Talk:Water fluoridation

Semi-protected edit request on 17 December 2024

The latter part of the following paragraph is incorrect; the cited report (Reference 7, https://www.ncbi.nlm.nih.gov/books/NBK606081/) only found reliable evidence of lower IQ in children in areas where fluoride levels exceeded the WHO Guidelines for Drinking-water Quality of 1.5 mg/L (as per the conclusion of said report), not "within the range of ordinary water fluoridation levels" as currently stated. To correct this, consider removing the bold parts in square brackets and then appending the suggested replacement that follows in italics:

In 2024, the Department of Health and Human Services' National Toxicology Program found that higher [cumulative] fluoride exposure is consistently linked to lower IQ in children[, even within the range of ordinary water fluoridation levels. These findings emphasize that as fluoride exposure increases, IQ consistently decreases, regardless of whether the exposure is considered normal or within regulatory limits.] Suggested replacement: [ from areas where fluoridation levels exceeded the 1.5 mg/L recommended by the WHO Guidelines for Drinking-water Quality.] 2406:2D40:726E:1710:E90B:B414:995D:24F9 (talk) 04:28, 17 December 2024 (UTC)

This critique overlooks the NTP’s clear acknowledgment that "because people receive fluoride from multiple sources (not just drinking water), individuals living in areas with optimally fluoridated water can have total fluoride exposures higher than the concentration of their drinking water." While the strongest evidence comes from high-exposure regions (fluoride concentrations at or above 1.5 mg/L), the findings remain relevant to children in areas with lower drinking water fluoride concentrations if cumulative exposure surpasses neurotoxic thresholds.

The report further emphasizes that cumulative exposure matters, noting that "additional exposures to fluoride from other sources would increase total fluoride exposure," making the conclusion of an inverse association between total fluoride exposure and IQ in children applicable beyond high-exposure areas. In order to correctly address the cumulative fluoride intake, while also taking into account your critique, I've modified the summary of the NTP's conclusion to accurately reflect their findings, which highlights risks tied to total fluoride exposure, not just water concentrations. MightyLebowski (talk) 06:04, 18 December 2024 (UTC)

 Done PianoDan (talk) 19:29, 17 December 2024 (UTC)

Semi-protected edit request on 17 December 2024 (2)

Edit #1: The following misrepresents the cited documents. Current: No clear evidence of other adverse effects exists, though almost all research thereof has been of poor quality. Suggested Revision: No clear evidence of other adverse effects exists. Many studies of other potential negative effects have not met inclusion criteria on each specific outcome and studies were generally of poor quality. (citation stays the same)

Edit #2: The following is a misrepresentation of the source cited. The paper states that there is no evidence that one type of topical application is more effective than another. Current: The World Health Organization reports that water fluoridation, when feasible and culturally acceptable, has substantial advantages, especially for subgroups at high risk,[12] while the European Commission finds that while water fluoridation likely reduces caries, there is no evidence that it is more effective than topical application.[20] Suggested Revision: The World Health Organization reports that water fluoridation, when feasible and culturally acceptable, has substantial advantages, especially for subgroups at high risk,[12] and the European Commission finds that water fluoridation likely reduces caries.[20] Jaredagilbert (talk) 21:23, 17 December 2024 (UTC)

I'm assuming you intended "cavities," rather than "caries" here? PianoDan (talk) 22:29, 17 December 2024 (UTC)

See our article on dental caries. WhatamIdoing (talk) 00:17, 20 December 2024 (UTC)

 Already done Looks like we're all good here? (3OpenEyes's talk page. Say hi!) | (PS: Have a good day) 01:01, 6 January 2025 (UTC)

NTP report

The NTP report is highly flawed, the CDA even stated that "Media coverage of the report has been misleading." Hence, there is no point of a flawed report to press it prominently w/o any criticism in the lead. Stop it. --Julius Senegal (talk) 19:19, 19 December 2024 (UTC)

Hi Julius, your interpretation of the National Toxicology Program's (NTP) systematic review on fluoride exposure and neurodevelopment/cognition is subjective and violates WP:OR. Personal opinions hold no weight when discussing scientific and medical research. By removing the NTP's findings from the lead, which have had community consensus since August 2024, you are engaging in disruptive editing (WP:DE) and pushing original research/your point of view. Your statement saying "the NTP report is highly flawed" is a clear admission that your intentions behind the deletions/edits are based on WP:OR. You cannot remove content from the lead or other parts of the article because you don't personally like them.

