Prevalence and Determinants of Fluorosis and Association with Periodontal Health in an Endemic Region in Central India: A Community based Cross-sectional Study
Devashish Marskoley, Trina Sengupta, Saurav BasuAbstract
Introduction:
Dental fluorosis represents a significant public health concern in some communities of India. The groundwater of Rajgarh block, Madhya Pradesh, is considered fluoride-endemic as fluoride concentrations consistently exceed the World Health Organization (WHO)-recommended limit of 1.5 ppm for drinking water. While the effect of fluoride on teeth is well known, information is scarce on its effect on the surrounding periodontal structures. The study objective was to assess the prevalence and severity of fluorosis and its association with periodontal health status among individuals residing in rural areas of Rajgarh block, Madhya Pradesh.
Materials and Methods:
This cross-sectional, observational study was conducted among 246 participants, aged between 30 and 49 years, who reported consuming untreated water from the ground, and were continuous residents of the fluoride-endemic villages of Rajgarh. Assessment of dental fluorosis was done by Dean’s fluorosis index, and periodontal status by standard WHO guidelines.
Results:
A total of 246 participants (mean age: 38 ± 5.79 years) were included, of whom 34.1% had non-healthy periodontium. Dental fluorosis (mild to severe) was present in 26.0% of participants. On adjusted analysis, individuals with dental fluorosis had significantly higher odds of non-healthy periodontal status (aOR: 2.6; 95% confidence interval: 1.62–5.12), indicating independent association. Increasing age (40–49 years) and daily tobacco use were significantly associated with poorer periodontal health.
Conclusion:
Dental fluorosis remains a major public health challenge in endemic regions, affecting nearly one in four adults aged 30–49 years, with a higher burden among males, smokers, and alcohol users, and a significant association with poorer periodontal health.