• Nausheen Mobeen 1Department of, Saveetha Dental College and Hospitals, Saveetha University, Chennai, Tamil Nadu, India
  • Pradeep Kumar Department of Public Health Dentistry, Saveetha Dental College and Hospitals, Saveetha University, Chennai, Tamil Nadu



Defluoridation, Dental fluorosis, Skeletal fluorosis


Fluoride in drinking water plays a vital role in dental health. Due to excessive fluoride in water, enamel loses its luster. At lower concentration, it guards our teeth against cavities but at higher concentrations imparts fluorosis in varying concentrations. Excess fluoride in drinking water is reported from more than 35 countries around the globe with India and China. In countries like India, the severe contamination of drinking water with excess fluoride acquired the dimensions of a social economic rather than a public health problem triggering defluoridation research.


Download data is not yet available.


Grynpas MD, Chachra D, Limeback H. The action of fluoride on bone. In: Henderson JE, Goltzman D, editors. The Osteoporosis Primer. Cambridge, UK: Cambridge University Press; 2000.

Hem JD. Study and Interpretation of the Chemical Characteristics of Natural Water. 3rd ed. Washington, DC, USA: US Geological Survey; 1989. p. 263.

Barbier O, Arreola-Mendoza L, Del Razo LM. Molecular mechanisms of fluoride toxicity. Chem Biol Interact 2010;188(2):319-33.

Gazzano E, Bergandi L, Riganti C, Aldieri E, Doublier S, Costamagna C, et al. Fluoride effects: The two faces of janus. Curr Med Chem 2010;17(22):2431-41.

UNICEF. State of the Art Report on the Extent of Fluoride in Drinking Water and the Resulting Endemicityin India. New Delhi: Report by Fluorosis Research & Rural Development Foundation for UNICEF; 1999.

Susheela AK. Fluorosis: Indian scienario, a treatise on fluorosis. Fluoride. Vol. 34. New Delhi, India: Fluorosis Research and Rural Development Foundation; 2001. p. 181-3.

Ayoob S, Gupta AK. Fluoride in drinking water: A review on the status and tress effects. Crit Rev Environ Sci Technol 2006;36(6):433-87.

Mohapatra M, Anand S, Mishra BK, Giles DE, Singh P. Review of fluoride removal from drinking water. J Environ Manage 2009;91(1):67-77.

Mkongo FJ. Water Defluoridation for Rural Fluoride Affected Communities in Tanzania. The 1st International Workshop on Fluorosis Prevention and Defluoridation of Water, Ngurdoto, Tanzania, The International Society for Fluoride Research; 1995.

Whiteford GM. Determinants and Mechanism of Enamel Fluorosis Ciba Foundation Symposium; 1997. p. 205, 226-41.

WHO. Guidelines for drinking water quality. Health Criteria and Other Supporting Information. 2nd ed., Vol. 2. Geneva: World Health Organisation; 1996.

IPSC. Fluorides. Environment Health Criteria 227. Geneva: World Health Organisation; 2002.

FRRDF. State of Art Report on the Extent of Fluoride in Drinking Water and the Resulting Endemicity in India. New Delhi: Fluorosis Research and Rural Development Foundation; 1999.

Yama S, Khan TI, Gupta S, Yadava RN. Fluorosis in India with special reference to Rajasthan. In: Proceedings of International Conference on Water, Environment, Ecology, Socioeconomics and Health Engineering, Seoul National University, 18-21st October, 3-10; 1999.

Choubisa SL, Choubisa DK, Joshi SC, Choubisa L. Fluorosis in some tribal villages of Dungarpur district of Rajasthan, India. Fluoride 1997;30(4):223-8.

Kodali VR, Krishnamachari KA, Gowrinathsastry J. Determinal effects on high fluoride concentrations in drinking water on teeth in an endemic fluorosis area in South India. Trop Doct 1994;24:39-49.

Yadav JP, Lata S. Urinary fluoride levels and prevalence of dental fluorosis in children of Jhajjar district, Haryana. Indian J Med Sci 2003;57:394-9.

Reddy NB, Prasad KS. Pyroclastic fluoride in ground waters in some parts of Tadpatri Taluk, Anantapur district, Andhra Pradesh. Indian J Environ Health 2003;45(4):285-8.

Short HE, Pandit CG, Taghavachari TN. Endemic fluorosis in Nellore district of South India. Indian Med Gaz 1937;72:396-8.

Agarwal V, Vaish AK, Vaish P. Ground water quality: Focus on fluoride and fluorosis in Rajisthan. Curr Sci 1997;73(9):743-6.

