A long-awaited report from the U.S. National Toxicology Program (NTP) has confirmed that high levels of fluoride in drinking water—specifically levels exceeding 1.5 milligrams per liter—are linked to lower IQs in children.
This report, which marks a significant development in the ongoing debate over water fluoridation, provides a comprehensive review of existing research and raises important questions about the safety of fluoride exposure.
Key Findings of the Report
- “Moderate Confidence” in Link Between Fluoride and IQ: The NTP’s evaluation of studies published through October 2023 concludes with “moderate confidence” that higher levels of fluoride exposure are associated with lower IQs in children. This conclusion is based on a review of 72 studies, 19 of which were considered high-quality. Of these, 18 reported an inverse association between fluoride exposure and IQ.
- International Evidence: Most of the studies reviewed were conducted in countries outside the United States, including Canada, China, India, Iran, Pakistan, and Mexico. These studies focused on populations with fluoride exposures greater than 1.5 mg/L, which is above the recommended limit by both the U.S. Public Health Service (0.7 mg/L) and the World Health Organization (1.5 mg/L).
- Wide-Ranging Exposure Sources: Fluoride exposure doesn’t only come from drinking water. The report emphasizes that many individuals, including children, are exposed to fluoride through multiple sources, such as processed foods, beverages, dental products, and pharmaceuticals. This cumulative exposure can easily exceed safe levels.
- Impact on Pregnant Women and Infants: The report highlights that pregnant women and young children may be particularly vulnerable to the effects of high fluoride levels. Some studies reviewed by the NTP suggested that IQ could be 2 to 5 points lower in children exposed to higher fluoride levels.
What Does This Mean for You?
If You Live in an Area with High Fluoride Levels
According to the report, about 1.9 million people in the U.S. are on water systems where fluoride levels naturally exceed 1.5 mg/L. If you’re in one of these areas, it might be wise to consider additional precautions to limit fluoride exposure, especially for young children and pregnant women.
Monitoring Cumulative Fluoride Intake
Even in areas where water fluoride levels are within recommended limits, cumulative exposure from other sources like toothpaste and processed foods can add up.
Consider how much extra water a child might be drinking while playing sports, or how much babies may be consuming from formula. Think about water used for cooking. It’s not difficult or unrealistic to consume twice the average amount of fluoridated water, which is associated with lower IQs.
But What About Cavity Prevention?
Although fluoride has been found to be effective in preventing cavities, here are a few things to bear in mind:
- The benefits of fluoride come from topical application rather than ingestion. Therefore, if you choose to do so, you can continue using fluoride in your toothpaste and/or mouthwash, while avoiding it in your drinking water.
- Hydroxyapatite is now used as a safer anti-cavity ingredient in toothpaste that has been found to be just as effective as fluoride.
- Additionally, bear in mind that the form of fluoride in toothpaste is different than what’s in drinking water (which is a phosphate fertilizer byproduct).
What You Can Do
Given the findings of this report, you may be wondering how to protect your family from potential risks associated with high fluoride levels. Here are some practical steps:
- Check Your Local Water Fluoride Levels: Do an online search for your local water supply’s annual report, which should contain information about the fluoride level in your water supply. If it’s above 1.5 mg/L, you may want to be extra mindful about consumption.
- Filter Your Drinking Water: For drinking and cooking at home, consider using a water filter that removes or reduces fluoride. Look for the NSF/ANSI Standard 60 certification, which indicates the filter has been third-party verified to be able to reduce fluoride.
- Limit Fluoride Exposure from Other Sources:
- Toothpaste: A CDC study showed that more than a third of children put too much toothpaste on their toothbrush, which increases the chances of swallowing larger amount of fluoride. The ADA recommends children use only a pea-sized amount of toothpaste and that parents ensure they spit it out rather than swallow it. Consider using fluoride-free toothpaste for very young children who can’t spit.
- Other Oral Care Products: Check the fluoride content in mouthwash and other dental products. Use them sparingly, especially for children.
- Processed Foods and Beverages: Be mindful of the fluoride content in processed foods and beverages, especially those made with fluoridated water.
- Switch to Hydroxyapatite: Look for toothpaste and mouthwash brands that use hydroxyapatite instead of fluoride, which has been found to be safer than fluoride and just as effective at cavity-prevention.
- Advocate for Transparency and Research: Consider advocating for better labeling of fluoride content in beverages and foods, as well as more research into the long-term effects of low-level fluoride exposure.
The U.S. Is In the Minority When It Comes to Water Fluoridation
In addition to a few other places such as Australia and Ireland, the United States is one of the few countries that still fluoridates their water.
In addition to concerns about decreased IQ and other health effects (such as dental and skeletal fluorosis, adverse effects on insulin levels and glucose tolerance, and thyroid disfunction), there is also an ethical concern for many scientists and policy makers surrounding informed consent. Although fluoride helps with cavity prevention, it may not be the right treatment for everyone and therefore many ask whether it makes sense to put it in our water supplies.