Glycosaminoglycan and its sulphated isomers are an integral part of the tooth matrix and play a significant role in calcification of the tooth. Studies on normal and fluorosed human teeth with reference to total glycosaminoglycans and its sulphated isomers have shown that although there is an overall reduction in total glycosaminoglycan content, the most significant change that takes place in the matrix of the tooth as a result of exposure to fluoride is the accumulation of dermatan sulphate which under normal circumstances does not occur in calcified structures like tooth or bone except during the developmental stages. Accumulation of dermatan sulphate induces loss of calcium and the tooth becomes soft (demineralized) and such soft areas get pitted or perforated. Fluoride induces pitting / cavity formation on the sur­face of the enamel - a fact that was never understood before. The cavities formed in fluorosed teeth are distinctly different from the cavities formed as a result of Dental Caries. In Dental Caries, the decay commences from the lateral sides or in-between two teeth and / or hidden crevices of the teeth. Cavities caused by fluoride in Dental Fluorosis occur on the tooth surface. Fluoride in drinking water ranging from 0.5 mg/1 and above has been found damaging the teeth as a result of demineralization, pitting and chipping off the teeth.

The status of glycosaminoglycan disaccharidesa and sulphated isomersb in fluorosed human teeth compared to controls from endemic and non -endemic areas


Control from non-endemic areas

Control from endemic areas

Fluorosed tooth (n=6)

Total GAG disaccharides

0.42 + 0.11

0.61 ±0.18

0.27 ±0.12*


48.57 ± 4.39

51.57 ±2.73

41.93 ±13.26

Dermatan Suphate

10.60 ± 5.63

18.61 ± 6.08

27.37 ± 7.37**


40.83 ± 2.44

29.83 ±3.15

30.72 ± 7.35

*p<0.02 compared to endemic controls
**p<0.05 compared to non-endemic controls
All values are mean ± standard deviation
a µm/g dry defatted toothpowder
b Relative percentages of isomers

Source of Information:       
Susheela A.K., Kamal Sharma, B.P. Rajan and Gnanasundaram N. Human Den­tal Fluorosis: The Status of Sulphated Isomers of Glycosaminoglycan. Arch Oral Biology 33, 765 - 767, 1988