Hemens J, Warwick RJ. The effects of fluoride on estuarine organisms. Water Res 1972;6:1301-8.

Ares JO, Villa A, Gayoso AM. Chemical and biological indicators of fluoride input in the marine environment near an industrial source (Argentina). Arch Environ Contam Toxicol 1983;12:589-602.

Buse A. Fluoride accumulation in invertebrates near an aluminium reduction plant in Wales. Environ Pollut A 1986;41(3):199-217.

Wright DA, Davison AW. The accumulation of fluoride by marine and intertidal animals. Environ Pollut 1975;8(1):1-13.

Vikøren T, Stuve G. Fluoride exposure and selected characteristics of eggs and bones of the herring gull (Larus argentatus) and the common gull (Larus canus). J Wildl Dis 1996;32(2):190-8.

Suttie JS, Dickie R, Clay AB, Nielsen P, Mahan WE, Baumann DP, et al. Effects of fluoride emissions from a modern primary aluminium smelter on a local population of white-tailed deer (Odocoileus virginianus). J Wildl Dis 1987;23(1):135-43.

Mourad NM, Sharshar T, Elnimr T, Mousa MA. Radioactivity and fluoride contamination derived from a phosphate fertilizer plant in Egypt. Appl Radiat Isot 2009;67(7-8):1259-68.

Pankhurst NW, Boyden CR, Wilson JB. The effect of a fluoride effluent on marine. J Chromatogr Sci 2011;49:???. Wilson JB (1980) The effect of a fluoride effluent on marine organisms. Environ Pollut A 1980;23:299-312.

Groth E IIIrd. Fluoride pollution. Environment 1975;17(3):29-38.

WHO. Drinking water quality control in small community supplies. Guidelines for Drinking Water Quality. Vol. 8. Geneva: WHO; 1985. p. 121.

ISO. Water quality-determination of fluoride-part1: Electrochemical probe method for portable and light polluted water, ISO 10359-1. ???: International Organization for Standardization; 1992.

Lefler JE, Ivey MM. Ion chromatography detection of fluoride in calcium carbonate. J Chromatogr Sci 2011;49(8):582-8.

Frant MS, Ross JW Jr. Electrode for sensing fluoride ion activity in solution. Science 1966;154(3756):1553-5.

Veselý J, Štulík K. Effect of solution acidity on response of the lanthanum trifluoride single-crystal electrode. Anal Chim Acta 1974;73(1):157-66.

Frant MS, Ross JW Jr. Use of a total ionic strength adjustment buffer for electrode determination of fluoride in water supplies. Anal Chem 1968;40(7):1169-71.

Campbell AD. Determination of fluoride in various matrices. Pure Appl Chem 1987;59:695-702.

Jensen B. The determination of fluoride in environmentally relevant matrices. Anal Chim Acta 1986;182:1-16.

Bellack E. Methods and materials for fluoride analysis. J Am Water Works Assoc 1972;64:62-6.

Fawell JK, Bailey K, Chilton J, Dahi E, Magara Y. Fluoride in Drinking-Water. London: IWA Publishing; 2006.

Bregnhoj ED. Significance of Oxygen in Processing of Bone Char for De-fluoridation of Water, The 1st International Workshop on Fluorosis Prevention and De-fluoridation of Water, Ngurdoto, Tanzania: The International Society for Fluoride Research; 1995.

Dunckley GG, Malthus RS. Removal of fluoride from fluoridation water. N Z J Sci 1961;4:504.

Phantumvanit P, Songpaisan Y, Moller IJ. A defluoridator for individual households. World Health Forum 1988;9(4):555-8.

Christoffersen J, Christoffersen MR, Larsen R. Regeneration of surface coating of bone char used for de-fluoridation of water. Water Resour J 1991;25:223-9.

Larsen MJ, Pearce EI. Defluoridation of drinking water by boiling with brushite and calcite. Caries Res 2002;36(5):341-6.

Dahi E. Contact Precipitation for DE Fluoridation of Water. Paper Presented at 22nd WEDC Conference, New Delhi, 9-13 September; 1996.

Dahi E. Small Community plants for low cost DE fluoridation of water by contact precipitation. In: Proceedings of 2nd International Workshop in Fluorosis and Defluoridation of Water. Nazareth, 19- 22 November 1997. Auckland: The International Society of Fluoride Research; 1998.

Boruff CS. Removal of fluorides from drinking waters. Ind Eng Chem 1934;26(1):69-71.

