ADA says exploratory study should not change public health recommendation

Association supports fluoride’s benefit for oral health


The ADA is affirming its support of water fluoridation in light of a study in the Journal of the American Medical Association which examines fluoride exposure during pregnancy.

The study, published May 20, looked at whether prenatal fluoride exposure is associated with neurobehavior in children. Researchers concluded that prenatal fluoride exposure may increase the risk of neurobehavioral problems among children living in an optimally fluoridated area of the United States.

In response, the ADA released a statement saying it has seen no peer-reviewed research that would change its long-standing recommendation to the public to brush twice a day with fluoride toothpaste and drink optimally fluoridated water.

The statement also expanded upon the limitations of this study, which the study authors also acknowledge, said Howard Pollick, B.D.S., a professor at the University of California-San Francisco’s School of Dentistry and member of the ADA’s National Fluoridation Advisory Committee.

Dr. Pollick said while new research is always welcome, this particular study is flawed. 

“Most of the measures of behavior were not statistically significant and it is irresponsible of the authors, based on this study, to suggest that recommendations be changed on the beneficial use of fluoride to prevent dental problems,” Dr. Pollick said.

“The JAMA study should be considered exploratory,” according to the statement. “The study is not nationally representative and has a number of limitations, including a small sample size from one population group in one U.S. city. Also, the study did not measure the actual consumption of fluoridated water.

Public health policy is based on a collective weight of scientific evidence, not a single study, the ADA said.

“Decades of research and practical experience indicate that fluoride — in topically-applied dental products, such as toothpaste, rinses and fluoride varnish, as well as in fluoridated drinking water — is safe and beneficial to oral health,” according to the statement.

“Tooth decay is one of the most common chronic diseases among children. There are decades of research and practical experience indicating community water fluoridation is safe and effective in reducing cavities by 25% in both children and adults.”

To help separate fact from fiction, the ADA provides science-based answers to common questions about water fluoridation via the Fluoridation FAQs on the ADA’s website.

To learn more about the benefits of fluoride, visit

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