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Community water fluoridation, which recently celebrated its 75th anniversary, has been touted as a major advance in public health, but new research suggests it may have negative health effects. There is little doubt that fluoride supplementation strengthens teeth and reduces cavities. But at what cost? Most older studies were either snapshot studies that only looked at group-level data, or were based on higher-than-normal exposures. That changed with the publication of a prospective study that tracked the individual exposure levels of mother-child pairs over time.
The first few were from Mexico, and higher levels of fluoride in the urine of pregnant women were linked to future developmental delays in their infants. They found worse cognitive performance at age 4 and lower IQ between ages 6 and 12. However, the fluoride came from fluoridated salt, a water source where fluoride is naturally present. Then, this The study from Canada is the first prospective study using individual exposure data to directly address tap water fluoridation in communities receiving “optimally fluoridated” water without quotation marks. None of the city's tap water fluoride levels exceeded 1.5 ppm, and the majority (more than 90%) fell short of the U.S. target number 7.
Despite drinking “optimally fluoridated water,” a study of more than 500 mother-child pairs found once again that higher fluoride exposure during pregnancy was associated with lower intelligence in children aged 3 to 4 years. . The American College of Obstetricians and Gynecologists recommends that pregnant women drink at least eight glasses of water per day. According to a Canadian study, following this advice – using water at the U.S. target fluoridation level – could reduce IQ by as much as five points.
The Canadian study was published in the Journal of Pediatrics of the American Medical Association, the longest-running pediatric journal in the United States. The editor-in-chief defended the decision to publish the study “to establish the facts.” JAMA Pediatrics We are committed to disseminating the best science, regardless of how controversial the results may be.”
The Canadian Agency for Drugs and Technologies in Health issued a rapid response report concluding that there was insufficient evidence. as a result We conclude that optimal levels of fluoride exposure affect neurodevelopment. But a Canadian study said otherwise. Researchers have suggested a “need” to reduce fluoride intake during pregnancy. The accompanying editorial concluded that the new data “require a sober and measured discussion of the potential neurotoxicity of fluoride.”
What was the response from US regulators? Within a month of the publication of the Canadian study, the National Toxicology Program, part of the U.S. Department of Health and Human Services that evaluates substances for potentially harmful human health effects, published a draft assessment of fluoride exposure and neurodevelopmental and cognitive health effects. And they concluded, “Based on a systematic review of the evidence, NTP concludes that fluoride is suspected to be harmful to cognitive neurodevelopment in humans.”
So we've moved from dismissing people who question the safety of water fluoridation as fanatics or anti-science fanatics to saying that the official U.S. National Toxicology Program should assume it's dangerous. Now, this is just draft report. To ensure the integrity of the report, NTP asked the National Academies, perhaps the most prestigious scientific institutions, to review the report. This review raised many concerns in the dental literature, with IQ research being described as “unreliable”. But that's ~ no This is what the National Academy said. They explicitly stated that their doubts did not mean that the NTP's conclusion that fluoride should be presumed to be neurotoxic was incorrect. They just wanted further analysis. So in 2020, they rewrote the draft and arrived at the same conclusion once again, assuming cognitive neurodevelopmental risk based on the breadth, consistency, and robustness of the IQ data. The National Academies then re-examined the revised draft, concluding that it was much improved, but urging NTP to further improve the clarity of the document. And we are awaiting the final NTP report.
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