Does fluorosis affect the intelligence profile of children? A cross sectional analysis of school children of district Una, Himachal Pradesh, India
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20180759Keywords:
IQ, adolescents, sub Himalayan, fluoride, waterAbstract
Background: The sub Himalayan region of the country does not fall in highly endemic region for fluorosis. Researchers over the world have hypothesized that high fluoride level in water is the cause of low intelligence level among children and adolescents. We aim to establish the association of high and low fluoride levels with intelligence level and oral health status of children aged 10-14 years in district Una, Himachal Pradesh.
Methods: The study was conducted in randomly selected 15 government high schools of district Una. Study population included 600 students of government run schools in age group 10-14years. This ICMR funded project was carried out from 2014 through 2017. Dean fluorosis index was used to study fluorosis level and Intelligence test was conducted on students by using Raven’s standard progressive matrices questionnaire.
Results: The 60% of sites studied for fluoride levels were found to have >0.5 ppm fluoride level in water and none of them with level more than 1 ppm. Prevalence of dental fluorosis was 12.2%. Dental caries and high Dental Aesthetic Index were positively associated with high fluoride level in water. Low intelligence level of adolescents was not significantly associated with high fluoride level (OR;95% CI: 1.34; 0.72-2.49).
Conclusions: This sub Himalayan region is not endemic for fluorosis however lower level of fluoride is observed in many sites. Fluorosis was not significantly associated with intelligence hence indicating towards multifactorial causation of disease.
Metrics
References
Government of India. National health portal. Fluorosis. 2016. Available at: https://www.nhp. gov.in/disease/non-communicable-disease/fluorosis. Accessed 27 November 2017.
Government of India. Directorate General of Health Services. Ministry of Health & Family Welfare. National health programme for Prevention and Control of Fluorosis (NPPCF). India; 2014.
Arlappa N, Aatif Qureshi I, Srinivas R. Fluorosis in India: an overview. Int J Res Dev Health. 2013;1(2): 97-102.
Saravanan S, Kalyani C, Vijayarani MP, Jayakodi P, Felix AJ, Nagarajan S, et al. Prevalence of dental fluorosis among primary school children in rural areas of Chidambaram Taluk, Cuddalore District, Tamil Nadu, India. Indian J Community Med. 2008;33:146-50.
Mondal D, Dutta G, Gupta S. Inferring the fluoride hydrogeochemistry and effect of consuming fluoride-contaminated drinking water on human health in some endemic areas of Birbhum district, West Bengal. Environ Geochemistry Health. 2016;38:557–76.
Khan SA, Singh RK, Navit S, Chadha D, Johri N, Navit P, et al. Relationship Between Dental Fluorosis and Intelligence Quotient of School Going Children In and Around Lucknow District: A Cross-Sectional Study. J Clinical Diagnostic Res. 2015;9(11):10-5.
Sebastian ST, Sunitha S. A cross-sectional study to assess the intelligence quotient (IQ) of school going children aged 10-12 years in villages of Mysore District, India with different fluoride levels. J Indian Soc Pedod Prev Dent. 2015;33:307–11.
Saxena S, Sahay A, Goel P. Effect of fluoride exposure on the intelligence of school children in Madhya Pradesh, India. J Neurosci Rural Pract 2012;2:144-9.
Kotecha PV, Patel SV, Bhalani KD, Shah D, Shah VS, Mehta KG. Prevalence of Dental fluorosis and dental caries in association with high levels of drinking water fluoride content in a district of Gujarat, India. Indian J Med Res. 2012;135:873-7.
Shekar C, Cheluvaiah MB, Namile D. Prevalence of dental caries and dental fluorosis among 12 and 15 years old school children in relation to fluoride concentration in drinking water in an endemic fluoride belt of Andhra Pradesh. Indian J Public Health 2012;56:122-8.
Shivaprakash PK, Ohri K, Noorani H. Relation between dental fluorosis and Intelligence quotient in school children of Bagalkot district. Journal of Indian Society of Pedodontics and Preventive Dentistry. 2011;29(2):117-20.