Parthasarathy N, Buttle J, Haeridi W. Combined used of calcium salts and polymeric aluminium hydroxide for deluoridation of waste water. J Water Resour 1986;20:443-8.

Dahi E, Bregnhoj H, Orio L. Sorption isotherms of fluoride on flocculated alumina. In: Proceedings of the First International Workshop on Fluorosis and Defluoridation of Water. 18-22October 1995. Tanzania, Auckland: The International Society for fluoride Research; 1997. p. 35-9.

Mameri N, Yeddou AR, Lounicih H, Belhiccine D, Garib H, Bariou B. Defluoridation of septentrionalsahara water of North Afrika by electro coagulation process using bipolar aluminium electrodes. J Water Resour 1998;32(1):1604-32.

Piddennavar R, Krishnappa P. Review on defluoridation techniques of water. Int J Eng Sci 2013;2(3):86-94.

Bulusu KR, Nawlakhe WG, Patil AR, Karthikeyan G. Prevention and control of fluorosis. Water Quality and Defluoridation Techniques. Vol. 11. New Delhi: Rajiv Gandhi National Drinking Water Mission, Ministry of Rural Development; 1993.

Apparao BV, Kartikeyan G. Permissible limits of fluoride on in drinking water in India in rural environment. Indian J Environ Prot 1986;6(3):172-5.

Nayak P. Review aluminium: Impacts and disease. Environ Res 2002;89(2):101-15.

Meenakshi S, Maheshwari RC. Fluoride in drinking water and its removal, Microfiltration and ultrafiltration membranes in drinking water. J Hazard Mater 2006;B137:456-63.

COWI. Review of Practical Experiences with DE Fluoridation in Rural Water Supply Programmes Part 11. Dandia, Copenhagen: Ministry of Foreign Affairs; 1998. p. 73.

Schoeman JJ. An investigation of the performance of two newly installed DE fluoridation plants in South Africa and some factors affecting its performance. Water Sci Technol 1987;19(5-6):953-65.

Schoeman JJ, Botha GR. An evaluation of the activated alumina process for fluoride removal from drinking water and some factors influencing its performance. Water SA 1985;11(1):25-32.

Fink GJ, Lindsay FK. Activated alumina for removing fluorides from drinking water. Ind Eng Chem 1936;28(8):947-8.

Swope GH, Hess RH. Removal of fluoride from natural water by defluorite. Ind Eng Chem 1937;29(4):424-6.

Savinelli EA, Black AP. Defluordation of water with activate alumina. J Am Water Works Assoc 1958;50(1):33-44.

Bishop PL, Sansoucy G. Fluoride removal from drinking water by fluidized activated alumina adsorption. J Am Water Works Assoc 1978;70(10):554-9.

Hao OJ, Asce A, Huang CP, Asce M. Adsorption characteristics of fluoride onto hydrous alumina. J Environ Eng1986;112(6):1054-69.

Schoeman JJ, MacLeod H. The effect of the particle size and interfering ions on fluoride removal by activated alumina. Water 1987;13(4):229-34.

Farrah H, Slavek J, Pickering WF. Fluoride interactions with hydrous aluminium oxides and alumina. Aust J Soil Res 1987;25(1):55-69.

Karthikeyan G, Apparao BV, Meenakshi S. Defluoridation Property of Activated Alumina. 2nd International Workshop on Fluorosis Prevention and Defluoridation of Water, Nazreth, Ethiopia; 1997. p. 78-82.

Bahena JL, Cabrera AR, Valdivieso AL, Urbina RH. Fluoride adsorption onto α-Al2O3 and its effect on the zeta potential at the alumina - Aqueous electrolyte interface. Sep Sci Technol 2002;37(8):1973-87.

Ku Y, Chiou HM. The adsorption of fluoride ion from aqueous solution by activated alumina. Water Air Soil Pollut 2002;133(1-4):349-60.

Ghorai S, Pant KK. Investigations on the column performance of fluoride adsorption by activated alumina in a fixed-bed. Chem Eng J 2004;98(1-2):165-73.

Pietrelli L. Fluoride wastewater treatment by adsorption onto metallurgical grade alumina. Ann Chim 2005;95(5):303-12.

Shimelis B, Zewge F, Chandravanshi BS. Removal of excess fluoride from water by aluminium hydroxide. Bull Chem Soc Ethiop 2006;20(1):17-34.

Rao CR, Karthikeyan J. Adsorption of Fluoride by Gamma Alumina. 12th International Water Technology Conference (IWTC12), Alexandria, Egypt; 2008. p. 141-51.