This article requires claims to be supported by peer-reviewed, high-quality evidence like the NTP's systematic review—not personal judgments such as "I think the study is flawed, so it shouldn't be included." Additionally, your repeated deletions suggest a misunderstanding of the NTP's findings, as you referred to the NTP's systematic review as a "single study" in one of your edit summaries, indicating you may not have read or understood it, despite claiming to have knowledge that would warrant its removal. This behavior is inconsistent with Wikipedia's standards, especially for articles reliant on rigorous scientific research.

Please refrain from removing key content from the article and attempting to obscure these deletions with additional edits. MightyLebowski (talk) 21:02, 19 December 2024 (UTC)

Lebowski, this study does not belong in the lead. WP:MEDRS requires that we don't overstate or give undue weight to single studies, yes, even systemic reviews. Julius is not engaging in OR. DolyaIskrina (talk) 22:41, 19 December 2024 (UTC)

They are engaging in WP:OR, since they stated that the systematic review is flawed, with zero evidence to backup their claim. Do you have evidence to backup their claim that the NTP's findings are "flawed"?

Nothing is being overstated. Based on recency of the findings, the high-quality nature of the studies in the systematic review, and the fact that it was funded and released by a major government agency (Health and Human Services), this absolutely belongs in the lead. It has been in the lead for 4 months, since August 2024, and has been edited by others during that timeframe.

Additionally, I do not believe that you read the study before editing the lead, because it clearly states that higher fluoride exposures are "consistently associated with lower IQ in children." I know that you had a problem with the use of "consistently", but that is the verbatim findings of the NTP in their systematic review. MightyLebowski (talk) 23:27, 19 December 2024 (UTC)

There is a very large "Limitations" section of the review makes it clear that it's not "hight-quality" I could quote it all day long, but here is a particularly damning bullet point: "Studies conducted in areas with high, naturally occurring fluoride levels in drinking water often did not account for potential exposures to arsenic or iodine deficiencies in study subjects in areas where these substances were likely to occur." This is not WP:MEDRS compliant to have this in the lead. DolyaIskrina (talk) 00:33, 20 December 2024 (UTC)

You are misinterpreting the findings of the systematic review. The limitation you cited explicitly refers to epidemiological studies with a high risk of bias. This is clearly stated in the text: "Limitations in the epidemiological studies with high risk of bias include..." Not all studies reviewed were of high risk of bias. In fact, the review distinguishes between studies of varying quality, and 18 studies were specifically noted as high quality. These high-quality studies consistently found that higher estimated fluoride exposures were "consistently associated with lower IQ in children."

Your edit also misrepresents the findings of the report and references information completely out of context. The monograph states:

"higher estimated fluoride exposures (e.g., as in approximations of exposure such as drinking water fluoride concentrations that exceed the WHO Guidelines for Drinking-water Quality of 1.5 mg/L of fluoride) are consistently associated with lower IQ in children."

However, your edit altered this to:

"concentrations that exceed the WHO Guidelines for Drinking-water Quality are consistently associated with lower IQ in children."

This mischaracterization disregards the fact that the findings relate to estimated fluoride exposures, not just drinking water concentrations. The systematic review explicitly considers cumulative fluoride intake from all sources, not solely water.

Additionally, your wording without context—"concentrations that exceed the WHO Guidelines"—could lead to confusion about the scope of the findings and lacks the nuance conveyed in the systematic review's conclusion. To ensure accuracy and alignment with WP:MEDRS, direct quotes or well-contextualized summaries should be used rather than vague or overly broad paraphrasing that you included. MightyLebowski (talk) 02:05, 20 December 2024 (UTC)

"The current version of the report concludes “with a moderate degree of confidence” that 1) exposure to fluoride at/above the level of ≥1.5 mg/L is “consistently associated with lower IQ in children” and 2) “more research is needed on the effects of fluoride exposure at levels below 1.5mg/L.”"[1]https://ilikemyteeth.org/troubled-government-report-finally-sees-the-light-of-day/ DolyaIskrina (talk) 18:13, 20 December 2024 (UTC)

