Developmental fluoride neurotoxicity: an updated review
Abstract Background After the discovery of fluoride as a caries-preventing agent in the mid-twentieth century, fluoridation of community water has become a widespread intervention, sometimes hailed as a mainstay of modern public health. However, this practice results in elevated fluoride intake and...
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doaj-fbce0974c4e74b66a49fd27e7122bec62020-12-20T12:16:49ZengBMCEnvironmental Health1476-069X2019-12-0118111710.1186/s12940-019-0551-xDevelopmental fluoride neurotoxicity: an updated reviewPhilippe Grandjean0Department of Environmental Health, Harvard T.H. Chan School of Public HealthAbstract Background After the discovery of fluoride as a caries-preventing agent in the mid-twentieth century, fluoridation of community water has become a widespread intervention, sometimes hailed as a mainstay of modern public health. However, this practice results in elevated fluoride intake and has become controversial for two reasons. First, topical fluoride application in the oral cavity appears to be a more direct and appropriate means of preventing caries. Second, systemic fluoride uptake is suspected of causing adverse effects, in particular neurotoxicity during early development. The latter is supported by experimental neurotoxicity findings and toxicokinetic evidence of fluoride passing into the brain. Method An integrated literature review was conducted on fluoride exposure and intellectual disability, with a main focus on studies on children published subsequent to a meta-analysis from 2012. Results Fourteen recent cross-sectional studies from endemic areas with naturally high fluoride concentrations in groundwater supported the previous findings of cognitive deficits in children with elevated fluoride exposures. Three recent prospective studies from Mexico and Canada with individual exposure data showed that early-life exposures were negatively associated with children’s performance on cognitive tests. Neurotoxicity appeared to be dose-dependent, and tentative benchmark dose calculations suggest that safe exposures are likely to be below currently accepted or recommended fluoride concentrations in drinking water. Conclusion The recent epidemiological results support the notion that elevated fluoride intake during early development can result in IQ deficits that may be considerable. Recognition of neurotoxic risks is necessary when determining the safety of fluoride-contaminated drinking water and fluoride uses for preventive dentistry purposes.https://doi.org/10.1186/s12940-019-0551-xCognitive disorderDental cariesDrinking waterFluoridationFluoride poisoningIntellectual disability |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Philippe Grandjean |
spellingShingle |
Philippe Grandjean Developmental fluoride neurotoxicity: an updated review Environmental Health Cognitive disorder Dental caries Drinking water Fluoridation Fluoride poisoning Intellectual disability |
author_facet |
Philippe Grandjean |
author_sort |
Philippe Grandjean |
title |
Developmental fluoride neurotoxicity: an updated review |
title_short |
Developmental fluoride neurotoxicity: an updated review |
title_full |
Developmental fluoride neurotoxicity: an updated review |
title_fullStr |
Developmental fluoride neurotoxicity: an updated review |
title_full_unstemmed |
Developmental fluoride neurotoxicity: an updated review |
title_sort |
developmental fluoride neurotoxicity: an updated review |
publisher |
BMC |
series |
Environmental Health |
issn |
1476-069X |
publishDate |
2019-12-01 |
description |
Abstract Background After the discovery of fluoride as a caries-preventing agent in the mid-twentieth century, fluoridation of community water has become a widespread intervention, sometimes hailed as a mainstay of modern public health. However, this practice results in elevated fluoride intake and has become controversial for two reasons. First, topical fluoride application in the oral cavity appears to be a more direct and appropriate means of preventing caries. Second, systemic fluoride uptake is suspected of causing adverse effects, in particular neurotoxicity during early development. The latter is supported by experimental neurotoxicity findings and toxicokinetic evidence of fluoride passing into the brain. Method An integrated literature review was conducted on fluoride exposure and intellectual disability, with a main focus on studies on children published subsequent to a meta-analysis from 2012. Results Fourteen recent cross-sectional studies from endemic areas with naturally high fluoride concentrations in groundwater supported the previous findings of cognitive deficits in children with elevated fluoride exposures. Three recent prospective studies from Mexico and Canada with individual exposure data showed that early-life exposures were negatively associated with children’s performance on cognitive tests. Neurotoxicity appeared to be dose-dependent, and tentative benchmark dose calculations suggest that safe exposures are likely to be below currently accepted or recommended fluoride concentrations in drinking water. Conclusion The recent epidemiological results support the notion that elevated fluoride intake during early development can result in IQ deficits that may be considerable. Recognition of neurotoxic risks is necessary when determining the safety of fluoride-contaminated drinking water and fluoride uses for preventive dentistry purposes. |
topic |
Cognitive disorder Dental caries Drinking water Fluoridation Fluoride poisoning Intellectual disability |
url |
https://doi.org/10.1186/s12940-019-0551-x |
work_keys_str_mv |
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