Journal article
An update on community water fluoridation, part 2: Fluoride exposure and children's intelligence (IQ) scores-relevance of systematic reviews and meta-analyses to community water fluoridation
The Journal of the American Dental Association (1939), Vol.157(5), pp.471-486
05/2026
DOI: 10.1016/j.adaj.2026.02.010
PMID: 41941356
Abstract
The authors provide an overview of the literature on the association between fluoride (F) exposure related to community water fluoridation (CWF) and children's intelligence (IQ). It also critically evaluates the limitations of the evidence base.
This review is grounded in assessments from 4 government reports and supplemented by means of 3 independent reports and 7 other meta-analyses and systematic reviews. Collectively, these resources offer an overview of the literature on the relationship between F exposure and IQ. In addition, a meta-analysis of the association between urinary F and IQ is reanalyzed for its relevance to CWF.
The authors found there is no association between F concentrations relevant to CWF and IQ scores. Although researchers reported an association in endemic areas (ie, with F levels exceeding 1.5 mg/L), the design and conduct of these studies have numerous methodological weaknesses, including a limited number of high-quality studies; weak study designs; inadequate attention to accurately measuring F exposure, confounding variables, and outcomes; and the use of inappropriate statistical procedures. There is no established biological mechanism to explain F's effect on IQ. These limitations raise questions about the findings and preclude discussion of causal relationships. Furthermore, differences in water intake among countries should be considered when making cross-national comparisons.
The evidence does not support a causal link between F in drinking water and children's IQ. Dental and public health care practitioners should use this evidence to inform, educate, and empower patients and the public about the safety and benefits of CWF.
Details
- Title: Subtitle
- An update on community water fluoridation, part 2: Fluoride exposure and children's intelligence (IQ) scores-relevance of systematic reviews and meta-analyses to community water fluoridation
- Creators
- Jayanth V Kumar - California Department of Public HealthSteven M Levy - University of IowaJohn J Warren - University of Iowa
- Resource Type
- Journal article
- Publication Details
- The Journal of the American Dental Association (1939), Vol.157(5), pp.471-486
- DOI
- 10.1016/j.adaj.2026.02.010
- PMID
- 41941356
- NLM abbreviation
- J Am Dent Assoc
- ISSN
- 1943-4723
- eISSN
- 1943-4723
- Publisher
- Elsevier
- Language
- English
- Electronic publication date
- 04/06/2026
- Date published
- 05/2026
- Academic Unit
- Preventive and Community Dentistry; Epidemiology
- Record Identifier
- 9985152122502771
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