Dental fluorosis, nutritional status, kidney damage, and thyroid function along with bone metabolic indicators in school-going children living in fluoride-affected hilly areas of Doda district, Jammu and Kashmir, India

Environ Monit Assess. 2017 Oct 23;189(11):579. doi: 10.1007/s10661-017-6288-5.


A case-control study was undertaken among the school children aged 8-15 years to know the presence and severity of dental fluorosis, nutrition and kidney status, and thyroid function along with bone metabolic indicators in Doda district situated at high altitude where drinking water was contaminated and heat stress. This study included 824 participants with an age of 8-15 years. The results of the study reviled that dental fluorosis was significantly higher in affected than control area children. Urinary fluoride was significantly higher (p < 0.05) in affected children as compared to the control area school children. Nutritional status of affected children was lower than control area children. The chronic kidney damage (CKD) was higher in affected than control school children. Thyroid function was affected more in affected than control area schools. Serum creatinine, total alkaline phosphatase, parathyroid hormone, 1, 25(OH)2 vitamin D, and osteocalcin were significantly higher in affected school children (p < 0.05) as compared to control school children, whereas there was no significant difference in triiodothyronine (T3), thyroxine (T4), and 25-OH vitamin D among the two groups. There was a significant decrease in thyroid-stimulating hormone (TSH) in the affected area school children compared to control. In conclusion, fluorotic area school children were more affected with dental fluorosis, kidney damage, along and some bone indicators as compared to control school children.

Keywords: 1,25(OH)2 vitamin D; Dental fluorosis; Fluoride; Glomerular filtration rate; Urinary fluoride.

MeSH terms

  • Adolescent
  • Bone and Bones / metabolism*
  • Case-Control Studies
  • Child
  • Drinking Water / chemistry
  • Environmental Monitoring
  • Female
  • Fluorides / analysis*
  • Fluorides / urine
  • Fluorosis, Dental / blood
  • Fluorosis, Dental / metabolism*
  • Fluorosis, Dental / urine
  • Humans
  • India
  • Kidney / metabolism*
  • Kidney Function Tests
  • Male
  • Nutritional Status*
  • Schools
  • Thyroid Hormones / blood*


  • Drinking Water
  • Thyroid Hormones
  • Fluorides