis (mottled enamel). Public Health Reports, 50, 1719–1729.

    CAS  Article  Google Scholar 

  • DenBesten, P. K. (1994). Dental fluorosis: its use as a biomarker. Advances in Dental Research, 8, 105–110.

    CAS  Google Scholar 

  • Dey, U., Mondal, N. K., Das, K., & Datta, J. K. (2012). Dual effects of fluoride and calcium on the uptake of Fluoride, growth physiology, pigmentation, and biochemistry of Bengal gram seedlings (Cicer arietinum L.). Fluoride, 45(4), 389–393.

    CAS  Google Scholar 

  • Ding, Y., Sun, H., Han, H., Wang, W., Ji, X., Liu, X., & Sun, D. (2011). The relationships between low levels of urine fluoride on children’s intelligence, dental fluorosis in endemic fluorosis areas in Hulunbuir, Inner Mongolia, China. Journal of Hazardous Materials, 186, 1942–1946.

    CAS  Article  Google Scholar 

  • Dissanayake, C. B., & Chandrajith, R. (1999). Medical geochemistry of tropical environments. Earth Science Reviews, 47(3–4), 219–258.

    CAS  Article  Google Scholar 

  • Fordyce, F. M., Vrana, K., Zhovinsky, E., Povoroznuk, V., Toth, G., Hope, B. C., Iljinsky, U., & Baker, J. (2007). A health risk assessment for fluoride in Central Europe. Environmental Geochemistry and Health, 29, 83–102.

    CAS  Article  Google Scholar 

  • Fuge, R. (1988). Sources of halogens in the environment, influences on human and animal health. Environmental Geochemistry and Health, 10(2), 51–61.

    CAS  Article  Google Scholar 

  • García-Pérez, A., Irigoyen-Camacho, M., & Borges-Yáñez, A. (2013). Fluorosis and dental caries in Mexican schoolchildren residing in areas with different water fluoride concentrations and receiving fluoridated salt. Caries Research, 47, 299–308.

    Article  Google Scholar 

  • Grimaldo, M., Borja-Aburto, V. H., Ramírez, A. L., Ponce, M., Rosas, M., & Diaz-Barriga, F. (1995). Endemic fluorosis in San Luis Potosi, Mexico. I. Identification of risk factors associated with human exposure to fluoride. Environmental Research, 68, 25–30.

    CAS  Article  Google Scholar 

  • Heintze, S. D., Bastos, J. R. D. M., & Bastos, R. (1998). Urinary fluoride levels and prevalence of dental fluorosis in three Brazilian cities with different fluoride concentrations in the drinking water. Community Dentistry and Oral Epidemiology, 26, 316–323.

    CAS  Article  Google Scholar 

  • Hussain, J., Hussain, I., & Sharma, K. (2010). Fluoride and health hazards: community perception in a fluorotic area of central Rajasthan (India): an arid environment. Environmental Monitoring and Assessment, 162, 1–14.

    CAS  Article  Google Scholar 

  • Karimzade, S., Aghaei, M., & Mahvi, A. H. (2014). Investigation of intelligence quotient in 9-12-year-old children exposed to high-and low-drinking water fluoride in West Azerbaijan Province, Iran. Fluoride, 47(1), 9–14.

    Google Scholar 

  • Kaseva, M. (2006). Contribution of trona (magadi) into excessive fluorosis—a case study in Maji ya Chai ward, northern Tanzania. Science of the Total Environment, 366, 92–100.

    CAS  Article  Google Scholar 

  • Kazi, T. G., Arain, M. B., Jamali, M. K., Jalbani, N., Afridi, H. I., Sarfraz, R. A., Baig, J. A., & Shah, A. Q. (2009). Assessment of water quality of polluted lake using multivariate statistical techniques: a case study. Ecotoxicology and Environmental Safety, 72(20), 301–309.

    CAS  Article  Google Scholar 

  • Khan, S. A., Singh, R. K., Navit, S., Chadha, D., Johri, N., Nait, P., Sharma, A., & Bahuguna, R. (2015). Relationship between dental fluorosis and intelligence quotient of school going children in and around Lucknow District: a cross-sectional study. Journal of Chemical Diagnosis Research, 9(11), ZC10–ZC15.

    Google Scholar 

  • Kravchenko, J., Rango, T., Akushevich, I. V., Atlaw, B., Mccornick, P., & Merola, R. B. (2014). The effect of non-fluoride factors on risk of dental fluorosis: evidence from rural populations of the Main Ethiopian Rift. Science of the Total Environment, 488–489, 595–606.

    Article  Google Scholar 

  • Lahermo, P., Sandstrom, H., & Malisa, E. (1991). The occurrence and geochemistry of fluorides in natural waters in Finland and East Africa with reference to their geomedical implications. Journal of Geochemical Exploration, 41, 65–79.

