Skip to main content

Diagnosis of Fluorosis by Analysis of Fluoride Content in Body Fluids Using Ion Selective Electrode Method

  • Chapter
  • First Online:
Translational Urinomics

Part of the book series: Advances in Experimental Medicine and Biology ((PMISB,volume 1306))

Abstract

Analysis of fluoride in body fluids (urine and serum) is essential for fluorosis diagnosis. Although 24-h urine collection is adopted to assess community defluoridation/fluoride supplementation program/research studies, but not feasible for Clinical/Pathological laboratories. Patients are reluctant to bring 24-h urine samples. Hence, spot urine samples are collected in clean, dry polypropylene bottles (not glass) without any preservative and analyzed on the same day by the Ion analyzer (ISE method). Equal volumes of Total Ionic Strength Adjustment Buffer (TISAB) solution are then added with body fluids before analysis and mixed well to eliminate interference from other ions besides pH adjustment and to provide a constant ionic strength. Results are reported as mg of Fluoride/l (ppm). High fluoride level in body fluids is an indication of confirmed cases of fluorosis. Two interventions, e.g. withdrawal of fluoride intake and intake of nutritive diet was introduced for prevention and control of fluorosis. The present study is to provide useful guidelines for monitoring of fluorosis disease in human beings, those who are at the risk of fluoride exposure.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Susheela, A.K.: A Treatise on Fluorosis (Revised 3rd Edition). Fluorosis Research & Rural Development Foundation, New Delhi (2007)

    Google Scholar 

  2. Susheela, A.K.: Fluorosis in developing countries: remedial measures and approaches. Proc. Indian Natn. Sci. Acad. (PINSA). B68(389–400) (2002)

    Google Scholar 

  3. Susheela, A.K.: Fluorosis and associated health issues. Indian J. Prac. Ped. 17(2), 58–66 (2015)

    Google Scholar 

  4. Susheela, A.K., Sharma, K., Das, T.K.: Issues in fluoride toxicity and fluorosis. Ann. Natl. Acad. Sci. (India). 25(1), 5–9 (1988)

    Google Scholar 

  5. Shortt, H.E., McRobert, G.R., Barnard, T.W., Mannadi, N.A.S.: Endemic fluorosis in the Madras presidency. Indian J. Med. Res. 25, 553–568 (1937)

    CAS  Google Scholar 

  6. Arlappa, N., Qureshi, A.I., Srinivas, R.: Fluorosis in India – An overview. Int. J. Res. Dev. Health. 1, 97–102 (2013)

    Google Scholar 

  7. Kanduti, D., Sterbenk, P., Artnik, B.: FLUORIDE – A review of use and effects on health. Mater. Sociomed. 28(2), 133–137 (2016)

    Article  PubMed  PubMed Central  Google Scholar 

  8. Buzalaf, M.A., Whitford, G.M.: Fluoride metabolism. Monogr. Oral Sci. 22, 20–36 (2011)

    Article  PubMed  Google Scholar 

  9. Whitford, G.M.: The metabolism and toxicity of fluoride. Monogr. Oral Sci. 16, 1–153 (1996)

    Article  PubMed  Google Scholar 

  10. Bond, A.M., Murray, M.M.: Kidney function and structure in chronic fluorosis. Br. J. Exp. Pathol. 33(2), 168–176 (1952)

    Google Scholar 

  11. Villa, A., Anabalon, M., Zohouri, V., Maguire, A., Franco, A.M., Rugg-Gunn, A.: Relationships between fluoride intake, urinary fluoride excretion and fluoride retention in children and adults: an analysis of available data. Caries Res. 44, 60–68 (2010)

    Article  CAS  PubMed  Google Scholar 

  12. Choubisa, S.L.: A brief and critical review of endemic hydrofluorosis in Rajasthan, India. Fluoride. 51(1), 13–33 (2018)

    CAS  Google Scholar 

  13. Dharmaratne, R.W.: Fluoride in drinking water and diet: The causative factor of chronic kidney diseases in the North Central Province of Sri Lanka. Environ. Health Prev. Med. 20, 237–242 (2015)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Nanda, R.S.: Fluoride content of North Indian foods. Indian J. Med. Res. 60, 1470–1482 (1972)

    CAS  PubMed  Google Scholar 

  15. Rao, K.V., Mahajan, C.L.: Fluoride content of some South Indian foods and their contribution to fluorosis. J. Sci. Food Agric. 51, 275–279 (1990)

    Article  CAS  Google Scholar 

  16. Susheela, A.K., Mondal, N.K., Singh, A.: Exposure to fluoride in smelter workers in a Primary Aluminium Industry in India. Intl. J Occup. Environ. Med. 4, 61–72 (2013)

