Non-Cochrane · aetiology · PM41174838
Fluoride and Neurodevelopmental Hazard Modelling: An Assessment of Concentration-Response Analysis.
Kumar Jayanth V, Moss Mark E, Liu Honghu, et al. · Community dentistry and oral epidemiology · 2026 · PubMed · doi:10.1111/cdoe.70027
Findings
12 findings
| Population | ||||
|---|---|---|---|---|
| Children in fluoridated and non-fluoridated communities | Higher fluoride exposure (fluoridated community water) | Lower fluoride exposure (non-fluoridated community water) | Children's IQ score (standardized mean difference) Childhood to young adulthood IQ assessment · Fluoridated and non-fluoridated communities (Broadbent, Green, Ibarluzea, Dewey, Do) · Fluoridated vs non-fluoridated areas (5 studies) | SMD 0.04 [-0.06, 0.14] GRADE not reported 5 studies · 2295 participants |
| Children (prenatal exposure assessed by maternal urinary fluoride) | Higher fluoride exposure (maternal urinary fluoride, ELEMENT and OCC groups) | Lower fluoride exposure | Children's IQ score (standardized mean difference) Childhood IQ assessment · Mexico (ELEMENT) and Denmark (OCC) cohorts · Other studies subgroup (Bashash 2017, Grandjean 2023) | SMD 0.13 [0.01, 0.26] GRADE not reported 2 studies · 992 participants |
| Children (prenatal and early childhood fluoride exposure) | Higher fluoride exposure (water or maternal urinary fluoride) | Lower fluoride exposure | Children's IQ score (standardized mean difference) Childhood IQ assessment · Fluoridated communities and maternal urinary fluoride cohorts · All seven studies | SMD 0.08 [-0.00, 0.16] GRADE not reported 7 studies · 3287 participants |
| Children of pregnant women, maternal urinary fluoride cohorts | 1 mg/L increase in maternal spot urinary fluoride | Lower maternal urinary fluoride (continuous exposure) | Children's IQ/cognition score (regression coefficient per 1 mg/L maternal urinary fluoride) Childhood IQ/GCI assessment · Maternal urinary fluoride cohorts (OCC, MIREC, ELEMENT, INMA) · Excluding the salt fluoridation ELEMENT study (Goodman); random effects (3 cohorts: MIREC, OCC, INMA) | Regression coefficient (beta) -0.13 [-2.51, 2.25] GRADE not reported 3 studies |
| Children of pregnant women, maternal urinary fluoride cohorts | 1 mg/L increase in maternal spot urinary fluoride | Lower maternal urinary fluoride (continuous exposure) | Children's IQ/cognition score (regression coefficient per 1 mg/L maternal urinary fluoride) Childhood IQ/GCI assessment · Maternal urinary fluoride cohorts (OCC, MIREC, ELEMENT, INMA) · Grandjean et al. reproduced with negative OCC coefficient (-0.94), 3 cohorts: MIREC, ELEMENT, OCC; fixed effects | Regression coefficient (beta) -2.07 [-3.61, -0.52] GRADE not reported 3 studies |
| Children of pregnant women, maternal urinary fluoride cohorts | 1 mg/L increase in maternal spot urinary fluoride | Lower maternal urinary fluoride (continuous exposure) | Children's IQ/cognition score (regression coefficient per 1 mg/L maternal urinary fluoride) Childhood IQ/GCI assessment · Maternal urinary fluoride cohorts (OCC, MIREC, ELEMENT, INMA) · Leave-one-out: excluding Grandjean (OCC) | Regression coefficient (beta) -1.57 [-4.99, 1.86] GRADE not reported 3 studies |
| Children of pregnant women, maternal urinary fluoride cohorts | 1 mg/L increase in maternal spot urinary fluoride | Lower maternal urinary fluoride (continuous exposure) | Children's IQ/cognition score (regression coefficient per 1 mg/L maternal urinary fluoride) Childhood IQ/GCI assessment · Maternal urinary fluoride cohorts (OCC, MIREC, ELEMENT, INMA) · Leave-one-out: excluding Green (MIREC) | Regression coefficient (beta) -0.57 [-4.33, 3.19] GRADE not reported 3 studies |
| Children of pregnant women, maternal urinary fluoride cohorts | 1 mg/L increase in maternal spot urinary fluoride | Lower maternal urinary fluoride (continuous exposure) | Children's IQ/cognition score (regression coefficient per 1 mg/L maternal urinary fluoride) Childhood IQ/GCI assessment · Maternal urinary fluoride cohorts (OCC, MIREC, ELEMENT, INMA) · All 4 cohorts with positive OCC coefficient (MIREC, ELEMENT, OCC, INMA); random effects | Regression coefficient (beta) -1.06 [-3.63, 1.50] GRADE not reported 4 studies |
| Children of pregnant women, maternal urinary fluoride cohorts | 1 mg/L increase in maternal spot urinary fluoride | Lower maternal urinary fluoride (continuous exposure) | Children's IQ/cognition score (regression coefficient per 1 mg/L maternal urinary fluoride) Childhood IQ/GCI assessment · Maternal urinary fluoride cohorts (OCC, MIREC, ELEMENT, INMA) · OCC negative coefficient replaced by positive OCC coefficient (0.26), 3 cohorts: MIREC, ELEMENT, OCC; random effects (also leave-one-out excluding INMA) | Regression coefficient (beta) -1.78 [-4.28, 0.73] GRADE not reported 3 studies |
| Children, concentration-response analysis of group-level mean IQ/GCI | Increasing fluoride concentration (maternal urine or community water) | Lowest concentration group (benchmark response 0.5 SD) | Mean IQ/GCI score (benchmark dose, 0.5 SD decrease) Childhood IQ/GCI assessment · Group-level summary data · Water fluoride in fluoridated communities (Dunedin, MIREC, INMA, APrON, NCOHS) | BMD (mg/L) 2.159 GRADE not reported 5 studies · 2295 participants |
