Systematic Review Finds Fluoride Exposure Linked to Children's IQ

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In American culture, people who express concern about fluoridated water are all cranks of the flat-earth variety. With the arrival of Trump’s 2nd term and the possibility that RFK Jr. could become our next HHS Secretary, this topic has been getting a lot of attention. RFK Jr. is a fluoridated water skeptic.

In an interview with NPR’s Steve Inskeep this morning, Robert F. Kennedy Jr. said that the Trump administration, which he will likely be a part of, will recommend removing fluoride from the country’s drinking water…

“We don’t need fluoride in our water,” Robert F. Kennedy said on Morning Edition. “It’s a very bad way to deliver it into our systems.”

But despite the cultural positioning of this issue, there is some fresh evidence that, on this issue, RFK Jr. has a point. A newly released systematic review and meta-analysis of past studies found a link between fluoride levels and IQ in children.

A comprehensive federal analysis of scores of previous studies, published this week in JAMA Pediatrics, has added to those concerns. It found a significant inverse relationship between exposure levels and cognitive function in children.

Higher fluoride exposures were linked to lower I.Q. scores, concluded researchers working for the National Institute of Environmental Health Sciences.

None of the studies included in the analysis were conducted in the United States, where recommended fluoridation levels in drinking water are very low. At those amounts, evidence was too limited to draw definitive conclusions.

Observational studies cannot prove a cause-and-effect relationship. Yet in countries with much higher levels of fluoridation, the analysis also found evidence of what scientists call a dose-response relationship, with I.Q. scores falling in lock step with increasing fluoride exposure…

For every one part per million increase in fluoride in urinary samples, which reflect total exposures from water and other sources, I.Q. points in children decreased by 1.63, the analysis found.

Fluoride levels in American water systems are usually set around 0.7 parts per million which is well below the 1.5 ppm threshold at which the new study found a correlation with IQ. However, because fluoride levels are set by local governments in most places, there are about 3 million people in America who get higher fluoride levels.

Beyond this, just because the current studies didn’t find a correlation with IQ at lower levels doesn’t mean lower levels are harmless. As one doctor not involved in the current study said, “The more we study a lot of chemicals, especially the chemicals that affect I.Q., like lead — there’s really no safe level.”

Fluoridation is not common in Europe anymore. Denmark, France, Germany, Italy, the Netherlands, Norway and Sweden have all ended water fluoridation. So on this issue, RFK Jr. seems to have a point. Yes, removing fluoride from water will likely increase tooth decay problems but that’s something that can be addressed in other ways. The potential downside for unborn children and infants is more serious and cannot be remedied after the fact.

There is still a lot of resistance to RFK Jr. from the medical community for other reasons. A group of 15,000 doctors have signed a letter calling on Senators to reject him.

“The health and well-being of 336 million Americans depend on leadership at HHS that prioritizes science, evidence-based medicine, and strengthening the integrity of our public health system,” the letter reads. “RFK Jr. is not only unqualified to lead this essential agency — he is actively dangerous.”

The letter was posted online by the Committee to Protect Health Care, a physicians advocacy group. Beyond his well-documented anti-vaccine views and advocacy, the letter cites other conspiracy theories Kennedy has actively spread, including baseless claims about a link between school shootings and antidepressants and his promotion of disproven treatments for Covid-19.

“This appointment is a slap in the face to every health care professional who has spent their lives working to protect patients from preventable illness and death,” the letter says.

So at least a subset of doctors see him as outside the mainstream on a bunch of issues including vaccinations, but their letter apparently doesn’t mention fluoridated water. That seems like an acknowledgement that, on this one divisive issue, he may have a point.