Fluoride is essential for bone and tooth health but excess intake can cause dental and skeletal fluorosis. The daily requirement is less than 2ppm and fluoride strengthens tooth enamel and prevents cavities. Dental fluorosis, characterized by mottled enamel, occurs from overexposure to fluoride as a child. While water fluoridation and fluoride toothpaste help many communities, they are not recommended for areas where water already contains over 1.2ppm fluoride to avoid excess intake.

2.  Present in
i) bones
ii) teeth.
 Daily requirement : less than 2 ppm per day.

3.  Essential for the
normal mineralization
of bones and the
formation of dental
enamel.
 Prevents development
of dental caries.
 Forms a protective layers
of acid resistant
fluorapatite.
 fluoride inhibits the
bacterial enzymes

4.  Dental fluorosis
 If fluoride intake > 2 ppm
 mottling of tooth enamel
 a developmental
disturbance of dental
enamel
 caused by excessive
exposure to high
concentrations of fluoride
 teeth become rough with
brown/yellow patches on
their surface
 Occurs at the age of 0-6
year only.

5.  Intake of fluorine > 20 ppm causes severe
skeletal disorders ( skeletal fluorosis).

6. Classification
1. Very Mild
2. Mild
Small opaque, paper white areas
covering less than 25% of the tooth
surface.
Opaque white areas covering less than
50% of the tooth surface
3. Moderate
4. Severe
All tooth surfaces affected; marked wear
on biting surfaces; brown stain may be
present
All tooth surfaces affected; discrete or
confluent pitting; brown stain present

8.  Controlled addition of a fluoride compound to a
public water supply
 Reasons : low fluoride content in water resulting into
increased cases of dental caries.
 Community water fluoridation is possible only
where a central public water supply system is
present.
 In India Water Fluoridation Is not Practiced.

10.  Fluoridated Toothpastes were first introduced
in U.S.
 To Fight against increasing cases of dental
caries.
 Approved by ADA
 Due to significant decrease in dental caries and
tooth decay after using fluoridated toothpastes.

11. In a research by Consumer Education and
Research Society (CERS)
It was found all fluoridated toothpastes to be
high in fluoride content.

12. FLUORIDECONC.(INPPM)
TOOTHPASTE BRANDS 

13.  Fluoride content in
water in India is
already around 1.2
mg/l
 More than this
much fluorine
intake can lead to
dental and skeletal
fluorosis .
WHY IS DENTAL FLUOROSIS SO COMMON IN
INDIA ?

14. CASE
STUDy
SOURCE : INTERNERT/IDA MAGAZINE

15. A CASE STUDY FROM PRIMARY
SCHOOLS OF RURAL AREAS OF
TAMIL NADU
 Children studying in six primary schools of six
villages were surveyed.
 Five hundred and twenty-five 5- to 12-year-old school
children were surveyed
 Every child was clinically examined at the school.

16.  Three out of six villages studied were in ‘borderline’
public health significance (CFI score 0.4-0.6).
CFI VALUE RANGE PUBLIC HEALTH
SIGNIFICANCE
0.00-0.04 Negative
0.04-0.06 Borderline
0.06-1.00 Slight
1.00-2.00 Medium
2.00-3.00 Marked
3.00-4.00 Very Marked

17.  High conc. Of fluorine Was Responsible For
Dental Fluorosis.

18.  Fluoride removal plants
 Reverse osmosis plants (RO Plants)
 Household and public system reverse osmosis
plants are common in the market.
 Example :
In Bhatinda (Punjab) Water is rich in Fluoride.
So, Various RO plants are fitted by govt. after
every few Kilometers.

20.  Know the fluoride concentration of
drinking water
 This information should help with
decisions about using other fluoride
products
 Fluoride tablets or drops should not be
used at all

21.  Indian brands of
toothpastes like
 meswak
 Dabur Babool
 Dabur red
 Promise
are Non-fluoridated.
 Especially, Children
below the age of 5-6,
should not use
fluoridated toothpastes.
 Supervision to reduce
the swallowing of
excess toothpaste by
children.

22.  In latest researches Indian researchers
has found that the leaves and stem of
Tulsi can detoxify water with high-
fluoride content.
 How does it act?
 It has natural bio-adsorbent
properties.
 leaves and stem serve as natural
magnet to adsorb the fluoride
molecules in water.
 The All one has to do is to take a
few leaves or stem pieces of Tulsi
and dip them in a glass of water for
20 minutes. Remove the leaves or
stem pieces and drink the water.