U.S. government report finds that fluoride levels twice the recommended amount might lower kids' IQs
A U.S. government report found that children exposed to twice the recommended amount of fluoride in drinking water might have lower IQs. This is the first time a federal agency has said there’s a connection—though they’re only "moderately confident" about it. The report was based on existing research and wasn’t specifically focused on fluoride in drinking water, but it does highlight a possible risk to children’s brain development from high levels of fluoride.
According to the U.S. Centers for Disease Control and Prevention, fluoride helps strengthen teeth and prevent cavities by restoring minerals that are lost from everyday use. Adding small amounts of fluoride to drinking water has been seen as one of the biggest public health successes of the past century.
“I think this (report) is crucial in our understanding” of this risk, said Ashley Malin, a researcher from the University of Florida who has studied how higher fluoride levels affect pregnant women and their children. She described it as the most carefully done report of its kind.
The much-anticipated report, released on Wednesday, is from the National Toxicology Program, which is part of the Department of Health and Human Services. The report reviews studies from Canada, China, India, Iran, Pakistan, and Mexico, and concludes that drinking water with more than 1.5 milligrams of fluoride per liter is often linked to lower IQs in children.
The report didn’t measure exactly how much IQ might drop at different fluoride levels. However, some studies it looked at found that children with higher fluoride exposure had IQs that were 2 to 5 points lower.
Since 2015, federal health officials have recommended adding 0.7 milligrams of fluoride per liter of water. Before 2015, the recommended upper limit was 1.2 milligrams. The World Health Organization says the safe limit for fluoride in drinking water is 1.5 milligrams per liter.
The report stated that around 0.6% of the U.S. population, which is about 1.9 million people, are using water systems where the natural fluoride levels are 1.5 milligrams or higher.
“The findings from this report raise the questions about how these people can be protected and what makes the most sense,” Malin said.
The 324-page report didn't come to a conclusion about the risks of lower levels of fluoride, saying that more research is needed. It also didn't address what high levels of fluoride might do to adults.
The American Dental Association, which supports adding fluoride to water, had criticized earlier versions of the new analysis and Malin's research. When asked for a comment, a spokesperson for the organization said their experts were still reviewing the report.
About 80 years ago, scientists found that people who had more fluoride in their water had fewer cavities. This led to a big effort to add fluoride to water for better dental health. In 1945, Grand Rapids, Michigan, became the first U.S. city to add fluoride to its tap water.
By 1950, the government recommended water fluoridation to prevent tooth decay and kept supporting it even after fluoride toothpaste became available. Today, drinking water is the main source of fluoride for Americans.
In 2015, officials lowered the recommended fluoride levels in drinking water to help reduce a condition called fluorosis, which was causing splotches on children's teeth and becoming more common.
Meanwhile, the Environmental Protection Agency (EPA) has a rule that water systems can't have more than 4 milligrams of fluoride per liter. This rule is meant to prevent skeletal fluorosis, a serious condition that can make bones weaker, cause stiffness, and lead to pain.
More studies are raising concerns about a different issue: the link between high levels of fluoride and brain development. Researchers are worried about how fluoride might affect developing fetuses and very young children, especially if they drink water mixed with baby formula. Animal studies have shown that fluoride could affect brain chemistry and cell function in areas of the brain responsible for learning, memory, decision-making, and behavior.
In 2006, the National Research Council, a nonprofit group in Washington, D.C., found some evidence from China that high levels of fluoride might affect brain function. They recommended doing more research to understand how fluoride might impact intelligence.
As more research raised concerns, the National Toxicology Program started reviewing the studies in 2016 to decide if new rules on fluoride were needed.
There were several drafts of the report, but the final version was delayed multiple times. At one point, experts said the research didn't support the conclusions in an earlier draft.
“Since fluoride is such an important topic to the public and to public health officials, it was imperative that we made every effort to get the science right,” said Rick Woychik, director of the National Toxicology Program, in a statement.
Malin suggested that pregnant women should reduce their fluoride intake, not just from water but also from certain teas. She also mentioned that it might be a good idea to discuss adding fluoride information to beverage labels.
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