: Fluorosis from brick-tea was discovered during the last decade in
western and northern parts of China. Dental fluorosis has a high prevalence among
children in these brick-tea endemic areas, but skeletal fluorosis does not normally
become apparent until adulthood. In July 2002 we examined 132 primary school
children, age 8 to 13 years, in a low-fluoride-water area of Naqu County, Tibet, and
found that 111 of the children (84.1%) had dental fluorosis from drinking traditional
brick-tea. Among these 111 children, 96 (86.5%) were found by radiological
examination to have developmental skeletal abnormalities in the wrist. We view
these findings as warning signs of early-stage skeletal fluorosis indicating that
dental fluorosis in children should be considered more than a matter of cosmetic
concern.