Water-borne Fluoride and Cortical Bone Mass: A Comparison of Two Communities

Abstract

This study investigated the relationship between cortical bone mass in an older female population and their ingestion of fluoride from community water supplies. The study was conducted among lifelong female residents in Lordsburg (3.5 ppm fluoride) and Deming (0.7 ppm fluoride), NM. A total of 151 postmenopausal women ranging in age from 39 to 87 years took part; 69 were residents of the optimal-fluoride community, while the remaining 82 were residents of the high-fluoride community. Although bivariate analyses showed no difference in cortical bone mass between women in the two communities, with multiple regression analyses, significant predictors of bone mass (p < 0.05) were weight, years since menopause, current estrogen supplementation, diabetes, and fluoride exposure status. Based on a model containing all of these variables, women living in the high-fluoride community had a bone mass ranging from 0.004 to 0.039 g/cm² less than that of similar women living in the optimum-fluoride community. These results suggest that lifelong ingestion of water containing 3.5 ppm fluoride, compared with water containing 0.7 ppm fluoride, does not increase cortical bone mass in women of similar age, weight, and menopausal status. Under the conditions of this study, cortical bone mass might be reduced in a high-fluoride area.

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References

Andresen, J. and Nielsen, H.E. (1986): Assessment of Bone Mineral Content and Bone Mass by Non-invasive Radiologic Methods, Acta Radiol 27:609-617.

Ansell, B.M. and Lawrence, J.S. (1966): Fluoridation and the Rheumatic Diseases. A Comparison of Rheumatism in Watford and Leigh, Ann Rheum Dis 25:67-75.

Arnala, I. ; Alhava, E.M. ; Kivivouri, R. ; and Kaura-Nen, P. (1986): Hip Fracture Incidence not Affected by Fluoridation. Osteofluorosis Studied in Finland, Acta Orthop Scand 57:344-348.

Avorn, J. and Niessen, L.C. (1986): Relationship Between Long Bone Fractures and Water Fluoridation, Gerodontics 2:175-179.

Bernstein, D.S. ; Sadowsky, N. ; Hegsted, D.M. ; Guri, D. ; and Stare, F.J. (1966): Prevalence of Osteoporosis in High-and Low-fluoride Areas in North Dakota, JAm Med Assoc 198 :499-504.

Briancon, D. and Meunier, P.J. (1981): Treatment of Osteoporosis with Fluoride, Calcium and Vitamin D, Orthop Clin North Am 12:629-648.

Dean, H.T. (1933): Distribution of Mottled Enamel in the United States , Public Health Rep 48:703-734.

Eastell, R. and Riggs, B.L. (1987): Treatment of Osteoporosis , Obstet Gynecol Clin North Am 14:77-88.

Eriksen, E.F. ; Mosekilde, L. ; and Melsen, F. (1985): Effect of Sodium Fluoride, Calcium, Phosphate and Vitamin D2 on Trabecular Bone Balance and Remodeling in Osteoporotics , Bone 6:381-389.

10.

Goggin, J.E. ; Haddon, W. ; Hambly, G.S. ; and Hove-Land, J.R. (1965): Incidence of Femoral Fractures in Postmenopausal Women. Before and After Water Fluoridation, Public Health Rep 80:1005-1012.

11.

Horowitz, H.S. ; Driscoll, W.S. ; Meyers, R.J. ; Heifetz, S.B. ; and Kingman, A. (1984): A New Method for Assessing the Prevalence of Dental Fluorosis-The Tooth Surface Index of Fluorosis, J Am Dent Assoc 109:37-41.

12.

Jowsey, J. ; Schenk, R.K. ; and Reutter, F.W. (1968): Some Results of the Effect of Fluoride on Bone Tissue in Osteoporosis, J Clin Endocrinol Metab 28:869-874.

13.

Leone, N.C. ; Stevenson, C.A. ; Hilbish, T.F. ; and Sosman, M.C. (1955): A Roentgenologic Study of a Human Population Exposed to High-fluoride Domestic Water (a 10-year study), Am J Roentg 74:874-885.

14.

Lian, Z.C. and Wu, E.H. (1986): Osteoporosis-an Early Radiographic Sign of Endemic Fluorosis, Skeletal Radiol 15:350-353.

15.

Madans, J. ; Kleinman, J.C. ; and Coroni-Huntley, J. (1983): The Relationship Between Hip Fracture and Water Fluoridation : an Analysis of National Data, Am J Public Health 73 :296-298.

16.

Parfitt, A.M. (1983): The Physiologic and Clinical Significance of Bone Histomorphometric Data. In: Bone Histomorphometry: Techniques and Interpretation, R. Recker , Ed., Boca Raton, FL: CRC Press, pp. 143-223.

17.

Revicki, D.A. and Israel, R.G. (1986): Relationship Between Body Mass Indices and Measures of Body Adiposity, Am J Public Health 76:992-994.

18.

Richardson, M.L. ; Genant, H.K. ; Cann, C.E. ; Ettinger, B. ; Gordan, G.S. ; Kolb, F.O. ; and Reiser, U.J. (1985): Assessment of Metabolic Bone Disease by Quantitative Computed Tomography, Clin Orthop 195:224-238.

19.

Riggs, B.L. ; Hodgson, S.F. ; Hoffman, D.L. ; Kelly, P.J. ; Johnson, K.A. ; and Taves, D. (1980): Treatment of Primary Osteoporosis with Fluoride and Calcium. Clinical Tolerance and Fracture Occurrence, J Am Med Assoc 243:446-449.

20.

Simonen, O. ; Knekt, P. ; and Laitinen, O. (1984): Fluoride in Drinking Water and Osteoporosis, Duodecim 100:342-350.

21.

Simonen, O. and Laitinen, O. (1985): Does Fluoridation of Drinking-Water Prevent Bone Fragility and Osteoporosis?, Lancet 2:432-434.

22.

Sowers, M.R. ; Wallace, R.B. ; and Lemke, J.H. (1986): The Relationship of Bone Mass and Fracture History to Fluoride and Calcium Intake: a Study of Three Communities, Am J Clin Nutr 44:889-898.

23.

Striffler, D.F. (1955): Fluoridation in New Mexico: its Present Status , NM State Dent J 5:3-11.

24.

Us Department Of Commerce (1980): Population Characteristics. New Mexico. Washington, DC: Bureau of the Census.

25.

Us Public Health Service (1959): Natural Fluoride Content of Communal Water Supplies, Bethesda , MD: National Institutes of Health.

26.

Us Public Health Service (1969): Natural Fluoride Content of Communal Water Supplies, Bethesda , MD: National Institutes of Health.

27.

Zipkin, I. ; McClure, F.J. ; Leone, N.C. ; and Lee, W.A. (1958): Fluoride Deposition in Human Bones after Prolonged Ingestion of Fluoride in Drinking Water, Public Health Rep 73:732-740.