Fluorosis is an important clinical and public health problem in several parts of the world, global prevalence of fluorosis is reported to be about 32%. There are several million people in India who are exposed to drinking water sources that represent a definite risk of developing fluorosis. Excess fluoride ingestion is a major health problem, with 15 of the 30 states and Union Territories in India being endemic for fluorosis.

Fluoride concentrations of up to 31.3 ppm in drinking water have been reported in some parts of Nalgonda. Dental and skeletal fluorosis in residents of rural areas of Nalgonda consuming water containing 3 ppm fluoride has been reported. Skeletal fluorosis in villages with drinking water containing 5 ppm of fluoride and crippling fluorosis in villages with mean fluoride levels of 6 ppm have been observed. The presence of excessive quantities of fluoride in drinking water is accompanied by a characteristic sequence of changes in teeth, bone and periarticular tissues. These changes lead to a variable degree of locomotor disability, ranging from simple mechanical back pain to severe crippling combined locomotor and neurological impairment. In endemic areas, a substantial proportion of the population may be affected, posing a severe public health problem. In some areas, the hazards to human health are not fully appreciated and are under-reported. The maximum impact is felt in communities engaged in physically strenuous activities, either agricultural or industrial. The need of these often isolated communities in economically restructuring countries for the provision of low-fluoride drinking water remains a hope rather than a possibility at the present time.

Genetics & Evolution Journal, Familial Aggregation, Familial Segregation, Endemic Fluorosis, Excess Fluoride Ingestion, Skeletal Fluorosis, World Health Organization, Consanguineous Marriages, Genetic Mechanism, Empirical Data, Molecular Markers, Empirical Models.