The "I Like My Teeth" website does not meet Wikipedia's WP:MEDRS standards, as it is not peer-reviewed or a respected scientific source. Replacing the NTP systematic review's conclusions with this water fluoridation advocacy site's analysis violates WP:MEDRS and misrepresents the NTP's findings. MightyLebowski (talk) 21:25, 20 December 2024 (UTC)

That is an extremely legalistic argument,WP:LAWYER and misrepresents MEDRS. This is a direct quote from the review itself. DolyaIskrina (talk) 00:27, 21 December 2024 (UTC)

Dolya, you're misrepresenting WP:MEDRS, the NTP review, and now WP:LAWYER. First, WP:MEDRS requires high-quality, peer-reviewed sources. Replacing the NTP’s findings with a fluoride advocacy site like "I Like My Teeth" fails this standard. Second, you misrepresented the NTP review by claiming all the studies were biased and low-quality. The purpose of a systematic review is to weigh studies based on quality. The NTP explicitly highlighted 18 high-quality studies that consistently found higher fluoride exposure linked to lower IQ in children. Lastly, calling this a WP:LAWYER issue misrepresents that policy—it’s not legalistic or pedantic to insist on using accurate sources adhering to scientific rigor and a faithful representation of the findings; it’s following Wikipedia’s core standards. MightyLebowski (talk) 02:50, 21 December 2024 (UTC)

The study you like says itself that "more research is needed on the effects of fluoride below 1.5mg/L". It is lawyering to try to keep this off the page because a source that quotes the original source isn't up to your standards. DolyaIskrina (talk) 02:14, 22 December 2024 (UTC)

That is not an accurate representation of the study. The actual statement from the study is:

"More studies are needed to fully understand the potential for lower fluoride exposure to affect children’s IQ."

This means the researchers are acknowledging the need for further investigation into whether fluoride exposures (from any source, not just water) lower than those studied might also have an adverse impact on children’s neurodevelopment and IQ. It does not, however, diminish their conclusion that higher estimated fluoride exposure is associated with lower IQ in children. The systematic review is clear on this point, and it is important to understand the difference between "lower" and "higher" exposure levels, as conflating the two misrepresents the findings.

Criticizing your use of a fluoride advocacy site has nothing to do with my standards, but rather the rigorous scientific standards outlined in WP:MEDRS. It's not even close to lawyering to point that out. MightyLebowski (talk) 03:16, 22 December 2024 (UTC)

"Associations between lower total fluoride exposure [e.g., as in approximations of exposure such as drinking water fluoride concentrations that were lower than the WHO Guidelines for Drinking-water Quality of 1.5 mg/L of fluoride (WHO 2017)] and children’s IQ remain unclear."

The association with IQ is unclear at levels below 1.5. DolyaIskrina (talk) 03:40, 22 December 2024 (UTC)

That is given as an example of a single exposure source, not a total exposure threshold, hence the "e.g." Did you not read the qualifying condition in the very next sentence?

"However, because people receive fluoride from multiple sources (not just drinking water), individuals living in areas with optimally fluoridated water can have total fluoride exposures higher than the concentration of their drinking water."

That's why the NTP found an inverse association between fluoride exposure and children's IQ: as fluoride exposure increases, IQ decreases, and vice versa. However, they did not establish a specific exposure threshold, only that the relationship was consistently negative. MightyLebowski (talk) 06:52, 22 December 2024 (UTC)

No, you have reverted all criticism (coming from experts) to this "report":

• https://adanews.ada.org/ada-news/2024/august/national-toxicology-program-releases-fluoride-exposure-monograph/
• https://www.cda.org/newsroom/community/national-toxicology-program-releases-systematic-review-on-fluoride-exposure/
• https://www.statnews.com/2024/09/05/fluoride-water-child-iq-study-national-toxicology-program/
• https://www.health.govt.nz/system/files/2024-12/Appendix%205%20CWF%20assessment%20of%20additional%20publications.pdf

You don't even know the history of the report.

