The Relationship between Fluoride Exposure and Cognitive Outcomes from Gestation to Adulthood—A Systematic Review

Banu Preethi Gopu, Liane B. Azevedo, Ralph M. Duckworth, Murali K. P. Subramanian, Sherley John and Fatemeh Vida Zohoori ()
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Banu Preethi Gopu: School of Health &and Life Sciences, Teesside University, Middlesbrough TS1 3BX, UK
Liane B. Azevedo: School of Human and Health Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK
Ralph M. Duckworth: School of Health &and Life Sciences, Teesside University, Middlesbrough TS1 3BX, UK
Murali K. P. Subramanian: School of Health &and Life Sciences, Teesside University, Middlesbrough TS1 3BX, UK
Sherley John: School of Health &and Life Sciences, Teesside University, Middlesbrough TS1 3BX, UK
Fatemeh Vida Zohoori: School of Health &and Life Sciences, Teesside University, Middlesbrough TS1 3BX, UK

IJERPH, 2022, vol. 20, issue 1, 1-13

Abstract: Chronic exposure to high levels of fluoride may cause health concerns, including in cognitive function. This study reviewed the evidence on the association between fluoride exposure and cognitive outcomes in children from gestation up to 18 years old. A literature search was conducted for studies on pregnant women and children below 18, exposed to any source of fluoride, and assessed with a validated cognitive tool. The data were analyzed using a systematic narrative synthesis approach and by subgroup: study design, age of participants, levels of fluoride exposure and methodological quality. Our search retrieved 15,072 articles, of which 46 met the inclusion criteria. Only 6 of the studies had a longitudinal design; the remainder were cross-sectional. The levels of fluoride exposure were ≥2 mg/L in 27 studies and <2 mg/L in 13 studies; 6 studies did not report levels of fluoride exposure. Only 1 of 5 studies graded as excellent quality showed a negative association between fluoride exposure and cognitive outcomes, whereas 30 of 34 poor and fair quality studies reported a negative association. The overall evidence from this review suggests that high fluoride exposure might be associated with negative cognitive outcomes in children. However, more longitudinal studies with high methodological quality are needed on this topic.

Keywords: fluoride; children; cognitive outcome; systematic review (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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