Childhood Fluoride Exposure and Cognition across the Life Course

How are children’s fluoride exposures associated with cognitive test performance in adolescence and midlife? Whereas most prior research has estimated effects of exposure to extremely high levels of fluoride, we consider exposure to levels of fluoride within the range typical in most places and of greatest relevance to policy debates about government water fluoridation. We use data from the nationally representative (United States) High School and Beyond cohort, characterize fluoride exposure from drinking water across adolescence, adjust for confounders, and observe cognitive test performance in both secondary school and at age ~60. We find that children exposed to recommended levels of fluoride in drinking water exhibit modestly better cognition in secondary school, an advantage that is smaller and no longer statistically significant at age ~60.