Ayyaz Ali Khan.
Fluoride Levels in Drinking Water of Pakistan.
Pak J Med Res Jan ;39(2):52-60.

It has now been established beyond doubt that dental diseases are the most common cause of human suffering. The socio-economic impact of these diseases on the individuals and communities is high enough for the World Health Organisation to include Oral Health as one of the basic indicators for a healthy individual1. Dental Caries and Periodontal Disease are the commonest of the dental ailments. Water fluoridation is the process of adjusting the fluoride content of fluoride-deficient water to the recommended level for optimal dental health. The optimum concentration for fluoride in the water has been established in the range of 0.7 to 1.2 parts per million (ppm). The specific optimum for a locality is dependent on the average annual temperature for the region. For estimation of fluoride in drinking water, 250 ml. of water was collected from its source, in a dry clean plastic container. This container was labeled with the name of the Province, district, tehsil, the location from where the sample was collected and the source of water supply. The samples were stored in a mobile refrigeration unit (Mobilcool). Mobilcool model MC-28 was used for this purpose. This unit has a cooling capacity of twenty five degree centigrade below ambient temperature, set point thermostat of plus five degree Centigrade. Ion selective electrode and colorimetric method are the two methods generally used for determination of fluoride contents in water.The electrode method is known to be more accurate, as it is less influenced by impurities, while the colorimetric method is more popular among the dental professionals because of its low cost and ease of use. A Total of 1015 samples were collected from the same number of locations in the country. Of the 991 water samples analyzed for fluoride levels, 470 were from Punjab; 250 from Sind; 148 from Balochistan and 123 from North West Frontier Province. Pakistan is basically a low fluoride country where 84% of all drinking water sources have less than the optimal (0.7 ppm) level of fluoride in them. Water resources of 632 (63.8%) locations had very low fluoride levels of below 0.3 ppm; While in 210 (21.2%) locations this level ranged from low to near optimal i.e. 0.3 ppm to 0.69 ppm. Only 61 (6.15%) locations had a range of 0.7ppm to 1.0 ppm, and 62 (6.25%) location had this mineral in the range of 1.01 ppm to 2.0 ppm. 11 (1.1%) locations had fluoride in the range of 2.01ppm to 3.0 ppm and15 (1.5%) had this level higher than 3 ppm.

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