The American Dental Association (ADA) remains committed to the oral health benefits of optimally fluoridated water. The recent article in the Journal of the American Medical Association (JAMA) Pediatrics “Fluoride Exposure and Children’s IQ Scores: A Systematic Review and Meta-Analysis” consists of the metanalysis left out of the National Toxicology Program’s (NTP) monograph released in August and does not provide any new evidence to warrant changing current community water fluoridation practices.

An accompanying commentary, “Caution Needed in Interpreting the Evidence Base on Fluoride and IQ,” by University of Iowa dental professor and international expert on fluoride intake, Steven Levy, D.D.S., M.P.H., cautions that the systematic review and meta-analysis, which contend fluoride exposure can lower children’s IQ levels, are deeply flawed. “While I have serious concerns about biases and other methodological flaws in this meta-analysis, the main takeaway is that it did not find any connection between lower IQ and fluoride intake at the level recommended for community water fluoridation,” Dr. Levy’s commentary explains. Dr. Levy is also a member of the ADA’s National Fluoridation Advisory Committee.

“The public needs to understand that the levels examined in NTP report are from countries with high levels of naturally occurring fluoride that is more than double the amount recommended by the U.S. Public Health Service to optimally fluoridate community water systems and help prevent dental disease,” said Brett Kessler, D.D.S., president of the American Dental Association. “A more recent study in which the level of fluoride in water is comparable to that in the U.S. found no measurable effect on cognitive neurodevelopment or IQ scores in children. To prevent dental disease the ADA continues to recommend drinking optimally fluoridated water along with twice daily brushing with fluoride toothpaste and eating a healthy diet, low in added sugars,” said Dr. Kessler.

The ADA’s National Fluoridation Advisory Committee and other experts concluded the final National Toxicology Program did not adequately address or overcome biases and weaknesses of the studies reviewed as identified from initial NTP draft reports. The report twice failed peer review by the National Academies of Science, Engineering and Medicine (NASEM), required additional scientific review by an NTP Board of Scientific Counselors (BSC), and underwent a significant number of revisions and edits before it was finally released earlier this year.

The final NTP report was also considered in a recent District Court case, and the key takeaway from the District Court ruling is that the final NTP report “does not conclude with any certainty that fluoridated water is injurious to public health,” as stated by District Court Judge Edward Chen.

“As a science-based organization with health care professionals dedicated to improving the oral and overall health of the public, the ADA welcomes future U.S.-based research and data relevant to this country’s practice of fluoridating water,” Dr. Kessler states. “The ADA has yet to see any peer-reviewed published research that would alter its long-standing position that optimally fluoridated water is beneficial and safe for the oral health of the public.”

For more information on community water fluoridation and ADA advocacy, visit ADA.org/fluoride.