{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T17:33:10Z","timestamp":1767979990363,"version":"3.49.0"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T00:00:00Z","timestamp":1717200000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T00:00:00Z","timestamp":1717200000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Evid Based Dent"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Data sources<\/jats:title>\n                <jats:p>Human, animal, and in vitro studies. Extensive literature search of multiple bibliographic databases, trial registries, major grey literature sources and bibliographies of identified studies.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Study selection<\/jats:title>\n                <jats:p>The authors aimed to identify studies which could be used to determine the maximum safe level for fluoride in drinking water. To identify new studies published since a 2016 Australian review, the search period was 2016 to July 2021. Studies which evaluated the association between either naturally or artificially fluoridated water (any concentration) and any health outcomes were included. No restrictions on study design or publication status. Articles published in a \u2018non-Latin language\u2019 were excluded. Screening of abstracts and full texts was in duplicate. For IQ and dental fluorosis, a top-up search was conducted between 2021 and Feb 2023.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Data extraction and synthesis<\/jats:title>\n                <jats:p>Extensive data extraction. Risk of bias assessment using the OHAT tool. A narrative synthesis of the results was carried out.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The review included 89 studies in humans, 199 in animals and 10 reviews of <jats:italic>in vitro<\/jats:italic> studies. Where there was consistent evidence of a positive association, in relation to a water fluoride concentration of &lt;20 ppm (mg F\/L), and where studies were judged to be acceptable or high quality, health effects were taken forwards for further examination of causality using Bradford Hill\u2019s 9 criteria. Of the 39 health outcomes reviewed, 4 were further assessed for causality. The authors reported \u2018strong\u2019 evidence of causality for dental fluorosis and reductions in children\u2019s IQ scores, \u2018moderate\u2019 strength evidence for thyroid dysfunction, \u2018weak\u2019 for kidney dysfunction, and \u2018limited\u2019 evidence for sex hormone disruption.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The authors conclude that moderate dental fluorosis and reductions in children\u2019s IQ scores are the most appropriate health outcomes to use when setting an upper safe level of fluoride in drinking water. For reductions in children\u2019s IQ, the authors acknowledge a biological mechanism of action has not been elucidated, and the dose response curve is not clear at lower concentrations, limiting the ability to set an upper safe threshold.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1038\/s41432-024-01022-6","type":"journal-article","created":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T16:01:54Z","timestamp":1717257714000},"page":"95-97","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Fluoride and children\u2019s IQ: evidence of causation lacking"],"prefix":"10.1038","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9965-9371","authenticated-orcid":false,"given":"Deborah","family":"Moore","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne-Marie","family":"Glenny","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,6,1]]},"reference":[{"key":"1022_CR1","unstructured":"Court Listener. Food & Water Watch, Inc. et al. v. Environmental Protection Agency et al. (3:17-cv-02162). 2024 [cited 2024 Apr 10]. Available from: https:\/\/www.courtlistener.com\/docket\/6201332\/food-water-watch-inc-v-environmental-protection-agency\/?filed_after=&filed_before=&entry_gte=&entry_lte=&order_by=desc"},{"key":"#cr-split#-1022_CR2.1","unstructured":"National Academies of Science Engineering and Medicine. Review of the Revised NTP Monograph on the Systematic Review of Fluoride Exposure and Neurodevelopmental and Cognitive Health Effects: A Letter Report (2021). The National Academies Press"},{"key":"#cr-split#-1022_CR2.2","unstructured":"2021 [cited 2023 Jan 11]. Available from: https:\/\/nap.nationalacademies.org\/catalog\/26030\/review-of-the-revised-ntp-monograph-on--thesystematic-review-of-fluoride-exposure-and-neurodevelopmental-and-cognitive-health-effects"},{"key":"1022_CR3","doi-asserted-by":"publisher","first-page":"1362","DOI":"10.1289\/ehp.1104912","volume":"1362","author":"AL Choi","year":"2012","unstructured":"Choi AL, Sun G, Zhang Y, Grandjean P. Developmental fluoride neurotoxicity: a systematic review and meta-analysis. Environ Health Perspect. 