Document Abstract
The study aims to assess the preclinical stage of fluorosis i.e. Non skeletal fluorosis in human populations using
a simple blood parameter, Neutrophil Lymphocyte Ratio as a predictive tool and includes different fluorosis categories (Dental,
Skeletal & Non skeletal) surveyed out in the endemic villages and compared with the control population of non endemic area.
Study Populations belonging to endemic villages Kowataal, Fulsar, Mahuapaani, Korbi and Amatikra within the block Podi
uproda, distt. Korba situated in Chhattisgarh state of central India were cross sectionally studied. Segregation was done on the
basis of Suspect (non-symptomatic) and Confirmed (Dental and Skeletal) cases of fluorosis and neutrophil to lymphocyte ratio
calculated. A total 180 individuals were included in the study, out of which 67.33 % were confirmed cases of fluorosis. A
significant decline in neutrophil to lymphocyte ratio was observed upon chronic fluoride ingestion. In the Receiver Operating
Characteristic curve analysis of obtained NL ratios, the overall cut off value for fluorosis was obtained as ≤ 2.379 in the selected
endemic region irrespective of symptoms of fluorosis i.e. dental or skeletal. The results concluding that The NL ratio can be
used as a simple parameter for preclinical identification of fluorosis in fluoride exposed populations. However, urine and blood
fluoride analyses of the subjects are also needed for further confirmation.