Fluoride Exposure: Neurodevelopment and Cognition

 Fluoride Exposure: Neurodevelopment and Cognition

The NTP monograph concluded that higher levels of fluoride exposure, such as drinking water containing more than 1.5 milligrams of fluoride per liter, are associated with lower IQ in children. The NTP review was designed to evaluate total fluoride exposure from all sources and was not designed to evaluate the health effects of fluoridated drinking water alone. It is important to note, however, that there were insufficient data to determine if the low fluoride level of 0.7 mg/L currently recommended for U.S. community water supplies has a negative effect on children’s IQ.

The NTP uses 4 confidence levels - high, moderate, low, or very low - to characterize the strength of scientific evidence that associates a particular health outcome with an exposure. After evaluating studies published through October 2023, the NTP Monograph concluded there is moderate confidence in the scientific evidence that showed an association between higher levels of fluoride and lower IQ in children.

The determination about lower IQs in children was based primarily on epidemiology studies in non-U.S. countries such as Canada, China, India, Iran, Pakistan, and Mexico where some pregnant women, infants, and children received total fluoride exposure amounts higher than 1.5 mg fluoride/L of drinking water. The U.S. Public Health Service currently recommends 0.7 mg/L, and the World Health Organization has set a safe limit for fluoride in drinking water of 1.5 mg/L. The NTP found no evidence that fluoride exposure had adverse effects on adult cognition.

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