Fluoride Facts from the American Dental Association

 

With all the news flying around about fluoride recently, I thought it pertinent to get this information to you.  The ADA recently put out a press release titled "You Ask, We Answer:  Fluoridation Facts".  In this debate facts matter and so does science.  So give this a read and if you want even more good and scientific information on this subject the ADA offers a *free* E-Book that members can download.

Here's the recent release:

With the release of the ADA’s new edition of Fluoridation Facts, readers can learn the answers to hundreds of frequently asked questions about community water fluoridation and the latest scientific research. Fluoridation Facts — the Association’s free resource on fluoridation that examines the mineral’s effectiveness, safety, practice and cost-effectiveness — works to assist policymakers and the general public in making informed decisions about fluoridation. The new edition contains more than 400 references and 10 new Q&A’s for a total of 69 covered over 114 pages. 

 

In a new series, the ADA News is delving into many questions explored in the book through conversations with experts about fluoridation information and misinformation — from overall effectiveness to whether ingesting fluoride impacts IQ, health and reproduction. 

 

This week, Susan Fisher-Owens, M.D., a pediatrician and professor at the University of California San Francisco, discussed the question of whether ingesting fluoride at recommended levels affects the intelligence in children or has a neurological impact – question #41 in Fluoridation Facts.  

 

While researching disparities with asthma years ago, Dr. Fisher-Owens learned that tooth decay is the most common chronic disease in children.  

 

“I like to say that pediatricians are preventionists. We try to prevent obesity by giving breast milk, we try to prevent disease by giving vaccines, how are we not preventing the most common chronic condition of childhood? That’s when I got involved in applying fluoride varnish and working on referral systems and training others to do so as well.”

But is fluoride safe? 

 

The Fluoridation Facts book states that several systematic reviews and individual studies provide evidence that consumption of optimally fluoridated water at levels recommended the U.S. (0.7 mg/L) is safe and effective. 

 

“High-quality evidence does not establish a casual relationship between consumption of water fluoridated at recommended levels and lowered intelligence or behavioral disorders in children,” the book said. 

 

According to Dr. Fisher-Owens, the myth that fluoride poses safety concerns stems from a small kernel of truth. In many countries with higher levels of naturally occurring fluoride like China, people drink more water per day than the U.S. and use different forms of coal that can add to fluoride levels. In these countries, there appears preliminarily to be a risk.

Looking at such places without taking into consideration other excessive exposures to fluoride might make it look like IQ and fluoridation are connected. However, Dr. Fisher-Owens emphasized that all these studies are observational, meaning that they show correlation but not any causation. Plus, studies performed in countries with similar backgrounds to the U.S. — including Spain, New Zealand, Canada and Australia — found no impact on IQ.  

 

In 2017, for instance, the Australian National Health and Medical Research Council’s systematic review information paper concluded that there is no association between water fluoridation at current Australian levels — which range from 0.6 to 1.1 mg/L depending on climate — and the cognitive function of children or adults. 

 

A systematic review and meta-analysis published in JAMA Pediatrics for the National Toxicology Program in January examined 74 international studies published from 1989 to 2023 on the relationship between fluoride and IQ in children. While the review suggested that more exposure to fluoride may be linked to lower IQ scores in children, Dr. Fisher-Owens noted, 52 of the 74 studies were considered “low quality,” with a high risk of bias.

“It’s another reason why we shouldn’t rely on that to make us concerned about an appropriate preventive tool at the right levels,” she said. 

 

Some of these studies were published in non-peer-reviewed journals and relied on IQ’s in 3- and 4-year-olds, which Dr. Fisher-Owens said is a “very unreliable age to be doing IQ testing” since performance at this age can vary depending on whether they’ve had a nap or snack. She added that there is cultural bias with IQ testing that doesn’t level out until kids are older and in school. 

 

“It’s not a good way to test for true differences in IQ, whereas the [study] in Australia looked at exposures in younger kids but then also tested them at higher ages to see their differences in IQ,” Dr. Fisher-Owens said. 

 

She said she completely understands whenever a parent is worried about their child and raises concerns surrounding fluoridation. But she also reminds them that dentists and public health experts know the recommended levels are safe and effectively treat dental caries. 

“As a pediatrician I care about the whole child. So, this was an issue that was a concern to me when I first heard it. But after looking at the research, looking at the locations, looking at the levels and looking at what’s going on in the United States and other countries that fluoridate like the United States does, I was very relieved to realize that this is still a safe way for us to protect children and adults,” Dr. Fisher-Owens said.