    CAS  Google Scholar 

  17. Baud, C.A., Boivin, G., Demeurisse, C.: Drug-induced skeletal fluorosis. Fluoride. 15, 54–56 (1982)

    Google Scholar 

  18. Drinking water specification (IS: 10500). Bureau of Indian Standards (BIS), (2005)

    Google Scholar 

  19. Krishnamachari, K.A.: Skeletal fluorosis in humans: a review of recent progress in understanding of the disease. Prog. Food Nutr. Sci. 10(3–4), 279–313 (1986)

    CAS  PubMed  Google Scholar 

  20. Susheela, A.K., Bhatnagar, M., Gananasundaram, N., Saraswathy, T.R.: Structural aberrations in human Fluorosed teeth: biochemical and scanning Electron microscopic studies. Curr. Sci. 77(10), 1677–1681 (1999)

    CAS  Google Scholar 

  21. Pandit, C.G., Radhavachari, T.N.S., Rao, D.S., Krishnamurti, V.: Endemic fluorosis in South India: a study of the factors involved in the production of mottled enamel in children and some bone manifestation in adults. Indian J. Med. Res. 28, 533 (1940)

    CAS  Google Scholar 

  22. Susheela, A.K., Jha, M.: Fluoride ingestion and its influence on glycosaminoglycans in cancellous and cortical bone – A structural and biochemical study. Fluoride. 15(4), 191–198 (1982)

    CAS  Google Scholar 

  23. Susheela, A.K., Jethanandani, P.: Serum haptoglobin and C-reactive protein in human skeletal fluorosis. Clin. Biochem. 27(6), 463–468 (1994)

    Article  CAS  PubMed  Google Scholar 

  24. Dasarathy, S., Das, T.K., Gupta, I.P., Susheela, A.K., Tandon, R.K.: Gastroduodenal manifestations in patients with skeletal fluorosis. J. Gastroenterol. 31, 333–337 (1996)

    Article  CAS  PubMed  Google Scholar 

  25. Kharb, P., Susheela, A.K.: Fluoride ingestion in excess and its effects on organic and certain inorganic constituents of soft tissues. Med. Sci. Res. 22, 43–44 (1994)

    CAS  Google Scholar 

  26. Kaul, R.D., Susheela, A.K.: The muscle. In symposium on the non-skeletal manifestations of chronic fluoride toxicity. Fluoride. 9(9) (1976)

    Google Scholar 

  27. Bruce, S.: The diagnosis of chronic fluoride intoxication including the use of serum and urinary fluoride ion levels and a forearm radiograph in the diagnosis of stage II and III skeletal fluorosis. Fluoride. 51(1), 3–12 (2018)

    Google Scholar 

  28. Susheela, A.K., Das, T.K., Gupta, I.P., Tandon, R.K., Kacker, S.K., Ghosh, P., Deka, R.C.: Fluoride ingestion and its correlation with gastrointestinal discomfort. Fluoride. 25(1), 5–22 (1992)

    Google Scholar 

  29. Das, T.K., Susheela, A.K., Gupta, I.P., Dasarathy, S., Tandon, R.K.: Toxic effects of chronic fluoride ingestion on the upper gastrointestinal tract. J. Clin. Gastroenterol. 18(3), 194–199 (1994)

    Article  CAS  PubMed  Google Scholar 

  30. Das, T.K., Susheela, A.K.: Chronic fluoride toxicity and pituitary adrenal function. Environ. Sci. 1, 57–62 (1991)

    CAS  Google Scholar 

  31. Susheela, A.K., Jain, S.K.: Fluoride toxicity: Erythrocyte Membrane Abnormality and “Echinocyte” formation. Fluoride Res. Stud. Environ. Sci. 27(99), 231–239 (1986)

    Article  CAS  Google Scholar 

  32. Susheela, A.K.: Fluorosis – Early warning signs and diagnostic test. Bull. Nutr. F. India. 10(2) (1989)

    Google Scholar 

  33. Susheela, A.K., Mondal, N.K., Nalini, T., Gupta, R.: Early diagnosis and complete recovery from fluorosis through practice of interventions. J. Assoc. Physicians India. 62, 572-579 (2014)

    Google Scholar 

  34. Martínez-Mier, E.A., Cury, J.A., Heilman, J.R., Katz, B.P., Levy, S.M., Li, Y., Maguire, A., et al.: Development of gold standard ion-selective electrode-based methods for fluoride analysis. Caries Res. 45(1), 3–12 (2011)

    Article  PubMed  CAS  Google Scholar 

  35. Konieczka, P., Zygmunt, B., Namiesnik, L.: Comparison of fluoride ion-selective electrode based potentiometric methods of fluoride determination in human urine. Bull. Environ. Contam. Toxicol. 64, 794–803 (2000)

    Article  CAS  PubMed  Google Scholar 

  36. Basic methods for assessment of renal fluoride excretion in community preventive programmes for oral health. World Health Manual. ISBN 978 924 1548700, www.who.int (2014)