Census of India. Provisional Population Totals, Paper 1 of 2011 India, Series-1. New Delhi: Office of the Registrar General & Census Commissioner; 2011.
Centre for Disease Control. Fluoridation of drinking. MMWR 1998;48:933-40.
Department of Psychology, Huadong Normal University. Manual of Combined Raven’s Test – the Rural China. 1989.
Broadbent JM, Thomson WM, Ramrakha S, Moffitt TE, Zeng J, Foster Page LA, et al. Community Water Fluoridation and Intelligence: Prospective Study in New Zealand. Am J Public Health. 2015;105:72–6.
Aravind A, Dhanya RS, Narayan A, Sam G, Adarsh VJ, Kiran M. Effect of fluoridated water on intelligence in 10-12-year-old school children. Journal of International Society Prevent Community Dent. 2016;6(Suppl 3):S237-42.
Razdan P, Patthi B, Kumar JK, Agnihotri N, Chaudhari P, Prasad M. Effect of fluoride concentration in drinking water on intelligence quotient of 12–14‑year‑old children in Mathura district: A cross‑sectional study. J Int Soc Prevent Communit Dent. 2017;7:252-8.
Trivedi MH, Verma RJ, Chinoy NJ, Patel RS, Sathawara NG. Effect of high fluoride water on intelligence of school children in India. Fluoride. 2007;40:178–83.
Eswar P, Nagesh L, Devaraj CG. Intelligence quotients of 12-14 year old school children in a high and a low fluoride village in India. Research report. Fluoride. 2011;44:168–72.
Xiang Q, Liang Y, Chen B, Chen L. Analysis of children’s serum fluoride levels in relation to intelligence scores in a high and low fluoride water village in China. New Zealand: The International Society for Fluoride Research. 2011;44(4):191-4.
Y, Sun ZR, Wu LN, Wang X, Lu W, Liu SS. Effect of high-fluoride water on intelligence in children. Fluoride. 2000;33:74–8.
Susheela AK, Bhatnagar M, Vig K, Mondal NK. Excess fluoride ingestion and thyroid hormone derangements in children living in Delhi, India. Fluoride. 2005;38:151–61.
Yadav S, Khan TI, Gupta S, Gupta AB, Yadava RN. Fluorosis in India with special reference to Rajasthan. In: Proceedings of the International Conference on Water, Environment, Ecology, Socioeconomics and Health Engineering (WEESHE), Seoul National University. 1999: 3–10.
Chandrasekhar J and Anuradha KP. Prevalence of dental fluorosis in rural areas of Davangere, India. Int Dent J. 2004;54(5):235-9.
Gopalakrishnan P, Vasan RS, Sarma PS, Nair KS, Thankappan KR. Prevalence of dental fluorosis and associated risk factors in Alappuzha district, Kerala. Natl Med J India. 1999;12(3):99-103.
Srikanth R. Challenges of sustainable water quality management in rural India. Curr Sci. 2009;97:317-25
Goodarzi F, Mahvi AH, Hosseini M, Nodehi RN, Kharazifard MJ, Parvizishad M. Prevalence of dental caries and fluoride concentration of drinking water: A systematic review. Dental Research J. 2017;14(3):163-8.
Chauhan D, Sachdev V, Chauhan T, Gupta KK. A study of malocclusion and orthodontic treatment needs according to dental aesthetic index among school children of a hilly state of India. J Int Society Preventive Community Dent. 2013;3(1):32-7.
Chandra Shekar BR, Suma S, Kumar S, Sukhabogi JR, Manjunath BC. Malocclusion status among 15 years old adolescents in relation to fluoride concentration and area of residence. Indian J Dent Res 2013;24:1-7.
Ciochon RL, Nisbett RA, Corruccini RS. Dietary consistency and craniofacial development related to masticatory function in minipigs. J Craniofac Genet Dev Biol. 1997;17:96-102.