    CAS  Article  Google Scholar 

  • Laluraj, C. M., Gopinath, G., & Dineshkumar, P. K. (2005). Groundwater chemistry of shallow aquifers in the coastal zones of Cochin, India. Applied Ecology and Environmental Research, 3(1), 133–139.

    Article  Google Scholar 

  • Liu, M., & Qian, C. (2008). Effect of endemic fluorosis on children’s intelligence development: a meta analysis. Chinese Journal of Contemporary Pediatrics, 10, 723–725.

    Google Scholar 

  • Liu, G. Y., Chai ,C. Y., & Cui, L. (2003). Fluoride causing abnormally elevated serum nitric oxide levels in chicks. Environmental Toxicology and Pharmacology, 13, 199--204.

  • Liu, S. S., Lu, Y., Sun, Z. R., Wu, L. N., et al. (2000). The investigation of children’s intelligence in high fluoride area. Chinese Journal of Control of Endemic Disease, 15, 231–232.

    Google Scholar 

  • Mabelya, L., König, K. G., & van Palenstein Helderman, W. H. (1992). Dental fluorosis, altitude, and associated dietary factors. Caries Research, 26, 65–67.

    CAS  Article  Google Scholar 

  • Malde, M. K., Zerihun, L., Julshamn, K., & Bjorvatn, K. (2004). Fluoride, calcium and magnesium intake in children living in high-fluoride area in Ethiopia. Intake through food. International Journal of Paediatric Dentistry, 14, 167–174.

    CAS  Article  Google Scholar 

  • Malinowska, E., Inkielewicz, I., Czarnowski, W., & Szefer, P. (2008). Assessment of fluoride concentration and daily intake by human from tea and herbal infusions. Food and Chemical Toxicology, 46, 1055–1061.

    CAS  Article  Google Scholar 

  • Martínez‐Mier, E., Soto‐Rojas, A. E., Ureña‐Cirett, J. L., Stookey, G. K., & Dunipace, A. J. (2003). Fluoride intake from foods, beverages and dentifrice by children in Mexico. Community Dentistry and Oral Epidemiology, 31, 221–230.

    Article  Google Scholar 

  • Meyer-Lueckel, H., Bitter, K., Khorrami, G., Kielbassa, A., & Paris, S. (2011). Relationship of caries and fluorosis in adolescents from high-and low-fluoride areas in Iran. Community Dentistry and Oral Health, 28, 248.

    CAS  Google Scholar 

  • Mondal, N. K., Pal, K. C., & Kabi, S. (2012). Prevalence and severity of dental fluorosis in relation to fluoride in ground water in the villages of Birbhum district, West Bengal, India. Environmentalist, 32, 70–84.

    Article  Google Scholar 

  • Mullenix, P. J., Denbesten, P. K., Schunior, A., & Kernan, W. J. (1995). Neurotoxicity of sodium fluoride in rats. Neurotoxicology and Teratology, 17, 169–177.

    CAS  Article  Google Scholar 

  • Murray, J. J. (1986). Appropriate use of fluorides for human health. Geneva: World Health Organization (WHO).

    Google Scholar 

  • Narbutaite, J., Vehkalahti, M. M., & Milcˇiuviene, S. (2007). Dental fluorosis and dental caries among 12-yr-old children from high- and low-fluoride areas in Lithuania. European Journal of Oral Sciences, 115, 137–142.

    CAS  Article  Google Scholar 

  • Ozsvath, D. L. (2006). Fluoride concentrations in a crystalline bedrock aquifer Marathon County, Wisconsin. Environmental Geology, 50, 132–138.

    CAS  Article  Google Scholar 

  • Perumal, E., Paul, V., Govindarajan, V., & Panneerselvam, L. (2013). A brief review on experimental fluorosis. Toxicology Letters, 223, 236–251.

    CAS  Article  Google Scholar 

  • Poureslami, H. R., Khazaeli, P., & Noori, G. R. (2008). Fluoride in food and water consumed in Koohbanan (Kuh-E Banan), Iran. Research Report Fluoride, 41, 216–219.

    CAS  Google Scholar 

  • Rango, T., Kravchenko, J., Atlaw, B., McCornick, P. G., Jeuland, M., Merola, B., & Vengosh, A. (2012). Groundwater quality and its health impact: an assessment of dental fluorosis in rural inhabitants of the Main Ethiopian Rift. Environment International, 43, 37–47.

    CAS  Article  Google Scholar 

  • Ruan, J. P., Bardsen, A., Astrom, A. N., Huang, R. Z., Wang, Z. L., & Bjorvatn, K. (2007). Dental fluorosis in children in areas with fluoride-polluted air, high-fluoride water, and low-fluoride water as well as low-fluoride air: a study of deciduous and permanent teeth in the Shanxi province, China. Acta Odontologica Scandanevica, 65, 65–71.

