In Reply We appreciate the widespread interest in our study and the opportunity to respond to the critiques and clarify some facts.
We agree that our study reported an association, not causation. Still, observational studies are optimal for testing many important questions in public health, and they are often used to infer causality. Indeed, if we dismissed observational studies, we would have no evidence that water fluoridation prevents tooth decay in children.
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Till C, Green R, Lanphear B. Association Between Maternal Fluoride Exposure and Child IQ—Reply. JAMA Pediatr. 2020;174(2):216–217. doi:10.1001/jamapediatrics.2019.5251
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