Summary: The ADA maintains its stance on the safety and benefits of optimally fluoridated water, challenging a recent JAMA Pediatrics meta-analysis associating fluoride exposure with lower IQ. Experts contend the study’s methodology is flawed and references fluoride levels exceeding U.S. recommendations. A District Court ruling also found no certainty that fluoridated water harms public health.
Two Key Takeaways:
- The ADA argues that the JAMA Pediatrics article and related NTP monograph do not justify altering current U.S. community water fluoridation practices.
- Despite ongoing discussions, no peer-reviewed, U.S.-based research has changed the ADA’s long-standing position on the safety and efficacy of optimal water fluoridation.
The American Dental Association (ADA) has contested the findings of a recent academic article on the possible negative effects of fluoridated water and stated that it remains committed to the oral health benefits of optimally fluoridated water.
JAMA Pediatrics Article & ADA Stance
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 meta-analysis 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, according to the ADA.
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, DDS, MPH, 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,” said Levy.
Levy is also a member of the ADA’s National Fluoridation Advisory Committee.
READ MORE: ADA Wants Caution from Upcoming Report on Fluoride Toxicity
Context of Fluoride Levels and Public Health
“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, DDS, 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.”
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.
District Court Ruling
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 US-based research and data relevant to this country’s practice of fluoridating water,” said Kessler. “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.”
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