USA: Developmental fluoride neurotoxicity: an updated review.

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USA: Developmental fluoride neurotoxicity: an updated review.

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Grandjean P(1)(2) - "Developmental fluoride neurotoxicity: an updated review" Environ Health 18(1):110 (2019)
doi: 10.1186/s12940-019-0551-x.
FULL TEXT: ... 019-0551-x

Author information:
(1)Department of Environmental Health, Harvard T.H. Chan School of Public Health,
Boston, MA, 02115, USA.
(2)Department of Public Health, University of Southern Denmark, Odense, Denmark.

BACKGROUND: After the discovery of fluoride as a caries-preventing agent in the
mid-twentieth century, fluoridation of community water has become a widespread
intervention, sometimes hailed as a mainstay of modern public health. However,
this practice results in elevated fluoride intake and has become controversial
for two reasons. First, topical fluoride application in the oral cavity appears
to be a more direct and appropriate means of preventing caries. Second, systemic
fluoride uptake is suspected of causing adverse effects, in particular
neurotoxicity during early development. The latter is supported by experimental
neurotoxicity findings and toxicokinetic evidence of fluoride passing into the

METHOD: An integrated literature review was conducted on fluoride exposure and
intellectual disability, with a main focus on studies on children published
subsequent to a meta-analysis from 2012.

RESULTS: Fourteen recent cross-sectional studies from endemic areas with
naturally high fluoride concentrations in groundwater supported the previous
findings of cognitive deficits in children with elevated fluoride exposures.
Three recent prospective studies from Mexico and Canada with individual exposure
data showed that early-life exposures were negatively associated with children's
performance on cognitive tests. Neurotoxicity appeared to be dose-dependent, and
tentative benchmark dose calculations suggest that safe exposures are likely to
be below currently accepted or recommended fluoride concentrations in drinking

CONCLUSION: The recent epidemiological results support the notion that elevated
fluoride intake during early development can result in IQ deficits that may be
considerable. Recognition of neurotoxic risks is necessary when determining the
safety of fluoride-contaminated drinking water and fluoride uses for preventive
dentistry purposes.

DOI: 10.1186/s12940-019-0551-x
PMCID: PMC6923889
PMID: 31856837
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