Wang SG, Ma Y, Shi YJ, Gong WX. Defluoridation performance and mechanism of nano-scale aluminium oxide hydroxide in aqueous solution. J Chem Technol Biotechnol 2009;84(7):1043-50.

Tang Y, Guan X, Su T, Gao N, Wang J. Fluoride adsorption onto activated alumina: Modelling the effects of pH and some competing ions. Colloids Surf A Physicochem Eng Asp 2009;337(1-3):33-8.

Yama RN, Yama R. Defluoridation of the potable water by aluminium sulphate. Int J Chem Sci 2009;7(2):760-74.

George S, Pandit P, Gupta AB. Residual aluminium in water DE fluoridation using activated alumina adsorption - Modelling and simulation studies. Water Res 2010;44(10):3055-64.

Sivasankari C, Mahadevan M, Arulanantham A. Comparative study of powdered activated alumina with granular polymer-agglomerated alumina in fluoride removal from drinking water. Asian J Chem 2010;22(6):4663-70.

Lee G, Cheng C, Yang ST, Ahn WS. Enhanced adsorptive removal of fluoride using mesoporous alumina. Microporous Mesoporous Mater 2010;127(1-2):152-6.

Kamble SP, Deshpande G, Barve PP, Rayalu S, Labhsetwar NK, Malyshew A, et al. Adsorption of fluoride from aqueous solution by alumina of alkoxide nature: Batch and continuous operation. Desalination 2010;264(1-2):15-23.

Kumar E, Bhatnagar A, Kumar U, Sillanpaa M. Defluoridation from aqueous solutions by nano-alumina: Characterization and sorption studies. J Hazard Mater 2011;186(2-3):1042-9.

Li W, Cao CY, Wu LY, Ge MF, Song WG. Superb fluoride and arsenic removal performance of highly ordered mesoporousaluminas. J Hazard Mater 2011;198:143-50.

Biswas K, Halder I, Dutta J, Basu T, Ghosh UC. Some physicochemical aspects on fluoride adsorption from aqueous solution by synthetic hydrous aluminium oxide. Int J Univ Pharm Life Sci 2012;2(4):42-65.

Gong WX, Qu JH, Liu RP, Lan HC. Adsorption of fluoride onto different types of aluminas. Chem Eng J 2012;189-190:126-33.

Goswami A, Purkait MK. The DE fluoridation of water by acidic alumina. Chem Eng Res Des 2012;90(12):2316-24.

Gupta AB, Savita, George S, Mandal P. Effect on Activated Alumina Fluoride Removal Capacity in Presence of Chloride. Proceedings of International Conference on Materials for the Future - Innovative Materials, Processes, Products and Applications-ICMF; 2013. p. 598-600.

Nawlakhe WG, Kulkarni DN, Pathak BN, Bulusu KR. Defluoridation of water by Algona technique. Indian J Environ Health 1975;17(1):26-65.

Dahi E, Mtalo F, Njau B, Bregnhi H. Defluoridation Using the Algona Technique in Tanzania. 22nd Water, Enginering and Development Centre (WEDC) Conference, New Delhi; 1996. p. 266-8.

Lunge S, Thakre D, Kamble S, Labhsetwar N, Rayalu S. Alumina supported carbon composite material with exceptionally high DE fluoridation property from eggshell waste. J Hazard Mater 2012;237- 238:161-9.

Bansiwal A, Pilleawan P, Biniwale RB, Rayalu SS. Copper oxide incorporated mesoporous alumina for DE fluoridation of drinking water. Microporous Mesoporous Mater 2010;129(1-2):54-6.

Chubar NI, Samanidou VF, Kouts VS, Gallios GG, Kanibolotsky VA, Strelko VV, et al. Adsorption of fluoride, chloride, bromide, and bromate ions on a novel ion exchange. J Colloid Interface Sci 2005;291(1):67-74.

Biswas K, Saha SK, Ghosh UC. Adsorption of fluoride from aqueous solution by a synthetic iron (III) aluminium (III) mixed oxide. Ind Eng Chem Res 2007;46(16):5346-56.

Dang D, Ding W, Cheng A, Liu S, Zhang X. Isother equation study of F adsorbed from water solution by Fe2(SO4)3 modified granular activated alumina. Chin J Chem Eng 2011;19(4):581-5.

Maliyekkal SM, Shukla S, Philip L, Indumathi MN. Enhanced fluoride removal from drinking water by magnesia-amended activated alumina granules. Chem Eng J 2008;140(1-3):183-92.

