Information on the Recent JAMA Study and Fluoridation

 A recent study published in the Journal of the American Medical Association identified an associated impact on fluoride levels in pregnant women and lower IQ scores of 3-4 year old children.   You may receive some questions from patients regarding this study or the impact of Community Water Fluoridation on IQ.  The information below will provide you with a brief synopsis of response for your patients.  

1. The JAMA study was not about community water fluoridation and does not reach any conclusion stating that community water fluoridation could be in any way harmful
2. We have a quote from one of the authors of the paper: Dr. Angeles Martinez-Mier, chair, cariology, operative dentistry and dental public health at the Indiana University School of Dentistry, “I am happy to go on the record to say that I continue to support water fluoridation.”
3. If folks have toxicology questions related to fluoride, here are some facts:

   Toxicity is related to dose. While large doses of fluoride could be toxic, it is important to recognize the difference between the effect of a massive dose of an extremely high level of fluoride versus the fluoride level currently recommended for public water systems. Like many common substances essential to life and good health - salt, iron, vitamins A and D, chlorine, oxygen and even water itself - fluoride can be toxic in massive quantities. 
   Fluoride at the much lower recommended concentrations (0.7 mg/L) used in community water fluoridation is not harmful or toxic. 
   
   The single dose (consumed at one time) of fluoride that could cause acute fluoride toxicity is 5 mg/kg of body weight (11mg/kg of body weight of sodium fluoride). This dose is considered the probably toxic dose (PTD) which "is defined as the minimum dose that could cause serious or life-threatening systemic signs and symptoms and that should trigger immediate therapeutic intervention and hospitalization." Acute fluoride toxicity occurring from the ingestion of optimally fluoridated water is impossible. With water fluoridated at 1 mg/L, an individual would need to drink five (5) liters of water for every kilogram of body weight. For example, an adult male (155 pound/70.3 kilogram man), it would require that he consume more than 350 liters (nearly 93 gallons) of water at one time to reach an acute fluoride dose. With optimally water now set at 0.7 mg/L, it would take almost 30% more, or nearly 120 gallons (more than 1,900 eight ounce glasses) of water at one time to reach the acute dose. 
   
   Sources:
   U.S. Department of Health and Human Services. Federal Panel on Community Water Fluoridation. U.S. Public Health Service recommendation for fluoride concentration in drinking water for the prevention of dental caries. Public Health Rep 2015; 130(4):318-331. Article at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4547570. Accessed August 9, 2010.

   Whitford GM. Acute toxicity of ingested fluoride. In Buzalaf MAR (ed): Fluoride and the Oral Environment. Monogar Oral Sci. Basel, Karger. 2011; 22:66-80. Abstract at: https://www.ncbi.nlm.nih.gov/pubmed/21701192. Accessed August 9, 2010.

4. Here is another article commenting on some of the research methods.

    

5. For more information on Community Water Fluoridation go to the “Mouthhealthy” website developed by the American Dental Association. https://www.mouthhealthy.org/en