{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T13:36:27Z","timestamp":1786628187251,"version":"build-2736575974"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Dental fluorosis represents a significant public health concern in some communities of India. The groundwater of Rajgarh block, Madhya Pradesh, is considered fluoride-endemic as fluoride concentrations consistently exceed the World Health Organization (WHO)-recommended limit of 1.5 ppm for drinking water. While the effect of fluoride on teeth is well known, information is scarce on its effect on the surrounding periodontal structures. The study objective was to assess the prevalence and severity of fluorosis and its association with periodontal health status among individuals residing in rural areas of Rajgarh block, Madhya Pradesh.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>This cross-sectional, observational study was conducted among 246 participants, aged between 30 and 49 years, who reported consuming untreated water from the ground, and were continuous residents of the fluoride-endemic villages of Rajgarh. Assessment of dental fluorosis was done by Dean\u2019s fluorosis index, and periodontal status by standard WHO guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 246 participants (mean age: 38 \u00b1 5.79 years) were included, of whom 34.1% had non-healthy periodontium. Dental fluorosis (mild to severe) was present in 26.0% of participants. On adjusted analysis, individuals with dental fluorosis had significantly higher odds of non-healthy periodontal status (aOR: 2.6; 95% confidence interval: 1.62\u20135.12), indicating independent association. Increasing age (40\u201349 years) and daily tobacco use were significantly associated with poorer periodontal health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Dental fluorosis remains a major public health challenge in endemic regions, affecting nearly one in four adults aged 30\u201349 years, with a higher burden among males, smokers, and alcohol users, and a significant association with poorer periodontal health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijcm.ijcm_341_25","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T07:00:23Z","timestamp":1786604423000},"page":"694-700","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence and Determinants of Fluorosis and Association with Periodontal Health in an Endemic Region in Central India: A Community based Cross-sectional Study"],"prefix":"10.4103","volume":"51","author":[{"given":"Devashish","family":"Marskoley","sequence":"first","affiliation":[{"name":"Indian Institute of Public Health \u2013 Delhi, Public Health Foundation of India, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trina","family":"Sengupta","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, ESIC Medical College and Hospital, Joka, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saurav","family":"Basu","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, ESIC Medical College and Hospital, Joka, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"R1-20260813","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/S0140-6736(19)31146-8","article-title":"Oral diseases: A global public health challenge","volume":"394","author":"Peres","year":"2019","journal-title":"Lancet"},{"key":"R2-20260813","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1922\/CDH_3707OMullane31","article-title":"Fluoride and oral health","volume":"33","author":"O'Mullane","year":"2016","journal-title":"Community Dent Health"},{"key":"R4-20260813","doi-asserted-by":"crossref","first-page":"476","DOI":"10.4314\/ahs.v20i1.54","article-title":"Periodontal and dental conditions of a school population in a volcanic region of Tanzania with highly fluoridated community drinking water","volume":"20","author":"Miranda-Rius","year":"2020","journal-title":"Afr Health Sci"},{"key":"R5-20260813","doi-asserted-by":"crossref","first-page":"2146160","DOI":"10.1155\/2020\/2146160","article-title":"Global prevalence of periodontal disease and lack of its surveillance","volume":"2020","author":"Nazir","year":"2020","journal-title":"ScientificWorldJournal"},{"key":"R6-20260813","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1111\/j.1600-0757.2011.00425.x","article-title":"The global burden of periodontal disease: Towards integration with chronic disease prevention and control","volume":"60","author":"Petersen","year":"2012","journal-title":"Periodontol 2000"},{"key":"R9-20260813","first-page":"178","article-title":"Assessment of fluoride level in groundwater and prevalence of dental fluorosis in Didwana block of Nagaur district, Central Rajasthan, India","volume":"4","author":"Arif","year":"2013","journal-title":"Int J Occup Environ Med"},{"key":"R10-20260813","first-page":"1421","article-title":"Classification of mottled enamel diagnosis","volume":"21","author":"Dean","year":"1934","journal-title":"J Am Dent Assoc"},{"key":"R12-20260813","doi-asserted-by":"crossref","first-page":"1110777","DOI":"10.3389\/fpubh.2023.1110777","article-title":"A community-based study of dental fluorosis in rural children (6-12 years) from an aspirational district in Karnataka, India","volume":"11","author":"Prasad","year":"2023","journal-title":"Front