Objectives : 1 ) To identify the hydrogeological characteristics and fluoride (F - ) concentration in drinking water in the southeast of the state of Morelos, Mexico, and 2 ) to estimate the association between the prevalence and severity of fluorosis, dental caries, and water F - concentration. Methods : A hydrogeological model was developed to determine the vertical distribution of lithostratigraphic units, rocks’ hydraulic conductivities, and groundwater flow characteristics. A total of 649 schoolchildren from two communities received oral examinations. One community was located in an area with 0.75 mg F - /L in the water supply and the other in an area with 1.6 mg F - /L. Fluorosis was assessed using the Thylstrup & Fejerskov Index (TFI) and the dental caries were assessed with the decayed, missing, and filled teeth (DMFT) index. The region groundwater was extracted from an inter-granular aquifer consisting of volcano clasts of intermediate volcanic chemical composition. Results : Oral examinations showed that 32.35% of the children had severe forms of fluorosis (TFI ≥ 4) in the community with 1.60 mg F - /L and 7.8% in the 0.75 mg F - /L community (p < 0.0001). DMFT = 0.53 (±1.28) and 0.42 (±0.95) in the community with 1.60 mg F - /L and 0.75 mg F - /L, respectively (p = 0.2259). Conclusions : The increasing extraction of underground water was associated with deeper water flows and higher F - concentration. In the community with high F - concentration, a third of the children showed objectionable levels of fluorosis. Adequate groundwater management actions are required to reduce fluorosis risk.
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