1. Fluorosis in the Arusha region, TZ
Heidi Johansen
Fluorosis in the Arusha region, TZ

2. Dental and skeletal fluorosis
Bones & teeth
Long term exposure
Arthritis, osteoporosis

3. Background Arusha region Rift valley, ground water
WHO recommends <1.5 mg/L
1.5 – 24.9 mg/L, mean 8 mg/L
3-6 mg/L associated with skeletal fluorosis
1 mg/L associated with mild dental fluorosis

4. Mechanism Absorption in GIT Storage in bones & teeth
Excretion in urine and sweat
Bones – Calcium replacement
Thyroid – Iodine replacement

5. Characteristics
Functional & structural change in bone – severity proportionate to fluoride concentration
Symptoms of stage 1 & 2 fluorosis as arthritis – diagnostic difficulties
Osteoporosis, osteomalacia
secondary hyperparathyroidism, thyroid hypofunction

6. Treatment & prevention
No cure – limit fluoride exposure
Domestic, simple techniques
Bone ash, clay
Nalgonda method
Advanced, large scale techniques
Precipitation – Al and Ca salts
Reverse osmosis

7. Fluoridation of public drinking water
Benefit
Freedom of choice

8. Sources http://wedc.lboro.ac.uk/resources/conference/22/dahi.pdf
Dhar V, Bhatnagar M. Physiology and toxicity of fluoride. Indian J Dent Res 2009;20:350-5