Skeletal Fluorosis: Molecular Aspects

Publisher Summary This chapter discusses the molecular aspects of skeletal fluorosis. “Fluorosis” is a term used to describe the syndrome resulting from chronic exposure to excess fluoride. The disorder principally affects the skeletal and dental systems; although reports have highlighted metabolic and soft tissue manifestations such as glucose intolerance and “gastritis /dyspepsia” like syndromes. Traditional descriptions of skeletal fluorosis emphasize osteosclerosis, particularly of the axial skeleton. Early skeletal involvement in fluorosis may produce only mild or non-specific musculoskeletal symptoms, despite radiological evidence of significant disease. Overt skeletal fluorosis is characterized by generalized bone and joint pains, stiffness and restriction of movement of large joints and the spine. Fixed deformities, especially of the spine, hips, and knees are common in the late stages and may ultimately lead to incapacitation either because of the deformities themselves or as a result of the complicating compressive myeloradiculopathy. Some of these patients may present with bowing of the femur, tibia, radius, or ulna while others present with genu valgum or varum deformities. The latter typically occur in children with poor calcium intake and are described primarily from regions and populations where calcium undernutrition is common.