The fluoride debate rages on: Report reveals data further linking fluoridated water with lower IQ

In September of 2024, the National Toxicology Program (NTP) released a report linking high levels of fluoride with lower intelligence scores in children.¹ Less than two months later, the Trump administration announced its opposition to fluoride in US drinking water. Robert F. Kennedy Jr., longtime opposer of both vaccines and water fluoridation, will oversee the department of Health and Human Services and has made statements about potentially removing it in the future.²

This decision, on top of the ADA and the AAP keeping their guidelines the same, sparked a litany of discourse regarding the merits of fluoridated water.

Surprising results from new medical report

Medical journal JAMA Pediatrics published a paper this week analyzing a 2023 report from the NTP, which was more than 300 pages. This report concluded with "moderate confidence" that high levels of fluoride exposure may be connected to lowered IQ.1 When young children and those who are pregnant are exposed to drinking water with at least 1.5 milligrams of fluoride per liter (more than twice the recommended amount) it may cause possible neurodevelopmental harm. Researchers conducted additional studies in countries like China and India with results indicating an association between high levels of fluoride and a small decrease in children's IQ.¹

However, it is important to note that there was not enough evidence to conclude whether 0.7 mg/L of fluoride exposure (recommended amount in the US) was enough to affect IQ.¹

Conflicting evidence

With Trump set to take office at the end of this month, the timing of this research being published may act as a watershed moment for the future of US drinking water; RFK Jr. has already announced preliminary plans to remove fluoride from public water supplies. And although the new JAMA Pediatrics paper brings further awareness to fluoride's potential risks, the NTP study is not the end-all be-all.

Steven Levy, a public health dentist at the University of Iowa, questioned the report's analysis's methods and disagreed with its conclusions. In an editorial also published in JAMA Pediatrics, Levy noted that some of the more recent fluoride studies found no negative effect on IQ, and that these studies should have been considered alongside the NTP's findings.¹

Others make similar cases for imperfect or questionable evidence in the report, but the main concern for many health-care providers is keeping the populace safe. Children's health researcher Bruce Lanphear believes "the base level of fluoridation, plus the myriad other sources of fluoride in people's lives-such as toothpaste, mouthwash, and food and drinks, including some teas, fruits, vegetables, and seafoods-could be pushing fluoride to harmful levels in some vulnerable people."¹

Levy, meanwhile, suggests more high-quality research on the topic before upending long-standing public health policies. The federal court's order to the EPA to reduce regulated fluoride levels should come to a head by late January. Ultimately, the debate over fluoride's safety highlights the need for continued research and careful consideration of public health policies.

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