Introduction: Karnataka is an Indian state which has regions with endemic fluorosis. Objective: To assess the various defluoridation techniques and units implemented by the Government of Karnataka, along with the cost of installation, maintenance and repair, to mitigate the problem of fluorosis. Methods: Information regarding the various defluoridation units was obtained from the Panchyath Raj Engineering office before they were visited. Local authorities and residents were interviewed regarding the reasons behind the success or failure of the units. Results: Of the 100 reverse osmosis units installed, 77% are defunct, only one of the two state-of-the-art solar-based technique units is currently functioning but none of the activated alumina or Nalgonda technique units. Conclusion: Defluoridation units suitable for Indian conditions and operation by unskilled villagers have yet to be developed. Key words: fluoridation, dental fluorosis, water, India