Endemic fluorosis with particular reference to dental and systemic intoxication.

THE-studies of the toxic effects of fluoride on the human system have evoked a very lively interest throughout the world because the public health programmes of fluoridation for the prevention of dental caries have always considered the risk of a remote cumulative intoxication. However, the indices of early intoxication are very poorly defined. The affinity of fluoride for the bones is acknowledged by everybody, but there is no universal agreement on its effects on other systems of the body-particularly when it has been spread over a number of years. We have had a unique opportunity of studying the toxic potentialities of this ion because there exists an extensive belt of 'endemic fluorosis' in the southern parts of Punjab (India) mainly affecting the rural population. As already reported, people in these villages get their drinking water supply mostly from wells in which the fluorine content is high (varying from 2.5 to I4 parts per million-Singh, Jolly and Bansal, I96I; Singh and Jolly, I96I). The soil of this area is sandy and the temperature goes pretty high (iI6°-II7° F.) in the summer. The skeletal and neurological features of endemic fluorosis have already been described (Singh, Jolly and Bansal, I96I; Singh and Jolly, I96I; Singh, Dass, Hayreh and Jolly, I96I). The bones, due to heavy and irregular fluoride deposition, become grotesque and markedly irregular in their contours (Figs. i and 2). The