… 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/mL), 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…