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time of diagnosis. They also note that certain types of added fluoride may increase the risk of lead <br /> leaching from older pipes and that the role of lead could not be assessed. <br /> More studies of fluoride exposure at low levels, comparable to that found in fluoridated drinking <br /> water in the US and Canada are needed, particularly with control for potential confounders such as lead <br /> exposure. Ongoing studies in mammalian rodents by the National Toxicology Program will also add to <br /> the knowledge base about the neurocognitive effects of fluoride exposure. In the meantime, educational <br /> efforts should be continued regarding other sources of fluoride so that excessive exposure is avoided. <br /> Dental public health research should inform the discussion about whether lower concentrations of <br /> fluoride in drinking water will provide worthwhile protection from dental decay. <br /> References: <br /> 1. Community Water Fluoridation Programs: A Health Technology Assessment—Review of Dental <br /> Caries and Other Health Outcomes. Ottawa: CADTH 2O19 Feb. (CADTH technology review; <br /> no. 12) https://www.cadth.ca/sites/default/files/pdf/HT0022%20CWF%20- <br /> %20Clinical%20report.pdf <br /> 2. Choi AL, Sun G, Zhang Y, Grandjean P. Developmental fluoride neurotoxicity: a systematic review <br /> and meta-analysis. Environ Health Perspect. 2012;120(10):1362-1368. <br /> doi:10.1289/ehp.1104912 <br /> 3. Choi, Anna & Zhang, Ying & Sun, Guifan & Bellinger, David & Wang, Kanglin & Yang, Xiao & Li, Jin <br /> & Zheng, Quanmei & Fu, Yuanli & Grandjean, Philippe. (2014). Association of lifetime <br /> exposure to fluoride and cognitive functions in Chinese children: A pilot study. <br /> Neurotoxicology and teratology. 47. 10.1016A.ntt.2014.11.001. <br /> 4. Aggeborn, L. and Ohman, M. The Effects of Fluoride in the Drinking Water (working paper) , 2017 <br /> for the Institute for Evaluation of Labour Market and Education Policy <br /> 28 <br />