Introduction
The data suggest that in pakistan are fluoride endemic areas which contain increased levels of fluoride in drinking
water about >1.5 ppm. Around 62 million people in pakistan are suffering from dental fluorosis, skeletal fluorosis, and nonskeletal fluorosis. Of 1.5 million, 1 million children below the age of 14 years have been severely affected. Groundwater
is considered as the major source of drinking water in most of the part of pakistan .Fluorosis is a crippling and painful disease caused by excess intake of fluoride. Fluorosis may be classified into dental fluorosis and skeletal fluorosis. Dental fluorosis in teeth exhibits the first sign of fluoride toxicity in the form of "mottled enamel."
Esthetics changes in permanent dentition are the greatest concern in dental fluorosis, which are more prone to occur in children who are excessively exposed to fluoride between 20 and 30 months of age. It is also important to remind that the critical period to fluoride overexposure is between 1 and
4 years old, and the child would not be at risk around 8 years
old.
Fluorosis has attained an alarming dimension all over the
world. It has been identified as an endemic disease among which multan and mainwali is facing serious health problems. In
main wali , children have suffered from a high prevalence of dental fluorosis (60%–78%) for decades, and many risk factors were found associated with severe dental fluorosis.
The fluoride concentration in groundwater wells was measured up to 4.4 ppm fluoride. Dental fluorosis is the first visible sign indicating that much fluoride has poisoned the whole body. Besides the health hazards, there are other adverse effects of
dental fluorosis such as high costs of other medical and dental
problems and the effect on the victims and their loss of time.