Journal of Scientific Dentistry

Register      Login

VOLUME 5 , ISSUE 1 ( January-December, 2015 ) > List of Articles


Integrated Fluorosis Mitigation – An Indian Perspective

Pavithra R, Madan Kumar PD

Keywords : fluorosis mitigation, nutritional supplementation, quantitative chemical risk assessment

Citation Information : R P, PD MK. Integrated Fluorosis Mitigation – An Indian Perspective. 2015; 5 (1):30-35.

DOI: 10.5005/jsd-5-1-30

License: CC BY-NC 4.0

Published Online: 13-08-2020

Copyright Statement:  Copyright © 2015; The Author(s).


India is one among the 23 nations identified as fluoride endemic regions. The concentration of fluoride in the groundwater ranges from 1.0mg/l to 48.0mg/l, while The Bureau of Indian Standards has set 1.0mg/l as the acceptable limit. The constant exposure to fluoride through food and drinking water results in dental, skeletal and non-skeletal fluorosis. To mitigate the effects of fluoride, an Integrted approach is needed as it is advantageous than the conventional defluoridation techniques. The Integrated Fluorosis Mitigation approach imparts better understanding of the adverse effects of fluoride consumption through Information, Education and Communication activities. Using data from dental survery and Quantitative Chemical Risk Assessment tool, the hazard is identified and risk is characterised. Based on these data, mitigation strategies are planned. This review outlines the process of Integrated Fluorosis Mitigation and various programmes undertaken by the various Indian state and central governmental agencies.

PDF Share
  1. “Water for People, Water for Life” United Nations World Water Development Report, Part II: A look at the world's freshwater resources. UNESCO, 2003. Available from:
  2. Narayan G. Hegde. Water Scarcity and Security in India. BAIF Development Research Foundation, Pune. Available from:
  3. Guidelines for safe drinking water quality. Geneva: WHO; 2004: World Health Organisation.
  4. A.K. Susheela. Fluorosis in developing countries: Remedial measures and approaches. Proc Indian Nat Sci Acad. 2002; 68(5):389-400.
  5. NEERI, UNICEF. Report on Integrated Fluorosis Mitigation. 2007.
  6. Ayoob S, Gupta A K. Fluoride in drinking water: A review of the status and stress effects. Critical Review. Environ Sci Tech. 2006; 36:433-487.
  7. Fewtrell L, Smith S, Kay D, Bartram J. An attempt to estimate the global burden of disease due to fluoride in drinking water. J Water Health. 2006; 4:533-542.
  8. Indian Standard Drinking Water Specification. New Delhi: Bureau of Indian Standards; 2012.
  9. Whyte MP, Essmeyer k, Gannon F H, Reinus W R. Skeletal fluorosis and instant tea. Fluoride 2005; 38(1):76-81.
  10. Cao J, Zhao Y, Li Y, Deng H J, Yi J, Lin J W. Fluoride levels in various black tea commodities: Measurement and safety evaluation. Food Chem Toxicol 2006; 44: 1131-1137.
  11. Jolly S S, Singla V P, Sharma R, Ralham S M and Sandhu S S. Endocrine aspects of endemic fluorosis. Fluoride 1974; 7(4):208-219.
  12. Liang C K, Ji R, Cao S R. Epidemiological analysis of endemic fluorosis in China. Environ Carcinogen. Ecotoxixol Rev 1997;15(2):123-138.
  13. Susheela A K. Fluorosis: Indian Scenario: A treatise on fluorosis. Fluorosis research and rural development foundation. New Delhi, India.2001.
  14. Piddennavar R, Pushpanjali K. Review on Defluoridation Techniques of Water. The International Journal of Engineering and Science. 2013;2(3):86-94.
  15. Chinoy N J, Dilpi M. Beneficial effects of a protein supplementation diet on fluoride induced toxicity in liver of male mice. Fluoride 2005;3(4):276-283.
  16. Krishnamachari A K V P. Skeletal fluorosis in humans: a review of recent progress in the understanding of the disease. Prog Food Nutr Sci. 1986; 10(3):279-314.
  17. Chakma T, Rao V P, Singh S B, Tiwary R S. Endemic genuvalgum and other bone deformities in two villages of Mandla district in central India. Fluoride 2000; 33(4): 17-195.
  18. Vaish AK, Vaish P. A Case Study of Fluorosis Mitigation in Dungarpur District, Rajasthan, India. In: Dahi E, Rajchagool S, Osiriphan N, editors. Proceedings of the 3rd International Workshop on Fluorosis Prevention and Defluoridation of Water. 2000 Nov 20-24; Chiang Mai, Thialand. 97-104.
  19. People's Science Institute, Dehradun. Vasudha Vikas Sansthan (Dhar). Water Aid, India. Report on Fluorosis mitigation program in Dhar District (M.P.) 2011.
  20. Mythri H, Dinesh, Bennadi D. Current public health perspective of fluorosis mitigation project in Pavagada taluk, Karnataka. Indian J Occup Environ
  21. Gautam A, Tripathi RC. Fluoride Testing and Fluorosis Mitigation In Sonebhadra District Available from: https://ideas.
  22. Fluoride Testing and Fluorosis Mitigation nn Nuapada District Orissa: A Small Pilot-Scale Exercise. Available from:'s/EQMG/FLUORIDE%20TESTING%20 AND%20FLUOROSIS%20MITIGATION%20IN%20NUAPADA.pdf.
  23. Narayana AS, Khandare AL, Krishnamurthi MVRS. Mitigation of Fluorosis in Nalgonda District Villages. In: Dahi E, Rajchagool S, editors. Proceedings of the 4th International Workshop on Fluorosis Prevention and Defluoridation of Water. 2004 Mar 2-6; Colombo, Sri Lanka. 98-106.
  24. Hogenakkal Water Supply and Fluorosis Mitigation Project. Tamilnadu Water supply and Drainage Board. Available from
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.