ADA reaffirms commitment to community water fluoridation amid JAMA Pediatrics report

HPI poll reveals dentists’ strong support for fluoridation

The ADA continues to support water fluoridation in the U.S. at the recommended level of 0.7 parts per million following a report published in the Journal of the American Medical Association Pediatrics discussing the purported effects of water fluoridation on children’s IQ scores.  

The Jan. 6 report, “Fluoride Exposure and Children’s IQ Scores: A Systematic Review and Meta-Analysis,” was conducted for the U.S. National Toxicology Program and examined 74 cross-sectional and prospective cohort studies outside the U.S. While the report found inverse associations between fluoride exposure and IQ scores in children, an accompanying commentary urged caution when interpreting the data.   

The ADA said in a news release that the meta-analysis does not provide any new evidence to warrant changing current community water fluoridation practices.  

Steven Levy, D.D.S., a dental professor at the University of Iowa and international expert on fluoride intake, called the meta-analysis “deeply flawed” in, “Caution Needed in Interpreting the Evidence Base on Fluoride and IQ,” which accompanied the JAMA Pediatrics report.  

“While I have serious concerns about biases and other methodological flaws in this meta-analysis, the main takeaway is that it did not find any connection between lower IQ and fluoride intake at the level recommended for community water fluoridation,” said Dr. Levy, a member of the ADA National Fluoridation Advisory Committee.  

The ADA news release noted that the fluoride levels examined in the National Toxicology Report are from countries with high levels of naturally occurring fluoride that is more than double the U.S. recommended amount. It instead pointed to a new study from the University of Queensland — which looked at areas with fluoride levels comparable to the U.S. — that found no measurable effect on cognitive neurodevelopment or IQ scores in children.  

“To prevent dental disease, the ADA continues to recommend drinking optimally fluoridated water along with twice daily brushing with fluoride toothpaste and eating a healthy diet low in added sugars,” said ADA President Brett Kessler, D.D.S., in the release.  

Additionally, a new report from the ADA Health Policy Institute examined dentists’ fluoride-related experiences and attitudes in the fourth quarter of 2024. A polling survey was completed by over 900 panel members in private practice from Dec. 9-15, 2024, asking questions related to community water fluoridation.  

Eighty-two percent of dentists who responded to the poll said they “strongly support” community water fluoridation as a public health measure and 10% of respondents said they “somewhat support” it. Only 5% of respondents said they somewhat or strongly oppose community water fluoridation.  

“As a science-based organization with health care professionals dedicated to improving the oral and overall health of the public, the ADA welcomes future U.S.-based research and data relevant to this country’s practice of fluoridating water,” Dr. Kessler said in the news release. “The ADA has yet to see any peer-reviewed published research that would alter its long-standing position that optimally fluoridated water is beneficial and safe for the oral health of the public.” 

For complete panel reports with breakdowns, visit ADA.org/HPI. For more information on fluoride, visit ADA.org/Fluoride.