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Fluorosis is a condition which is caused by an excessive intake of fluoride. This condition can manifest in the form of skeletal fluorosis, meaning that it attacks the bones of the body, or dental fluorosis, sometimes called enamel fluorosis. The damage caused by fluorosis is permanent, making prevention very important in regions of the world where the problem is endemic, such as China and India. Fluorosis appears to be especially common in the developing world, for a variety of reasons, but it can also appear in the West.
As a general rule, someone needs to consume 10 times the recommended daily intake of fluoride for an extended period of time for fluorosis to develop. Dental fluorosis usually appears before the skeletal form, which can allow medical professionals to catch the problem early. Excessive fluoride can come from fluoride pollution, inhalation of fluoride dust and fumes, heavily fluoridated water, supplements, excessive consumption of tea, and consumption of fluoridated toothpaste.
Dental fluorosis starts with small marks and spots on the teeth, sometimes accompanied with a mild transparency of the tooth enamel. If the condition is allowed to progress, the teeth will become pitted, cracked, and brittle. If dental fluorosis is identified, the patient is typically educated about sources of fluoride so that he or she can learn to avoid them, and the teeth may be veneered or capped for aesthetic reasons, and to protect them from further damage.
The skeletal form of fluorosis causes brittle bones and joint pain. It can be tricky to identify because the bones are not readily visible, and because other conditions can cause similar problems. In regions of the world where fluorosis is endemic, these symptoms are often taken to be a sign that a patient has the condition, while in areas where the condition is more rare, it may take some time to get to the bottom of the problem. Sometimes, x-rays may be used to visualize the bones.
Fluoride is an important dietary supplement which has been shown to be very effective at cavity prevention in numerous studies. The fact that fluorosis exists is not a reason to stop using fluoride in dental care, but it is a reason to be careful. People with a naturally higher fluoride intake due to their diet should watch out for fluorosis, and consider using filters which can help to eliminate fluorides in their water. In the West, where water is typically fluoridated along with toothpaste and other dental care products, people may want to avoid fluoride supplements, unless advised to take them by a dentist or doctor.
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