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Excerpt from:

Massler M, Schour I. (1952). Relation of endemic dental fluorosis to malnutrition. JADA. 44: 156-165.

"The data from this and other investigations suggest that malnourished infants and children, especially if deficient in calcium intake, may suffer from the effects of water containing fluorine while healthy children would remain unaffected...Thus low levels of fluoride ingestion which are generally considered to be safe for the general population may not be safe for malnourished infants and children. Therefore, the nutritional status must be carefully assessed and guarded in areas with endemic fluorosis. Nutritional studies should be included in any comprehensive program of fluoridation of water with special attention to chronically ailing infants and children...When an individual or a population group shows mottling beyond the degree expected, the health and nutritional status of that group should be investigated."

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