title: Association of Temporomandibular Joint Signs & Symptoms with Dental Fluorosis & Skeletal Manifestations in Endemic Fluoride Areas of Dungarpur District, Rajasthan, India.
abstract: BACKGROUND
  Endemic fluorosis resulting from high fluoride concentration in groundwater is a major public health problem. India is among the numerous nations, where fluoride sullied groundwater is creating wellbeing issues. Safe drinking water in rural areas of India is predominantly rely on groundwater sources, which are exceptionally contaminated with fluoride.
  
  
  OBJECTIVE
  To investigate the association of temporomandibular joint Signs & Symptoms with Dental Fluorosis & Skeletal Manifestations among people living in Dad, Bokersal & Deotalab villages of Dungarpur District, Rajasthan, India.
  
  
  METHODS
  The study group consisted of 750 subjects who were born & brought up in Dad, Bokersal & Deotalab villages of Dungarpur District, Rajasthan. Temporomandibular joint & Dental fluorosis was assessed by performing type III clinical examination according to WHO guidelines (1997). For the assessment of skeletal manifestations, participants were asked to perform three diagnostic tests: (1)Touching the toes without bending the knees; (2) Touching the chest with the chin; (3) Stretching the arms sideways & folding the arms to touch the back of the head. Chi Square test & Multiple Logistic Regression were applied for statistical analysis.
  
  
  RESULTS
  Among the 750 (462 males & 288 females) who participated in the study, 53% had moderate grade of dental fluorosis. The most prominent symptom suggesting Temporomandibular Joint Disorder was the clicking sound affecting 21.4% population.(p>0.001). TMJ Signs & Symptoms were prominent in the age group of 45-54 years & males were highly affected than females.
  
  
  CONCLUSIONS
  Clinical examination of TMJ in Dental Fluorosis & Skeletal Fluorosis subjects showed a significant association with Dental Fluorosis & Skeletal Fluorosis.
authors.affiliation: Reader, Department of Public Health Dentistry, Pacific Dental College and Hospital , Debari, Rajasthan, India .
authors.forename: Kailash
authors.initials: K
authors.lastname: Asawa
authors.affiliation: Post Graduate Student, Department of Public Health Dentistry, Pacific Dental College and Hospital , Debari, Udaipur, Rajasthan, India .
authors.forename: Anukriti
authors.initials: A
authors.lastname: Singh
authors.affiliation: Professor and Head, Department of Public Health Dentistry, Pacific Dental College and Hospital , Debari, Udaipur, Rajasthan, India .
authors.forename: Nagesh
authors.initials: N
authors.lastname: Bhat
authors.affiliation: Senior Lecturer, Department of Public Health Dentistry, Pacific Dental College and Hospital , Debari, Udaipur, Rajasthan, India .
authors.forename: Mridula
authors.initials: M
authors.lastname: Tak
authors.affiliation: Post Graduate Student, Department of Public Health Dentistry, Pacific Dental College and Hospital , Debari, Udaipur, Rajasthan, India .
authors.forename: Kushal
authors.initials: K
authors.lastname: Shinde
authors.affiliation: Post Graduate Student, Department of Public Health Dentistry, Pacific Dental College and Hospital , Debari, Udaipur, Rajasthan, India .
authors.forename: Sandeep
authors.initials: S
authors.lastname: Jain
keywords: Dean’s fluorosis index; Skeletal fluorosis; TMJ
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