For Medical Professionals

It may be confusing for a Doctor / Medical Officer to differentiate Skeletal Fluorosis from other bone diseases viz: Arthritis (joint pain); Spondylites (neck pain); Osteoporosis (atrophy of bone); Osteomalacia (due to calcium deficiency in the diet) and Other Bone diseases

It is equally true that a Doctor / Medical Officer, needs to know how to differentiate the following health complaints due to fluoride poisoning from other disorders having similar complaints.

• Non-ulcer dyspepsia (stomach problems / irritable bowel syndrome)
• Polyuria (tendency to urinate more frequently)
• Polydipsia (excessive thirst)
• Anemia (low hemoglobin)
• Muscle weakness
• Extreme Fatigue

Normal	Fluorosed
Human Skeletal Muscle Structure

Doctors also have a problem to diagnose Fluorosis in children.

Differentiating Fluorosis from the following diseases require knowledge and skills.

• Rickets
• Genuvalgum (knock knee)
• Genuvarum (bow leg)
• Cretinism
• Low IQ
• Deaf mutism

Knock Knee	Bow Leg	Short stature (Low IQ)

For Dental Professionals:

It is equally important to up-date Dentists and Dental Health Administrators on the harmful effects of fluoride on teeth. Dental Fluorosis occur with.

• Loss of calcium from the teeth.
  
• Pitting and perforations with chipping off the teeth.
  
• Discolouration of teeth with varying shades – white, yellow, brown to black seen horizontally aligned / or as spots away from the gum on the enamel surface, is classical Dental Fluorosis.
• Exposure to fluoride need to be avoided from the stage of tooth germ eruption i.e. 6 weeks of intra-uterine life to 6 years of age. This is extremely crucial as the child is bound to develop Dental Fluorosis, if care is not exercised.
  
• It is also equally important to up-date all concerned on "Dental Caries" which is yet another problem of the teeth which is caused by bacteria breeding in unhygienic oral environment and producing acids.
  

Dental Fluorosis	Dental Caries

• It is also a fact that use of fluoride my lead to loosing of teeth (edentulous) at a much younger age.

For Public Health Engineers

• The Public health Engineers / Environmental Engineers / Chemical Engineers also need to be aware of the principles of water quality testing, quality control procedures to obtain reliable and reproducible results.
• It is also important for them to know monitoring of water quality and what it involves for ensuring sustainability.
• Defluoridation procedures, developed indigenously are alien to a large number of the Public Health Engineers / Civil and Chemical Engineers in the country, unless up-dates are conducted.