What you are doing is sole POV pushing of a highly controversial report as given fact. --Julius Senegal (talk) 17:48, 20 December 2024 (UTC)

You are engaging in POV pushing by relying on non-peer-reviewed sources to discredit the NTP's findings. The NTP's systematic review represents the gold standard of evidence synthesis, while your approach selectively amplifies weaker critiques, undermining Wikipedia's reliance on high-quality, peer-reviewed secondary sources for scientific accuracy and neutrality. MightyLebowski (talk) 21:26, 20 December 2024 (UTC)

Jumping quite late into this conversation. MightyLebowski indeed is strongly pushing a WP:FRINGE POV, and displaying a gross misunderstanding of a lot of WP policies.

From the top: It is not WP:OR to critically evaluate sources while discussing them in the Talk page of an article. To say his evaluation is "subjective", this "oh yeah?! That's just like, uh, your opinion, man!" (To quote the Great Lebowski) is not an argument. You were wrong to accuse Julius Senegal of OR, and you had no real argument to the contrary except for variations of the Lebowski quote. From the start he quoted the CDA, so it wasn't as baseless as you make it seem. And you have been pushing a very sensationalized version of their conclusions, including what I can only call misinformation. By framing a very small effect that has been found with "moderate confidence" and non-statistically significant effects as if they were some sort of very strong evidence, all while ignoring all context and refusing include any criticism from other experts.

DolyaIskrina linked to an expert website that quoted the the report. That's fine to bring up at the talk page, even if it doesn't meet MEDRS to be used in the article. That's why he accused you of WP:LAWYERING.

The weight being given to that review and everything else in that huge chunk of a paragraph in the LEAD is WP:UNDUE, as a new study that has been receiving a lot of criticism from experts, and by sensationalizing the findings in a biased way.

And MightyLebowski has even included some clear misrepresentations of the study that mirror anti-fluoride propaganda However, emerging evidence indicates even [the current proposed levels of 0,7 mg/l] may harm vulnerable populations and could have population-level effects, such as doubling intellectual disability rates. Added here, which I just removed. This is absurd and a big red flag. Add to that some of the argumentative and, arguably, WP:OR phrasing included in that paragraph like challenging its adequacy and strengthening its reliability. All of this looks right out of some anti-fluoridation (and therefore WP:FRINGE) pamphlet. VdSV9•♫ 17:52, 21 January 2025 (UTC)

Thx VdSV9, by coincidence I wanted also to point out that there is now vast criticism (besides the above mentioned):

• What a new study does — and doesn’t — say about fluoride and its link to IQ
• Is fluoride really linked to lower IQ, as a recent study suggested? Here’s why you shouldn’t worry

Bottom line is: Garbage in, garbage out. With highly biased studies you cannot generate "good" data. However, MightyLebowski states that it is now a eternal fact. Even in the last review (doi:10.1001/jamapediatrics.2024.5542) the authors stated that from 59 studies, 47 had a high risk of bias and 8 of them found no inverse connection between fluoride and IQ.

This is a violation against several Wikipedia standards. --Julius Senegal (talk) 18:50, 21 January 2025 (UTC)

PS, there is no metareview listed in the article clearly showing NO effect of F- to IQ. This is violationg WP:NPOV. --Julius Senegal (talk) 19:48, 21 January 2025 (UTC)

Thank you for your input, but I must strongly disagree with the assertion that the studies in question fall under WP:FRINGE or that my position misrepresents Wikipedia’s policies. Let me clarify.

The studies I cited are not fringe by any reasonable standard. They include systematic reviews and meta-analyses from credible, authoritative sources such as the U.S. Department of Health and Human Services (HHS) and JAMA Pediatrics. These are widely regarded as gold standards in medical research, relying on rigorous methodologies to synthesize findings from multiple high-quality, low-bias studies. Moreover, the JAMA meta-analysis specifically incorporates longitudinal studies, which are particularly robust in their ability to establish associations over time. To suggest that findings from these sources constitute fringe science fundamentally misinterprets WP:FRINGE, which applies to ideas widely considered pseudoscientific or lacking serious academic credibility. That is simply not the case here.

I must reiterate once again that one purpose of a systematic review/meta-analysis is to remove the high risk of bias studies from consideration, hence why they are included in the review, but given little weight in the final conclusion. The fact that you and Julius Senegal do not understand this shows a complete lack of scientific literacy.

