Objective. The aim of this study is to investigate urine fluoride concentration as a toxicity factor in a rural community in the state of San Luis Potosi, Mexico. Materials and Methods. A sample of 111 children exposed to high concentrations of fluoride in drinking water (4.13 mg/L) was evaluated. Fluoride exposure was determined by measuring urine fluoride concentration using the potentiometric method with an ion selective electrode. The diagnosis of dental fluorosis was performed by clinical examination, and the severity of damage was determined using Dean’s index and the Thylstrup-Fejerskov (TF) index. Results. The range of exposure in the study population, evaluated through the fluoride content in urine, was 1.1 to 5.9 mg/L, with a mean of 3.14 ± 1.09 mg/L. Dental fluorosis was present in all subjects, of which 95% had severe cases. Higher urine fluoride levels and greater degrees of severity occurred in older children. Conclusions. The results show that dental fluorosis was determined by the presence of fluoride exposure finding a high positive correlation between the severity of fluorosis and urine fluoride concentration and the years of exposure suggested a cumulative effect