Fluoride Toxicity and Bone Health in Shekhawati: Prevalence, Skeletal Changes, and Fracture Risk Assessment”

Fluoride, a naturally occurring mineral, plays a dual role in bone health, with its effects largely dependent on exposure levels. At low to moderate concentrations, fluoride is known to stimulate osteoblast activity, enhancing bone mineralization and potentially increase osteoblast activity and enhancing bone mineral density (BMD). However, excessive fluoride intake, often due to prolonged exposure through drinking water, industrial emissions, or supplements, is associated with skeletal fluorosis, a condition characterized by increased bone fragility, joint stiffness, and pain. High fluoride levels can lead to abnormal bone mineralization, increased cortical bone thickness, and a higher risk of fractures. While fluoride has been used in osteoporosis treatment, its benefits remain controversial due to concerns over bone quality and structural integrity. The Shekhawati region of Rajasthan, India is known for high fluoride concentration in groundwater, leading to widespread fluorosis cases.