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Editor's Note
August 19, 2019

Decision to Publish Study on Maternal Fluoride Exposure During Pregnancy

Author Affiliations
  • 1University of Washington, Seattle
  • 2Seattle Children’s Research Institute, Seattle, Washington
  • 3Editor, JAMA Pediatrics
JAMA Pediatr. 2019;173(10):948. doi:10.1001/jamapediatrics.2019.3120

The decision to publish this article was not easy.1 Given the nature of the findings and their potential implications, we subjected it to additional scrutiny for its methods and the presentation of its findings. The mission of the journal is to ensure that child health is optimized by bringing the best available evidence to the fore. Publishing it serves as testament to the fact that JAMA Pediatrics is committed to disseminating the best science based entirely on the rigor of the methods and the soundness of the hypotheses tested, regardless of how contentious the results may be. That said, scientific inquiry is an iterative process. It is rare that a single study provides definitive evidence. This study is neither the first, nor will it be the last, to test the association between prenatal fluoride exposure and cognitive development. We hope that purveyors and consumers of these findings are mindful of that as the implications of this study are debated in the public arena.

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    2 Comments for this article
    This Should Not Have Been Published
    Julian Poulton-King | Monash Health
    I can see multiple red flags that lead me to believe this should not have been published without further exploration. There is no proposed mechanism explaining why there would be a gendered effect on IQ. This is frequently a sign that further data collection and analysis is necessary. Such a weak study design with such a low number of participants comparing two variables at two distant time points is tenuous at best, especially considering the fluoride concentration in the supply or urine fluoride concentration led to inconsistent IQ differences across genders.

    The number of statistical controls placed does
    not account for many confounding factors, e.g. drinking bottled water, among many others. The comparison of 3-4 IQ points difference comparing the highest fluoride concentration group with the lowest concentration does not establish a dose-response of any sort. Yet another red flag.

    If I had a study with 500 participants that showed using heavy bandaid use at a one-time point that only affected one gender was connected to basically negligible cancer at some distant point. I wouldn't be publishing it knowing it may lead to real harm with parents not using bandaids leading to infections. I would scrutinize my data, find other data to perform a retrospective analysis of this proposed effect and look at the numerous studies that don't appear to show such a connection and explain why they may have missed this effect. None of this has been done. I am very disappointed in JAMA Pediatrics.
    ingesting Fluoride
    Jacqueline Theriault | Clean Water Silicon Valley
    On Nov 22, 2016, a coalition including FAN, Food & Water Watch, Organic Consumers Association, American Academy of Environmental Medicine, International Academy of Oral Medicine and Toxicology, Moms Against Fluoridation, and several individual mothers, filed a petition calling on the EPA to ban the deliberate addition of fluoridating chemicals to the drinking water under provisions in the Toxic Substances Control Act (TSCA).

    This lawsuit is based on a large body of human, animal, and cellular research, which shows that fluoride is neurotoxic at doses within the range now seen in fluoridated communities. The judge of the U.S.
    District Court for the Northern District of California has just announced that the trial will begin on February 3, 2020.

    As many independent scientists now recognize, fluoride is a neurotoxin. The question, therefore, is not if fluoride damages the brain, but at what dose. This Federal Lawsuit against the EPA will allow the court to determine based on over 2800 studies (suppressed by EPA and CDC) showing the dangers of ingesting fluoride.