    Article  Google Scholar 

  • Sebastain, S. T., & Susmitha, S. (2015). 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. Journal of the Indian Society Pedodontics Preventive Dentistry, 33(4), 307–311.

    Article  Google Scholar 

  • Skinner, C. (2000). In praise of phosphates, or why vertebrates chose apatite to mineralise their skeletal elements. International Geology Review, 42, 232–240.

    Article  Google Scholar 

  • Suthar, S., Garg, V. K., Jahangir, S., Kaur, S., Goswami, N., & Singh, S. (2008). Fluoride contamination in drinking water in rural habitations of Northern Rajasthan, India. Environmental Monitoring and Assessment, 145, 1–6.

    CAS  Article  Google Scholar 

  • Tang, Q. Q., Du, J., Ma, H. H., Jiang, S. J., & Zhou, X. J. (2008). Fluoride and children’s intelligence: a meta-analysis. Biological Trace Element Research, 126, 115–120.

    CAS  Article  Google Scholar 

  • Teotia, S. P. S., & Teotia, M. (1975). Dental fluorosis in areas with a high natural content of calcium and magnesium in drinking water—an epidemiological study. Fluoride, 8, 34–38.

    CAS  Google Scholar 

  • Trivedi, M. H., Verma, R. J., Chinoy, N. J., Patel, R. S., & Sathawara, N. G. (2007). Effect of high fluoride water on intelligence of school children in India. Fluoride, 40, 178–183.

    Google Scholar 

  • Vazquez-Alvarado, P., Prieto-García, F., CoronelOlivares, C., Gordillo-Martinez, A. J., Ortiz-Espinosa, R. M., & Hernandez-Ceruelos, A. (2010). Fluorides and dental fluorosis in students from Tula De Allende Hidalgo, Mexico. Journal of Toxicology and Environmental Health Sciences, 2(3), 24–31.

    CAS  Google Scholar 

  • Viswanathan, G., Jaswanth, A., Gopalakrishnan, S., Siva Ilango, S., & Aditya, G. (2009). Determining the optimal fluoride concentration in drinking water for fluoride endemic regions in South India. Science of the Total Environment, 407(20), 5298–5307.

    CAS  Article  Google Scholar 

  • Viswanathan, G., Gopalakrishnan, S., & Siva Ilango, S. (2010). Assessment of water contribution on total fluoride intake of various age groups of people in fluoride endemic and non-endemic areas of Dindigul District, Tamil Nadu, South India. Water Research, 44, 6186–6200.

    CAS  Article  Google Scholar 

  • Wang, S. X., Wang, Z. H., Cheng, X. T., Li, J., Sang, Z. P., Zhang, X. D., Han, L. L., Qiao, X. Y., Wu, Z. M., & Wang, Z. Q. (2007). Arsenic and fluoride exposure in drinking water: children’s IQ and growth in Shanyin County, Shanxi Province, China. Environmental Health Perspectives, 115, 643–647.

    CAS  Article  Google Scholar 

  • WHO (1996). Trace elements in human nutrition and health. Geneva: World Health Organisation.

    Google Scholar 

  • WHO (2004). Fluoride in drinking-water. Background document for preparation of WHO Guidelines for Drinking-water Quality. Geneva, World Health Organization (WHO/SDE/WSH/03.04/96

  • WHO (World Health Organization). (2006). Guidelines for drinking-water quality: first addendum to third edition. Recommendations, Vol. 1.

  • Wu, D. L., & Li, Y. L. (1990). The investigation of the total amount of fluoride intake with correlative dental fluorosis polluted by burn coal in the epidemic fluorosis districts. Chinese Journal of Preventive Medicine, 24, 1–5.

    CAS  Google Scholar 

  • Xiang, Q. Y., Chen, L. S., & Wang, C. S. (2005). Study on the bench mark dose of urine fluoride in children and its relationship to the prevalence of dental fluorosis. Chinese Journal of Control of Endemic Disease, 20, 68–71.

    Google Scholar 

Download references

Acknowledgments

Authors express their sincere thank to the Mr. Sanat Goswami for his painstaking work for reformatting and language editing for the entire MS. Authors also extend their special thanks to other research scholar for their unconditional help for making the MS complete one.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Naba Kumar Mondal.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Das, K., Mondal, N.K. Dental fluorosis and urinary fluoride concentration as a reflection of fluoride exposure and its impact on IQ level and BMI of children of Laxmisagar, Simlapal Block of Bankura District, W.B., India. Environ Monit Assess 188, 218 (2016). https://doi.org/10.1007/s10661-016-5219-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s10661-016-5219-1

Keywords

  • Dental fluorosis
  • Urine fluoride
  • IQ
  • Health effect
  • Children
  • Groundwater
  • Bankura