A new meta-analysis linking fluoride exposure to lower IQ scores in children has reignited debate about water fluoridation, even as dental experts emphasize the safety and importance of fluoride at U.S. recommended levels.
Erica Caffrey, DDS
The JAMA Pediatrics study, published Jan. 6, analyzed 74 studies and found associations between higher fluoride exposure and lower IQ scores. However, the research primarily examined fluoride levels significantly higher than those used in U.S. water systems.
Erica Caffrey, DDS, clinical assistant professor at the University of Maryland School of Dentistry and a board-certified pediatric dentist, urges parents not to panic about U.S. water fluoridation programs.
"I encourage all parents and anyone who has concerns regarding fluoride to discuss it with their dentist, with their physician, and with any other health care providers that are involved in their daily lifestyle," Caffrey told NBC News.
Caffrey, who is chair of the American Academy of Pediatric Dentistry's Council for Clinical Affairs, notes the study focused on countries with much higher fluoride levels than permitted in U.S. water systems. While the study examined fluoride levels of 1.5 parts per million and higher, the U.S. Department of Health and Human Services recommends just 0.7 parts per million for community water systems.
"That's like throwing a penny into a jar of $14,000 — it is a very low amount already that we're allowed or recommended to use here in the United States for prevention of dental decay," Caffrey said.
A former Samuel D. Harris Health Policy & Research Fellow, Caffrey warns that reducing access to fluoridated water could have serious public health consequences, particularly for vulnerable populations.
She expressed “grave concerns” regarding increased decay rates among children if access to fluoride is lowered.
"Daily, I see children who suffer from pain, infection, inability to sleep, inability to eat, concerns regarding their appearance and susceptibility to bullying and extreme stress for families," she said, noting areas that have removed water fluoridation have seen increases in decay rates and dental costs.
While Caffrey supports continued research on fluoride safety, particularly in U.S. populations, she emphasizes that over 70 years of studies have demonstrated fluoride's benefits in preventing tooth decay. Multiple major health organizations, including the American Medical Association, American Academy of Pediatric Dentistry, and American Dental Association, continue to support fluoride use in multiple formats, including water systems.
"There have been no studies that have come out regarding the safety of fluoride in the United States that have shown any detrimental effects on IQ or other cognition," Caffrey said.
The American Academy of Pediatric Dentistry recommends both community water fluoridation and age-appropriate use of fluoride toothpaste — a rice grain-sized amount for children under 3 and a pea-sized amount for children 3 to 6 years old.