Relationship Between Dental Fluorosis and Intelligence Quotient of School Going Children In and Around Lucknow District: A Cross-Sectional Study

Abstract

Background: Fluoridation of drinking water, despite being regarded as one of the top ten public health achievements of the twentieth century, has remained a much debated concept. Various studies on animals and aborted human fetuses have confirmed that excessive fluoride intake during infancy and early childhood, causes a number of irreversible structural and functional changes in the CNS leading to memory, learning and intellectual deficits.

Aim: To compare the IQ levels of school children of two different locations, having different fluoride levels in water, and to establish a relationship between fluoride levels, prevalence of fluorosis and its effect on IQ levels.

Materials and methods: A cross-sectional study was conducted among 429 children aged 6 - 12 years, selected by stratified random sampling from two different areas with different levels of fluoride in drinking water in and around Lucknow district. Dental fluorosis was measured using Dean's Fluorosis Index. Intelligence Quotient was measured using Raven's Coloured Progressive Matrices (1998 edition).

Results: Majority of the fluorosis free children (76.3%) had an IQ grade 2 (definitely above the average). Majority of the children suffering from very mild and mild dental fluorosis were found to have IQ grade 3 (Intellectually average). Children with moderate cases of dental fluorosis were found to have IQ grade 4 (Definitely below average). Only 5 children with severe fluorosis were included in the study and they all were found to have an IQ grade 5. Hence, a trend of increase in the IQ grade (decrease in intellectual capacity) was observed indicating a strong correlation between fluorosis grade and IQ grade.

Conclusion: Findings of this study suggest that the overall IQ of the children exposed to high fluoride levels in drinking water and hence suffering from dental fluorosis were significantly lower than those of the low fluoride area.

Keywords: Cognitive dysfunction; Dean’s fluorosis index; Intellectual deficits; Neurotoxicity; Raven’s coloured progressive matrices.