An influential medical journal published a study on Monday that linked fluoride consumption during pregnancy to a lower childhood IQ – a finding that could undermine decades of public health messages, inflame conspiracy theorists and conspiracy theorists alarming mothers. The study was expected to be so controversial that JAMA Pediatrics included a note from an editor saying that its decision to publish was not easy and subject to "additional scrutiny".
"This is the only editor's note I have written," said Dimitri Kristakis, editor-in-chief of JAMA Pediatrics and a pediatrician, before The Daily Beast. "There was concern about the editorial staff of the magazine. this will play out in the public eye and what the public health consequences will be. "
About three-quarters of the US drink fluoridated tap water ̵
Six earlier studies suggest that prenatal fluoride exposure may affect neurodevelopment, but many experts consider you to be non-standard.
A new study, reviewed by a leading medical publisher in the US, is considered more rigorously, although some experts find it unconvincing, saying that the results are statistically marginal and the methodology is wrong.
"When we started through in this area, we were told that fluorine was safe and effective in pregnancy," said study co-author Christine Till of York University of Toronto. "But when we looked for evidence that suggested it was safe, we did not find any studies done on pregnant women."
They hire 512 pregnant women from six Canadian cities and measure their exposure in several ways: analyzing the amount of fluoride in urine them; looking at how much tap water and tea they drank; and comparing the concentration of fluoride in drinking water in the community.
Then, when women's children were 3 or 4 years old, researchers put their IQ tests and cut the numbers down to see if they could find any trends.
"We saw an association between prenatal fluoride exposure and lower IQ scores in children," says study author Rivki Green.
In particular, they found an increase in urinary fluoride concentration of 1 mg per liter associated with a decrease in IQ of 4.5 points among boys – although not girls. Another translation: The boys of the mothers with the highest fluoride in the urine have an IQ of about 3 points lower than the boys of the mothers with the least amount.
Although the study's critics point to different gender results as a red flag, when researchers measure fluoride exposure by examining fluid intake in women, they find a lower IQ in boys and girls. An increase of 1 mg per day was associated with an intelligence deficit of 3.7 points in both.
While medical organizations do not advise pregnant women to avoid fluoridated water – and the study has no implications for the use of fluoride after birth – Green believes the results are significant enough to warrant a change in behavior.
"What we recommend is to reduce fluoride uptake during pregnancy," she said.
" My initial inclination was, 'What the hell? ""
– JAMA Pediatrics Editor in Chief Dimitri Kristakis
Prior to the publication, the study was subjected to two statistical reviews, with the researchers combining the data to make sure the results were not distorted by the education of mothers, income levels or other factors.  The findings were astonishing for the editors of JAMA who throughout their medical training were told that fluoridation was completely safe and that opponents were winged nuts relying on "junk science".
"When I first saw this title, my initial inclination was 'What the hell?'" Kristakis said in a podcast on JAMA . "For me, before there were anti-vaccimers, there was some anti-fluoride."
In fact, fluoride has been a boom in conspiracy environments for decades. When water fluoridation became widespread in the United States in the 1950s, some claimed it was a Soviet conspiracy to physically and mentally weaken Americans. The far-right John Birch Society, among others, has accused the US government of using fluoride to introduce socialism, a conspiracy theory famously satirized in Stanley Kubrick's 1964 film by Dr. Strangelove.
Some contemporary conspiracy theorists claim that fluoridated water is a form of mind control, while others falsely associate it with Adolf Hitler. Some claim corporate conspiracy: They believe the dental industry or food companies are fluorinating water for their own needs.
Still others claim that fluoridated water causes diseases ranging from thyroid dysfunction to cancer. Infowars founder Alex Jones often attacks against fluoride in hyperbolic conditions and his site sells anti-fluoride products.
The arguments that the government was treating people against their will were influential. In the last five years, dozens of cities in the United States have voted to remove fluoride from their drinking water, much to the dismay of federal officials, who say the criticism is based on a two-step process.
According to the CDC, a bunch of studies show fluoridated water reduces cavities by 25 percent in children and adults, helps young children develop healthy permanent teeth, and protects tooth enamel in adults.
It is not certain that anti-fluoride activists, no matter how alien to their ideas, will benefit from new research findings as proof that they have been right all along. Results are also a major problem for healthcare providers and their pregnant patients.
"The effects of this study are comparable to the effects of lead, and if these findings are true, there should be so much concern about prenatal fluoride exposure," Kristakis told The Daily Beast.
The CDC declined to discuss the study, stating that it did not comment on external research. The American Academy of Pediatrics said it is looking forward to future studies "to see if they show the same results or provide more definitive evidence." The American College of Obstetrics and Gynecologists, which recommends that pregnant women use fluoridated toothpaste and scrub mouth, right?
"We would not change our guidelines without undertaking a thorough clinical review process," said ACOG spokeswoman Kate Connors.
Sofia Lubin, OB-GYN in Brooklyn, New York, said she had never had a patient ask her about fluoridated water, but expected that she would now be questioned about it.
"As an obstetrician, you should always think of two people – the mother and the baby," she said. "And oral health is important for mothers."
She expects to tell women that if they are really concerned, they can switch to bottled water during pregnancy. But at this point she does not think she will tell patients that they should not drink from the tap.
" That left me with a lot more questions than answers. "
– Obstetrician-midwife in New York Sofia Lubin
One part of the study that struck her was how much fluoride was in the black tea that drank it from the soil. She said she was more likely to tell patients to break away from tea than from water because it was important for them to stay hydrated.
"That left me with a lot more questions than answers," said Lubin.
Linda Murray, senior vice president of BabyCenter, an online pregnancy center, stated that concerns about fluoride would join a long list of potential danger areas for expectant mothers.
'Time is troubling for women. Every pregnant woman wants to do everything she can to have a healthy baby and they are overly aware, "she says.
Pregnant women are already being told to avoid too much coffee, raw droughts, high mercury fish, But water is in a league of its own.
"You can live without your California roll, but this is a daily routine and we tell pregnant people to stay hydrated," Murray said.
there is a broad consensus on how to respond to the study, women should focus on not states that they can do to improve pregnancy outcomes: seeing an early doctor, taking prenatal vitamins, eating healthy and worrying less.
"Stress and anxiety aren't healthy for pregnancy," he says she.
The authors of the study noted a number of limitations, the most important of which was that they did not assess how much fluoride children were exposed to after birth.
Dr. Stuart Ritchie, a neurologist at Kings College London, called the finding "rather weak."
"They may be of interest as part of a larger body of research on this, but in themselves they should not move the needle at all. on the issue of fluoride safety, ”he writes.
But in an analysis accompanying the study, Harvard professor David Bellinger says that while "high-quality epidemiological studies" are needed, "the hypothesis that fluoride is a neurodevelopment
These studies take time – which does not help millions of parents, who can now seek advice.
"The question that every pediatrician, scientist and epidemiologist should ask is what they will tell pregnant women," says Kristakis, who says he will advise pregnant friends and family to avoid fluoridated water.
"We cannot tell them to wait years for another study. They have to decide what to tell their patients now. “