Control of Fluorosis in India

All India Institute of Medical Sciences
Ansart Nagar, New Delhi - 110 029

A.K. Susheela, Ph.D., F.A.Sc., F.A.M.S.
Professor of Histocytochemistry, Department of Anatomy

Message to: Rotary International,
Oakmont, Pennsylvania
c/o Ellie Rudolph
Fax 412-828-5096

There are 20 nations in the world with health problems due to excess fluoride ingestion through water and food.

India, Africa, China, certain parts of Thailand, Japan, New Zealand, Australia, Israel, Pakistan, Syria, Turkey are severely affected. However, the problem exist in U.K., U.S.A., Canada to a lesser extent possibly due to better nutrition, calcium and Vitamin C in diet which can nullify the toxic manifestations to some extent. But "Water Fluoridation" is a guaranteed danger to health.

The major problem is that, very often, skeletal fluorosis and non-skeletal fluorosis are misdiagnosed and treated wrongly as clinicians do not fully understand the manifestations due to fluoride poisoning/toxicity. These are not described adequately in Medical/Dental text books.

Dental fluorosis, is quite evident from the discolouration of the teeth from white, yellow, brown, to black spots or streaks horizontally aligned on the enamel surface, away from the gums. Even Dentists, quite a large number, do not fully understand fluoride action on teeth. We have problems in India, as Dentists promote fluoride, among patients, who have dental fluorosis and the patients end-up with severe non-skeletal manifestations. Intense scientific debates have helped the Government, to amend our Drugs and Cosmetic Act of 1945, during 1992 to bring-in stipulations in the manufacture of fluoridated toothpaste. We would like to get the fluoridated toothpaste out of our country. But due to vested interests among concerned, it is not an easy task.

To summarise a few scientific facts which concerns the people around the world are: Fluoride ingestion affects adversely:

· muscle structure and function, resulting in muscle weakness.

· red blood cells (erythrocytes) are killed prematurely, lowering haemoglobin content, resulting in anaemia.

· blood vessels are blocked through calcification resulting in cardiac problems.

· the male reproductive organs are affected resulting in defective sperms, leading to infertility in some men, which is again related to the hormonal status of the individual.

· the gastrointestinal tract mucosa is deranged (the lining of the stomach and intestine) resulting in : pain in the stomach, gas formation, nausea, loss of appetite, constipation followed with intermittent diarrhoea.

· people loose their teeth and become edentulous at a relatively young age.

India is the first country in the world to develop two protocols for diagnosing Fluorosis at an early stage, so that prevention of the disease is possible. Radiographs revealing skeletal fluorosis is too late for reversal of the changes. Fluorosis has no treatment or cure. Prevention is the only solution provided the disease is diagnosed early.

· For early detection of fluoride poisoning we use 1) Gastrointestinal manifestations (non-ulcer dyspepsia) 2) a sensitive blood test SA/GAG for detection.

· In view of the enormous health problems due to fluoride, India is now investing massive amounts of funds for removing fluoride from drinking water.

· Dental caries on the contrary, is not a fluoride related disease: it is a bacterial disease. Can be easily prevented, if oral hygiene practises are promoted and calcium and vitamin C in the diet are given in adequate quantum to the child even before birth through maternal diet.

· However, Dentists invariably misguide the public by designating Dental caries as a fluoride deficiency disorder, which is grossly and scientifically incorrect.

· In India, we are educating our people through radio, TV and other print media, the dangers of fluoride and they shall avoid it. In the developed western world, as people are educated. I do not understand why it should be a problem to convince the Government against "water fluoridation" and to stop it.

· In early 1970 and 1980 some of the UN Organisations tried their very best to promote fluoridation of water in India (inspite of prevailing health problems due to excess of fluoride) and the scientific community fought the battle and was able to convey to the concerned Organisation(s) that they shall not enter India with the message for Fluoridation and we won the battle. They were trying to use the developing world to promote fluoridation based on the concepts of the "donor" countries but did not work.

"Peoples Health is the Nations' Wealth" and I hope the Rotary International would do everything possible to stop the cruel method of poisoning people through fluoridating drinking water in the name of prevention of Dental caries.

This truly reveals that no Organisation/Association can be taken for granted. Their intentions while promoting fluoride need to be questioned.

Professor A.K. Susheela
Dated: 24th February, 1996.