How does it occur? Flourine is one of the most abundant elements of nature and it’s commonly found in drinking water, foods such as fish, cheese and tea. According to the World Health Organization, the recommended level of fluoride in drinking water is 0.5-1.5 mg/l [3]. Studies show that India has become one of the worst fluorosis affected countries.This is because a large number of people rely on groundwater for drinking purposes and water at many places is rich in fluoride. Sometimes fluorosis may occur due to the inhalation of fluoride dusts/fumes in the industry and also from drinking tea. However, in India, the most common cause is fluoride-laden drinking water from deep bore wells. Almost half of groundwater sources in India have fluoride above recommended levels. As a result, the higher intake of fluoride is the main reason for dental and skeletal fluorosis. Types Dental fluorosis (also termed mottled enamel) is caused by ingestion of excessive fluoride during enamel formation. It appears as tooth discoloration.However, this ingestion of fluoride after a prolonged period of time will no longer cause dental fluorosis but instead begin to harm the skeletal structure of the body. This is when the person begins to suffer. Chronic high-level exposure to fluoride can lead to skeletal fluorosis where excessive fluoride accumulates in the bonescausing early symptoms of skeletal fluorosis such as stiffness and pain in the joints. Treatment Mr.Mallikarjun, 48, from North Karnataka, visited our outpatient department of Neurosurgery in Mazumdar Shaw Medical Centre, NH Health City, Bangalore. He complained of severe back pain accompanied by numbness in both his legs. He also mentioned that he found it difficult to walk as he was experiencing tightness in the legs as well. Mr. Mallikarjun underwent neurological examinations, including an MRI scan of his spinal cord, which helped diagnose his problem. His spinal cord showed that it was severely compressed due to the fluorosis of ligaments within the spinal canal. In order to remove the pressure on the spinal cord, a decompressive laminectomy was done. This surgery is a common practice, done to relieve the pressure imposed on the spinal nerve roots. Post-surgery, Mr. Mallikarjun was cured of his condition and was able to walk, move around and do his daily/normal activities. Prevent Flurosis 1. Supply of safe drinking-water with safe fluoride levels 2. De-fluoridation – actual practical solution. Removal of excessive fluoride from drinking-water is difficult and expensive. In India, near Hyderabad aluminium sulfate-based defluoridation was first set up at a water works level. 3. Health education regarding appropriate use of fluorides. Mothers in affected areas should be encouraged to breastfeed since breast milk is usually low in fluoride. Fluorosis is preventable and awareness is the solution.