Experts Question Draft Report Linking Fluoride Exposure to Lower IQ

When a draft report suggested fluoride exposure was linked to lower IQ, experts took a closer look at the evidence. The National Academies of Sciences, Engineering and Medicine released a review of the program’s monograph, stating it does not find that the National Toxicology Program (NTP) adequately supported its conclusion that fluoride is “presumed” to be a cognitive neurodevelopmental hazard to humans.

The American Dental Association’s (ADA) National Fluoridation Committee, a multidisciplinary team composed of experts from dentistry, academia and research, helped to assess the monograph and its findings as several experts questioned the validity and methodology of several of the studies included in the NTP’s review. 

“The National Academies of Sciences committee concluded they had concerns about the methods, issues associated with data presentation and communication, assessment of animal and human evidence, and NTP’s hazard conclusion,” says fluoridation spokesperson for the ADA Howard Pollick, BDS, MPH. Pollick explains there are some inconsistencies in the details provided in the protocol and the methods ultimately implemented in the monograph, including how mechanistic data would be considered, how the outcome assessment would be conducted, and which confounders were identified as critical covariates. “Those discrepancies are troubling because inconsistencies between the protocol and monograph raise questions about how the process was actually conducted, about what changes were made, and about when and why modifications were implemented,” he notes. 

This is not the first study to suggest fluoride impacts a person’s intelligence. Previous studies were determined to be flawed for various reasons, such as exposure to levels of fluoride much higher than the United States standard of 0.7 ppm.

In the ADA’s comments to the NPT,  Chad P. Gehani, DDS, ADA president, and Kathleen T. O’Loughlin, DMD, MPH, ADA executive director, wrote, “Even if the NTP report’s classification does not change, an extremely important element that is missing from the conclusion is a modifier to distinguish the difference between a high level of fluoride exposure and any exposure. Without replicated study findings showing strong correlations between fluoride exposures near 0.7 ppm (which is much less than 1.5 ppm, and a relatively rare level in the US) and neurodevelopment, the results are misleading to the public.”

In their 37-page review of  the NPT’s draft monograph, “Systematic Review of Fluoride Exposure and Neurodevelopmental and Cognitive Health Effects,” the  National Academies’ review committee said its finding does not mean that the program’s conclusion is incorrect. But analysis or reanalysis is needed to support conclusions in the monograph, the committee said. 

In their statement, the ADA National Fluoridation Committee said: “Based on the major concerns raised by the National Academies of Sciences, Engineering, and Medicine review, it is hoped that the National Toxicology Program will substantially revise their draft monograph and provide an adjusted statement to better reflect the status of current science with respect to the cognitive neurodevelopmental hazard of fluoride to humans.”

The committee concluded, “The ADA is truly gratified when, in the interest of the public’s health and welfare, communities provide optimally fluoridated water to their residents. The current classification is misleading to the public, could scare them unnecessarily, and could ultimately decrease the oral health status of individuals and communities.”

Community water fluoridation has been named as one of the 10 greatest public health achievements of the 20th century by the US Centers for Disease Control and Prevention (CDC) due to its oral health benefits. Research has shown fluoride as a safe and effective strategy in caries prevention. 

Read more about Fluoride’s Role as a Public Health Strategy at: https://dimensionsofdentalhygiene.com/article/fluoride-as-public-health-strategy/

Read more about Monitoring Water Fluoridation at the Patient Level at: https://decisionsindentistry.com/article/monitoring-water-fluoridation-at-the-patient-level/

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