It is concluded that long-term fluoride exposure from drinking water containing >4.32 ppm increases the risk of overall fractures as well as hip fractures. Water fluoride levels at 1.00 –1.06 ppm decrease the risk of overall fractures relative to negligible fluoride in water; however, there does not appear to be similar protective benefits for the risk of hip fractures.

Effect of Long-Term Exposure to Fluoride in Drinking Water on Risks of Bone Fractures
Yiming Li, Chaoke Liang, Charles W. Slemenda, Rongdi Ji, Shuzhuang Sun, Jingxiang Cao, Christine L. Emsley, Feng Ma, Yunpeng Wu, Po Jing, Yan Zhang, Sujuan Gao, Wu Zhang, Barry P. Katz, Shiru Niu, Shouren Cao, and Conrad C. Johnston, Jr

(J Bone Miner Res 2001;16:932–939)

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