There has been growing public concern about intellectual performance of children at high levels of fluoride exposure. A cross-sectional study was conducted in Simlapal Block of Bankura District, West Bengal, to find out the relationship between fluoride (F) exposure as exposure dose (ED) with dental fluorosis (DF), urinary fluoride concentration (UF), intelligence quotient (IQ) and body mass index (BMI). Fifty groundwater samples were collected from the target area. One hundred forty-nine children belonging to age group 6 to 18 years were considered for this study. Experimental results reveal that mean F(-) concentration of that area is 2.11 mg/L (±SD 1.64). On the basis of F concentration in groundwater and water consumption pattern, ED was calculated to explore the impact of F(-) on DF, UF, IQ, and BMI. Paired t test results suggest that exposure rate of F does not show any significant differences (<0.05) among the children of 12 different places. As a result of F exposure, DF cases are mostly found in the order of moderate> severe> mild> very mild> questionable> normal conditions. The highest UF concentration was recorded as 17 mg/L, but the status of DF in the affected children was recorded as moderate. The results also reveal that ED has a positive correlation with DF (r=0.299, P<0.01) and UF (r=0.513, P<0.01) and a negative correlation with IQ (r=-0.343, P<0.01) along with BMI (r=0.083, non-significant). Therefore, from this study, it may be concluded that UF and DF concentration could act as a biomarker of fluoride toxicity.