To the Editor The investigation by Green et al1 into the effect of maternal consumption of fluoride on the IQ of children is important. It is always wise to constantly evaluate and reevaluate long-standing public health practices in the light of new evidence.
However, the authors’ conclusion that fluoride is linked to lower IQs is not warranted by their data. Indeed, the conclusion fails to satisfy the Hill Criteria of Causality,2 which were epidemiologic criteria developed by Austin Bradford Hill, CBE, FRS, to discern correlation from causation. Notably, the conclusion violates at least 3 criteria.
Berezow AB. Association Between Maternal Fluoride Exposure and Child IQ. JAMA Pediatr. Published online December 30, 2019. doi:10.1001/jamapediatrics.2019.5236
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