Assessment of teeth as biomarkers for skeletal fluoride exposure

Skeletal fluorosis and dental fluorosis are diseases related to fluoride (F) ingestion. Bone is the largest storage site of F in our body. Therefore, bone F concentrations are considered biomarkers for total F body burden (exposure). However, difficult accessibility limits its use as a biomarker. Thus, a more accessible tissue should be considered and analyzed as a biomarker for total F body burden. The objective of this study, which was divided into two parts, was to evaluate teeth as a biomarker for skeletal F exposure. In part 1 of the study, 70 mice of three different strains (SWR/J, A/J and 129P3/J) were exposed to different levels of water fluoridation (0, 25, 50 and 100 ppm). Bone (femora and vertebrae) and teeth from these mice were then analyzed for F concentration using Instrumental Neutron Activation Analysis (INAA). In part 2 of the study, human teeth (enamel and dentin) and bone from 30 study subjects were collected and analyzed for F concentration using INAA. Study subjects lived in areas with optimum levels of water fluoridation (0.7 and 1 ppm) and underwent therapeutic extraction of their unerupted third molars. The values of bone and teeth F concentration were correlated for parts 1 and 2 of this study. The results showed that in the animal model, where animals were exposed to a wide range of F in their drinking water, tooth [F] correlated with bone [F]. However, no correlation was seen between bone and enamel F concentrations or between bone and dentin F concentrations in the human samples. Therefore, teeth are not good biomarkers for skeletal F exposure in humans when exposure is confined to optimum levels of F in the drinking water.