Early diagnosis and complete recovery from fluorosis through practice of interventions.

OBJECTIVES The objective of this communication is to disseminate scientific and technical information for early diagnosis of Fluorosis; recent developments in care and management of patients of Fluorosis. MATERIAL AND METHODS Body fluids collected from patients suspected of Fluorosis referred by hospitals, samples of drinking water used by them are the materials that have been investigated. Fluoride level in body fluids and water samples are tested by the ion selective electrode (ISE) potentiometry. Forearm X-ray radiograph is taken to assess interosseous membrane calcification. Upon diagnosis of the disease, two corrective measures, namely diet editing and diet counselling are introduced for practice in daily life. In the former, all sources of fluoride ingestion and use are withdrawn whereas in the latter, the patient is encouraged to consume a diet rich in essential nutrients, antioxidants and micronutrients through fruits, vegetables and dairy products. The patients are monitored at intervals to assess fluoride in body fluids. Reduction in fluoride levels has a direct relationship with disappearance of health complaints and subsequent recovery. RESULTS Eight case studies (5 male + 3 female) are described. Patients'complaints are gastrointestinal discomfort, polyuria, polydipsia, muscle weakness, fatigue and joint pain. Body fluids may have high fluoride with normal or high fluoride level in drinking water.The main source(s) of fluoride entry identified are (i) consuming fluoride contaminated food/snacks/beverages laced with black rock salt; (ii) drinking of untreated ground water; (iii) using fluoridated toothpaste. The duration of recovery varies from patient to patient depending upon their body physiology and the seriousness with which the interventions were practiced. Recurrence of the disease may occur in some patients due to change in life-style, not practicing interventions, entry of fluoride inadvertently. CONCLUSION This communication provides an overview of Fluorosis, its occurrence, manifestations, diagnostic tests, results, interventions practiced, monitoring and recovery from the disease.