WASHINGTON — The National Academies of Sciences, Engineering, and Medicine released today a review of the National Toxicology Program’s (NTP) second draft of the monograph Systematic Review of Fluoride Exposure and Neurodevelopmental and Cognitive Health Effects. 

The committee that wrote the National Academies report was tasked with reviewing the second draft of the monograph and focused on evaluating whether evidence as presented in the revised monograph supports NTP’s conclusions. The committee reviewed the first draft of the monograph in 2020. The committee did not conduct its own independent evaluation of the evidence in either review, nor did it conduct a data audit.

The new National Academies report recognizes the efforts made to revise the monograph and address some concerns previously raised. However, the second draft of the monograph still falls short of providing clear and convincing documentation of the evidence to support its conclusions. The monograph needs to emphasize that much of the evidence presented comes from studies that involve relatively high fluoride concentrations, and to make clear that the monograph cannot be used to draw conclusions about low fluoride exposure concentrations (less than 1.5 mg/L), including those in fluoridated drinking water systems.

The monograph has great importance in the discussion about effects of fluoride on neurodevelopmental and cognitive health effects. It is critical for the monograph to be able to withstand scientific scrutiny by those who have vastly different opinions on the risks and benefits associated with fluoride exposure given that the issue has become highly contentious. Therefore, the committee strongly recommends that NTP improve the revised monograph by implementing its suggestions to improve clarity and transparency.

The study — undertaken by the Committee to Review NTP Monograph on the Systematic Review of Fluoride Exposure and Neurodevelopmental and Cognitive Health Effects — was sponsored by the National Institute of Environmental Health Sciences. The National Academies are private, nonprofit institutions that provide independent, objective analysis and advice to the nation to solve complex problems and inform public policy decisions related to science, technology, and medicine. They operate under an 1863 congressional charter to the National Academy of Sciences, signed by President Lincoln.

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