Teng SX, Wang SG, Gong WX, Liu XW, Gao BY. Removal of fluoride by hydrous manganese oxide-coated alumina: Performance and mechanism. J Hazard Mater 2009;168(2-3):1004-11.

Tripathy SS, Raichur AM. Abatement of fluoride from water using manganese dioxidecoated activated alumina. J Hazard Mater 2008;153(3):1043-51.

Puri BK, Balani S. Trace determination of fluoride using lanthanum hydroxide supported on alumina. J Environ Sci Health A Tox Hazard Subst Environ Eng 2000;35(1):109-21.

Shi Q, Huang Y, Jing C. Synthesis, characterization and application of lanthanum-impregnated activated alumina for F removal. J Mater Chem A 2013;1(41):12797-803.

Karthikeyan M, Kumar KK, Elango KP. Conducting polymer/alumina composites as viable adsorbents for the removal of fluoride ions from aqueous solution. J Fluor Chem 2009;130(10):894-901.

Razbe N, Kumar R, AQ6 Pratima, Kumar R. Various options for removal of fluoride from drinking water. Int Organ Sci Res J Appl Phys 2013;3:40-7.

Fox KR. Removal of Inorganic Contaminants from Drinking Water by Reverse Osmosis EPA-600/2-81-115, Back to Cited Text No. 13. Cincinnati, OH: Municipal Environmental Research Laboratory, U.S. Environmental Protection Agency; 1981.

Huxstep MR. Inorganic Contaminants Removal from Drinking Water by Reverse Osmosis EPA-600/2-81. Cincinnati, OH: Office of Research and Development, U.S. Environmental Protection Agency; 1981.

Kumar S, Gopal K. A review on fluorosis and its preventive strategies. Indian J. Environ Prot 2000;20(6):430-6.

Donnan FG. The theory of membrane equilibria. Chem Rev 1924;1(1):73-90.

Garmes H, Persin F, Sandeaux J. De-fluoridation of groundwater by a hybrid process combining adsorption and Donnan dialysis. Desalination 2002;145:287-91.

Harma V. Nanofiltration for Water Quality Improvement in Finnish Surface Waterworks. Licentiate Thesis (Finnish). Finland: Helsinki University of Technology; 1999.

Tahaikt M, El-Habbani R, Haddou AA, Achary I, Amor Z, Taky M, et al. Fluoride removal from groundwater by nanofiltration. Desalination 2007;212(1):46-53.

Imen B, Amine M, Bechir H. Influence of operating conditions on the retention of fluoride from water by nanofiltration. Desalination Water Treat 2011;29(1-3):39-46.

Hoinkis J, Freitag SV, Caporgno MP, Patzold C. Removal of nitrate and fluoride by nanofiltrationa comparative study. Desalination Water Treat 2011;30(1-3):278-88.

Bulusu KR, Sundaresan BB, Pathak BN, Nawlakhe WG, Kulkarni DN, Thergaonkar VP. Fluorides in water, DE fluoridation methods and their limitation. J Inst Eng India 1979;60:1-25.

Zevenbergen C, van Reeuvijik LP, Louws RJ, Schuilin RD. A simple method for DE fluoridation of drinking water at village level by adsorption on Ando soil in Kenya. Science Total Environ1996;188:225-32.

Padmasiri JP. Low cost DE fluoridation of drinking water by means of brick chips. In: Proceedings of the 2nd International Workshop on Fluorosis and Defluoridation of Water. Nazareth, 19-22 November1997. Auckland: The International Society for Fluoride Research; 1998.

Bardsen A, Bjorvatn K. Fluoride sorption in fired clay. In: Proceedings of the First International Workshop on Fluorosis and Defluoridation of Water, 18-22 October 1995. Tanzania, Auckland: The International Society for fluoride Research; 1997. p. 46-9.

Jinadasa KB, Weerasooriya SW, Dissanayake CB. A rapid method for the DE fluoridation of fluoride-rich drinking waters at village level. Int J Environ Stud 1988;31:305-12.



How to Cite

Mobeen, N., and P. Kumar. “DEFLUORIDATION TECHNIQUES- A CRITICAL REVIEW”. Asian Journal of Pharmaceutical and Clinical Research, vol. 10, no. 6, June 2017, pp. 64-71, doi:10.22159/ajpcr.2017.v10i6.13942.



Review Article(s)

Most read articles by the same author(s)

1 2 3 > >>