  37. Mehta, A.: Biomarkers of fluoride exposure in human body. Indian J. Dent. 4(4), 207–210 (2013)

    Article  Google Scholar 

  38. Poydo-Szymaczek, P., Borysewicz-Lewicka, M.: Urinary fluoride levels for assessment of fluoride exposure of pregnant women in Poznan. Poland. Fluoride. 38(4), 312–317 (2005)

    Google Scholar 

  39. Jha, M., Susheela, A.K., Krishna, N., Rajyalakshmi, K., Venkiah, K.: Excessive ingestion of fluoride and the significance of sialic acid: glycosaminoglycans in the serum of rabbit and human subjects. J. Toxicol. Clin. Toxicol. 19(10), 1023–1030 (1982)

    Article  CAS  PubMed  Google Scholar 

  40. Yahyavi, H., Kaykhaii, M., Mirmoghaddam, M.: Recent developments in methods of analysis for fluoride determination. Crit. Rev. Anal. Chem. 46(2), 106–121 (2016)

    Article  CAS  PubMed  Google Scholar 

  41. Hall, L.L., Smith, F.A., De Lopez, O.H., Gardner, D.E.: Direct potentiometric determination of total ionic fluoride in biological fluids. Clin. Chem. 18(12), 1455–1458 (1972)

    Article  CAS  PubMed  Google Scholar 

  42. Tusl, J.: Direct determination of fluoride in human urine using fluoride electrode. J. Clin. Chem. Acta. 27(1), 216–218 (1970)

    Google Scholar 

  43. Fuchs, C., Dorn, D., Fuchs, C.A., Henning, H., McIntosh, C., Scheler, F., Stennert, M.: Fluoride determination in plasma by ion selective electrodes – a simplified method for the clinical laboratory. Clinica. Chemica. Acta. 60(2), 157–167 (1975)

    Article  CAS  Google Scholar 

  44. Barnes, F.W., Runcie, J.: Potentiometric method for the determination of inorganic fluoride in biological material. J. Clin. Path. 21, 668–676 (1968)

    Article  CAS  PubMed  Google Scholar 

  45. Kadioglu, Y., Gulaboglu, M., Ozturk, M., Dogan, N.: Determination of fluoride by using ion selective electrode (ISE) method in urine of healthy volunteer and patients before-after Sevoflurane Anesthesia. Lat. Am. J. Pharm. 34(8), 1658–1663 (2015)

    CAS  Google Scholar 

  46. Milde, D., Novakova, K., Cermakova, I.: Fluoride determination in urine with ion selective electrode: within laboratory method and sample storage optimization. Acta. Univ. Palacki. Olomuc. Fac. Rer. Nat. Chemica. 43, 104–109 (2004)

    CAS  Google Scholar 

  47. NIOSH Manual of Analytical Methods (NMAM), 4th Edition. FLUORIDE in urine: METHOD 8308. 2, 2–4 (1994)

    Google Scholar 

  48. Method 9214: Potentiometric determination of fluoride in aqueous samples with ion-selective electrode, part of test methods for evaluating solid waste, physical/chemical methods. https://www.epa.gov/sites/production/files/2015-12/documents/9214.pdf

  49. Torra, M., Rodamilans, M., Corbella, J.: Serum and urine ionic fluoride: normal range in a nonexposed population. Biol. Trace Elem. Res. 63(1), 67–71 (1998)

    Article  CAS  PubMed  Google Scholar 

  50. Standard Methods for the examination of water and wastewater, American Public Health Association (APHA), 21st Edition, (2005)

    Google Scholar 

  51. Mondal, N.K.: Diagnosis of fluorosis and recovery through easy to practise interventions. Fluoride. 51(3), 230–242 (2018)

    Google Scholar 

  52. Susheela, A.K., Mondal, N.K., Tripathy, N., Gupta, R.: Early diagnosis and complete recovery from fluorosis through practice of interventions. J. Assoc. Phys. India (JAPI). 62(7), 572–579 (2014)

    Google Scholar 

  53. Susheela, A.K., Bhatnagar, M.: Reversal of fluoride induced cell injury through elimination of fluoride and consumption of diet rich in essential nutrients and antioxidants. Mol. Cell. Biochem. 234/235, 335–340 (2002)

    Article  CAS  Google Scholar 

  54. Susheela, A.K., Rashmi, G., Mondal, N.K.: Anaemia in adolescent girls: An Intervention of diet editing and counselling. Natl Med. J. India. 29(4), 200–204 (2016)

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Mondal, N.K. (2021). Diagnosis of Fluorosis by Analysis of Fluoride Content in Body Fluids Using Ion Selective Electrode Method. In: Baptista Carreira dos Santos, H.M. (eds) Translational Urinomics. Advances in Experimental Medicine and Biology(), vol 1306. Springer, Cham. https://doi.org/10.1007/978-3-030-63908-2_9

Download citation

Publish with us

Policies and ethics