2012;1362:1362\u20138.","journal-title":"Environ Health Perspect"},{"key":"1022_CR4","unstructured":"National Toxicology Program, Public Health Service, U.S. Department of Health and Human Services. DRAFT NTP Monograph on the State of the Science Concerning Fluoride Exposure and Neurodevelopmental and Cognitive Health Effects: A Systematic Review. 2022. [cited 2024 Apr 10]. Available from: https:\/\/ntp.niehs.nih.gov\/sites\/default\/files\/ntp\/about_ntp\/bsc\/2023\/fluoride\/documents_provided_bsc_wg_031523.pdf"},{"key":"1022_CR5","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1080\/10408444.2023.2295338","volume":"54","author":"MK Taher","year":"2024","unstructured":"Taher MK, Momoli F, Go J, et al. Systematic review of epidemiological and toxicological evidence on health effects of fluoride in drinking water. Crit Rev Toxicol. 2024;54:2\u201334.","journal-title":"Crit Rev Toxicol"},{"key":"1022_CR6","unstructured":"Lambe K, Farragher A, Moloney T, Sunday S, Long J. Impact of community water fluoridation on systemic health excluding oral health An evidence review. Health Research Board. 2022. https:\/\/www.hrb.ie\/publications\/publication\/impact-of-community-water-fluoridation-on-systemic-health-excluding-oral-health-an-evidence-review\/returnPage\/1\/ [cited 2023 Jan 11]."},{"key":"1022_CR7","unstructured":"CADTH. Community Water Fluoridation Exposure: A Review of Neurological and Cognitive Effects \u2013 A 2020 Update. 2020 [cited 2024 Apr 9]. p. 1\u201342. Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK567579\/"},{"key":"1022_CR8","doi-asserted-by":"crossref","unstructured":"Till C, Green R, Flora D, Hornung R, Martinez-Mier EA, Blazer M. Fluoride exposure from infant formula and child IQ in a Canadian birth cohort. Environ Int 2020;134:105315.","DOI":"10.1016\/j.envint.2019.105315"},{"key":"1022_CR9","doi-asserted-by":"crossref","unstructured":"Farmus L, Till C, Green R, Hornung R, Martinez-Mier EA, Ayotte P. Critical windows of fluoride neurotoxicity in Canadian children. Environ Res. 2021;200:111315.","DOI":"10.1016\/j.envres.2021.111315"},{"key":"1022_CR10","unstructured":"Tomar S, Bedi R, Curtis D, Carter N, Douglas G, Caulfield T, et al. Letter of concern to National Institute of Environmental Health Sciences regarding Green et al. study (2019). 2019. [cited 2022 Dec 7]. Available from: https:\/\/www.asdwa.org\/wp-content\/uploads\/2019\/10\/NIEHSLetter10-23-19.pdf"},{"key":"1022_CR11","doi-asserted-by":"crossref","unstructured":"Guichon J, Cooper C, Rugg-Gunn A, Dickinson J. Flawed MIREC fluoride and intelligence quotient publications: A failed attempt to undermine community water fluoridation. Commun Dent Oral Epidemiol. 2024. https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cdoe.12954 [cited 2024 Apr 12].","DOI":"10.1111\/cdoe.12954"}],"container-title":["Evidence-Based Dentistry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41432-024-01022-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41432-024-01022-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41432-024-01022-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,28]],"date-time":"2024-06-28T09:24:43Z","timestamp":1719566683000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41432-024-01022-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6]]},"references-count":12,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["1022"],"URL":"https:\/\/doi.org\/10.1038\/s41432-024-01022-6","relation":{},"ISSN":["1462-0049","1476-5446"],"issn-type":[{"value":"1462-0049","type":"print"},{"value":"1476-5446","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6]]},"assertion":[{"value":"12 April 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 April 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 June 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}