Elevated serum fluoride concentrations in women are not related to fractures and bone mineral density

Mary Fran Sowers, Gary M. Whitford, M. Kathleen Clark, Mary L. Jannausch

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Epidemiologic studies of the relations between drinking-water fluoride levels and bone mineral density (BMD) and fracture are characterized by disparate conclusions and an absence of information about individual circulating fluoride levels. This study relates serum fluoride concentrations, which reflect individual fluoride exposures, to BMD and bone fractures. Data are from 1300 female residents of 3 small communities in which the water fluoride concentrations were 52.6 or 210.4 μmol/L. Circulating serum fluoride concentrations were assessed by ion-specific electrode. Fluoride intake was estimated from interviews describing water and water-based beverage consumption and duration of residence in the community. BMD was measured by dual-energy X-ray densitometry and single-photon densitometry. Self-reported fractures were confirmed by medical record abstraction. The mean serum fluoride concentration in the high-fluoride community, 2.11 ± 0.05 μmol/L, was significantly higher than serum fluoride concentrations in the control and high-calcium communities with water fluoridation to 52.6 μmol/L. The mean serum fluoride concentrations in these latter 2 communities were 1.6 ± 0.04 and 1.22 ± 0.05 μmol/L, respectively. Serum fluoride was not significantly related to BMD after adjusting for covariates including age and body size. The mean distal radius BMD, however, was significantly higher in the high-fluoride community. Serum fluoride concentrations were not related to incident osteoporotic fractures with 4 y of observation. Serum fluoride concentrations were not associated with BMD or osteoporotic fractures among female residents of communities with water fluoride concentrations of 52.6 or 210.4 μmol/L.

Original languageEnglish (US)
Pages (from-to)2247-2252
Number of pages6
JournalJournal of Nutrition
Issue number9
StatePublished - Sep 2005
Externally publishedYes


  • Bone fracture
  • Bone mineral density
  • Serum fluoride
  • Water fluoride

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics


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