| Children, concentration-response analysis of group-level mean IQ/GCI | Increasing fluoride concentration (maternal urine or community water) | Lowest concentration group (benchmark response 0.5 SD) | Mean IQ/GCI score (benchmark dose, 0.5 SD decrease) Childhood IQ/GCI assessment · Group-level summary data · Maternal urinary fluoride, excluding ELEMENT (OCC, MIREC, INMA) | BMD (mg/L) 19.965 GRADE not reported 3 studies · 1450 participants |
| Children, concentration-response analysis of group-level mean IQ/GCI | Increasing fluoride concentration (maternal urine or community water) | Lowest concentration group (benchmark response 0.5 SD) | Mean IQ/GCI score (benchmark dose, 0.5 SD decrease) Childhood IQ/GCI assessment · Group-level summary data · Maternal urinary fluoride, including ELEMENT (OCC, MIREC, INMA, ELEMENT) | BMD (mg/L) 3.158 GRADE not reported 4 studies · 1639 participants |
Included primary studies 16
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Bashash 2017 (ELEMENT) Prenatal Fluoride Exposure and Cognitive Outcomes in Children at 4 and 6–12 Years of Age in Mexico DOI:10.1289/ehp655 | 2017 | this review only | not stated | not extracted yet |
| Bashash 2017 (ELEMENT) Prenatal Fluoride Exposure and Cognitive Outcomes in Children at 4 and 6-12 Years of Age in Mexico. PMID:28937959 | 2017 | this review only | not stated | not extracted yet |
| Broadbent 2015 (Dunedin) Community Water Fluoridation and Intelligence: Prospective Study in New Zealand DOI:10.2105/ajph.2013.301857 | 2015 | this review only | not stated | not extracted yet |
| Broadbent 2015 (Dunedin) Community Water Fluoridation and Intelligence: Prospective Study in New Zealand. PMID:24832151 | 2015 | this review only | not stated | not extracted yet |
| Dewey 2023 (APrON) Fluoride exposure during pregnancy from a community water supply is associated with executive function in preschool children: A… DOI:10.1016/j.scitotenv.2023.164322 | 2023 | this review only | not stated | not extracted yet |
| Dewey 2023 (APrON) Fluoride exposure during pregnancy from a community water supply is associated with executive function in preschool children: A… PMID:37236475 | 2023 | this review only | not stated | not extracted yet |
| Do 2024 Early Childhood Exposures to Fluorides and Cognitive Neurodevelopment: A Population-Based Longitudinal Study. PMID:39692252 | 2025 | this review only | not stated | not extracted yet |
| Do 2024 (NCOHS) Early Childhood Exposures to Fluorides and Cognitive Neurodevelopment: A Population-Based Longitudinal Study DOI:10.1177/00220345241299352 | 2024 | this review only | not stated | not extracted yet |
| Goodman 2022 (ELEMENT) Domain-specific effects of prenatal fluoride exposure on child IQ at 4, 5, and 6–12 years in the ELEMENT cohort DOI:10.1016/j.envres.2022.112993 | 2022 | this review only | not stated | not extracted yet |
| Goodman 2022 (ELEMENT) Domain-specific effects of prenatal fluoride exposure on child IQ at 4, 5, and 6-12 years in the ELEMENT cohort. PMID:35276192 | 2022 | this review only | not stated | not extracted yet |
| Grandjean 2023 (OCC) Dose dependence of prenatal fluoride exposure associations with cognitive performance at school age in three prospective studies DOI:10.1093/eurpub/ckad170 | 2023 | this review only | not stated | not extracted yet |
| Grandjean 2023 (OCC) Dose dependence of prenatal fluoride exposure associations with cognitive performance at school age in three prospective studies. PMID:37798092 | 2024 | this review only | not stated | not extracted yet |
| Green 2019 (MIREC) Association Between Maternal Fluoride Exposure During Pregnancy and IQ Scores in Offspring in Canada DOI:10.1001/jamapediatrics.2019.1729 | 2019 | this review only | not stated | not extracted yet |
| Green 2019 (MIREC) Association Between Maternal Fluoride Exposure During Pregnancy and IQ Scores in Offspring in Canada. PMID:31424532 | 2019 | this review only | not stated | not extracted yet |
| Ibarluzea 2021 (INMA) Prenatal exposure to fluoride and neuropsychological development in early childhood: 1-to 4 years old children DOI:10.1016/j.envres.2021.112181 | 2022 | this review only | not stated | not extracted yet |
| Ibarluzea 2021 (INMA) Prenatal exposure to fluoride and neuropsychological development in early childhood: 1-to 4 years old children. PMID:34627799 | 2022 | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Children and pregnant women | Children from fluoridated and non-fluoridated areas; mothers and children in four maternal urinary fluoride cohorts (n=7 cohort studies) |
| Intervention | Higher fluoride assessed in drinking water or urine samples (child and maternal) | Higher water fluoride (n=5 studies) or higher maternal urinary fluoride (n=4 studies) |
| Comparison | Similar group(s) with lower fluoride exposure | Lower water fluoride or lower maternal urinary fluoride |
| Outcomes | Children's cognition or IQ scores | IQ/general cognitive index scores (SMD, regression coefficient, benchmark dose) |
| Study designs | Cohort studies (dose-response modelling) | Cohort studies (n=7) |
| Timing | Studies published through December 2024 | Not specified |