Public Health"},{"issue":"Spec No","key":"R13-20260813","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1177\/00220345900690S135","article-title":"The nature and mechanisms of dental fluorosis in man","volume":"69","author":"Fejerskov","year":"1990","journal-title":"J Dent Res"},{"key":"R14-20260813","doi-asserted-by":"crossref","first-page":"4394","DOI":"10.3390\/ijerph17124394","article-title":"Large gender gap in oral hygiene behavior and its impact on gingival health in late adolescence","volume":"17","author":"Abe","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"R15-20260813","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1159\/000325107","article-title":"Fluoride metabolism","volume":"22","author":"Buzalaf","year":"2011","journal-title":"Monogr Oral Sci"},{"issue":"(Suppl 1)","key":"R16-20260813","doi-asserted-by":"crossref","first-page":"S88","DOI":"10.4103\/jpbs.JPBS_77_17","article-title":"Comparative evaluation of dental and skeletal fluorosis in an endemic Fluorosed District, Salem, Tamil Nadu","volume":"9","author":"Ramesh","year":"2017","journal-title":"J Pharm Bioallied Sci"},{"key":"R17-20260813","doi-asserted-by":"crossref","first-page":"157","DOI":"10.5005\/jp-journals-10028-1255","article-title":"Fluorosis: Environmental risk factor for periodontal disease?","volume":"51","author":"Dalvi","year":"2016","journal-title":"J Postgrad Med Educ Res"},{"key":"R18-20260813","doi-asserted-by":"crossref","first-page":"67","DOI":"10.4103\/0970-9290.32423","article-title":"Assessment of periodontal status in dental fluorosis subjects using community periodontal index of treatment needs","volume":"18","author":"Vandana","year":"2007","journal-title":"Ind J Dent Res"},{"key":"R19-20260813","doi-asserted-by":"crossref","first-page":"1662","DOI":"10.1186\/s12889-022-14096-7","article-title":"Evidence from the Hamburg city health study \u2013 association between education and periodontitis","volume":"22","author":"Walther","year":"2022","journal-title":"BMC Public Health"},{"key":"R20-20260813","doi-asserted-by":"crossref","first-page":"9100665","DOI":"10.1155\/2024\/9100665","article-title":"Oral health and lifestyle factors in rural adults of Jharkhand, India","volume":"2024","author":"Kumar","year":"2024","journal-title":"Int J Dent"},{"key":"R21-20260813","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1111\/cdoe.12126","article-title":"Is frequency of tooth brushing a risk factor for periodontitis? A systematic review and meta-analysis","volume":"43","author":"Zimmermann","year":"2015","journal-title":"Community Dent Oral Epidemiol"},{"key":"R22-20260813","first-page":"CD007868","article-title":"Fluoride toothpastes of different concentrations for preventing dental caries","volume":"3","author":"Walsh","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"R23-20260813","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.31729\/jnma.6605","article-title":"Tobacco and its relationship with oral health","volume":"59","author":"Bhandari","year":"2021","journal-title":"JNMA J Nepal Med Assoc"},{"key":"R24-20260813","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1922\/CDH_4569Pulikkotil10","article-title":"Alcohol consumption is associated with periodontitis. A systematic review and meta-analysis of observational studies","volume":"37","author":"Pulikkotil","year":"2020","journal-title":"Community Dent Health"},{"key":"R25-20260813","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1111\/j.1600-0757.2011.00416.x","article-title":"Socioeconomic position indicators and periodontitis: Examining the evidence","volume":"58","author":"Borrell","year":"2012","journal-title":"Periodontol 2000"},{"key":"R26-20260813","doi-asserted-by":"crossref","first-page":"886","DOI":"10.4103\/jfmpc.jfmpc_990_19","article-title":"Evaluation of oral health care seeking behavior in rural population of central India","volume":"9","author":"Deolia","year":"2020","journal-title":"J Family Med Prim Care"},{"issue":"(Suppl 1)","key":"R27-20260813","first-page":"S159","article-title":"Staging and grading of periodontitis: Framework and proposal of a new classification and case definition","volume":"89","author":"Tonetti","year":"2018","journal-title":"J Periodontol"},{"key":"R28-20260813","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1111\/j.1442-200X.1996.tb03536.x","article-title":"Reversal of fluorosis in children","volume":"38","author":"Gupta","year":"1996","journal-title":"Acta Paediatr Jpn"}],"container-title":["Indian Journal of Community Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijcm.ijcm_341_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T12:59:24Z","timestamp":1786625964000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijcm.ijcm_341_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":24,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/ijcm.ijcm_341_25","relation":{},"ISSN":["0970-0218","1998-3581"],"issn-type":[{"value":"0970-0218","type":"print"},{"value":"1998-3581","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2025-05-09","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-09","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}