The purpose of this pilot study is to clarify the relationship between the ingestion of fluoride via community water supples and the prevention of osteoporosis in an aged population. If community water fluoridation can be associated with decreases in osteoporosis, ample justification would be available for the continuation of water fluoridation as public policy in the United States, regardless of trends in caries. The null hypothesis to be tested can be stated as: The prevalence of osteoporosis in an aged population with a life long exposure to 3.5 ppm of fluoride is the same as that in a similar population exposed to 0.7 ppm of fluoride for life. In reviewing the literature, three studies were identified which showed decreased osteoporosis in communities with fluoridated water; while four other studies showed no association between the prevalence of osteoporosis and community water fluoridation. Each of these seven studies had basic design flaws. This study is being designed in such a way as to overcome the flaws noted in previous studies. In this study a comparison will be made between two similar communities in southwest New Mexico, Lordsburg and Deming. Conventional radiogrammetry will be used to determine the cortical thickness of the metacarpal. The cortical thickness measurement will be used to assess bone loss and osteoporosis. The study population will consist of post-menopausal women age 50 and over who are life-long residents in each community. All known confounding variables will be measured including age, race, history of estrogen use, years since menopause, total calcium and vitamin D intake, history of thiazide use, and lean body mass. It is anticipated that a total of 200 individuals will participate in the study. The goal of the data analysis will be to evaluate the relationship between cortical thickness and history of fluoride ingestion given the inclusion of the confounding variables in the model. If the null hypothesis can be rejected, a logical follow-up to this pilot study would be a prospective study of bone fracture experience with a larger cohort to determine if fluoride exposure can also reduce the major consequences of osteoporosis.