It is ironic that I am being accused of misusing WP:OR, as I explicitly referenced the HHS and JAMA studies to ground my argument in published, peer-reviewed research. Criticisms derived from journalistic sources, on the other hand, do not meet WP:MEDRS, and relying on them in discussions of article content about medical research risks compromising the integrity of Wikipedia’s policies on reliable sourcing.

You also claim that I am sensationalizing findings and omitting context. This, too, mischaracterizes the evidence. The HHS and JAMA studies report consistent associations between higher fluoride exposure and lower IQ in children, including findings at levels below 1.5 mg/L. These results are significant, not only statistically in some cases but also because they raise important public health concerns. To label these findings as "sensationalized" when they stem from systematic reviews and meta-analyses is to dismiss their rigor without addressing their substance. Furthermore, the notion of fluoride as a potential neurotoxin is far from fringe; it has been the subject of extensive academic inquiry for decades, leading to the very systematic reviews I cited.

Lastly, the accusation that I mirrored "anti-fluoridation propaganda" is a misrepresentation of my contributions. I have not challenged the adequacy of the studies themselves but rather highlighted the findings and their implications, as reported in credible, peer-reviewed research. The use of terms like "doubling intellectual disability rates" was drawn directly from the conclusions of these studies, not from biased or fringe sources. If this interpretation is contested, the appropriate response would be to engage with the sources and evidence directly, not to dismiss them wholesale as fringe. However, I am receptive to your criticism, so this part has been removed pending further refinement.

I believe it is essential to remain focused on the evidence and ensure our discussions align with Wikipedia’s core policies, including WP:MEDRS and WP:NPOV. Critically evaluating reliable sources, especially in a talk page discussion, is entirely within the bounds of WP:OR. On the other hand, dismissing well-supported scientific findings as fringe undermines the integrity of Wikipedia’s commitment to neutrality and verifiability. MightyLebowski (talk) 21:12, 21 January 2025 (UTC)

Again, I needed to revert your POV edit.

No, you did cherrypick things you like to highlight and using Wikipedia:Wikilawyering to show your point.

You even did not mention that most of the studies are high risk of bias and then omitted sources which clearly shows that.

You pointed out to remain focused of the evidence but don't accept that there is not THE evidence. --Julius Senegal (talk) 21:23, 21 January 2025 (UTC)

Julius, I appreciate your input, but removing the entire lead is disruptive (WP:DE) and undermines collaborative editing. The sources I cited i.e. HHS and JAMA Pediatrics are systematic reviews and meta-analyses, widely recognized as reliable under WP:MEDRS. Dismissing them based on subjective or WP:OR views about their reliability is inappropriate.

Systematic reviews synthesize multiple studies to reduce bias and represent the best available evidence. If you believe key studies were omitted, please provide them for discussion. However, using personal interpretations to justify wholesale removals violates Wikipedia’s principles of neutrality and evidence-based editing. MightyLebowski (talk) 21:32, 21 January 2025 (UTC)

No, the point is not that the reviews are reliable or not (they are not, as pointed out several times).

The point is your disruptive editing to 1) omit all contradicting metareviews and supporting information, and especially 2) to only show two biased metareviews in the ledge as established knowledge. The latter is not the case. --Julius Senegal (talk) 21:41, 21 January 2025 (UTC)

Julius, your claim that my editing is disruptive is unfounded. I included findings from systematic reviews and meta-analyses by HHS and JAMA Pediatrics, which are recognized as credible sources under WP:MEDRS. These studies clearly document associations between fluoride exposure and lower IQ, yet you have removed all mentions of these associations from the lead.

Let's start with this:

No, the point is not that the reviews are reliable or not (they are not, as pointed out several times).

Claiming that both reviews aren't reliable is your opinion, plain and simple. You're clearly showing your bias by conveniently and erroneously asserting that all included studies showing associations between fluoride exposure and lower IQ in children are unreliable, especially considering one is from a major government organization (NTP) and a reputable journal (JAMA).

If you believe there are additional meta-reviews or contradicting evidence that should be included, please provide them instead of dismissing the studies as "biased" without justification. Removing well-supported findings entirely, rather than addressing them alongside opposing views, undermines neutrality and violates WP:NPOV.

The inclusion of the generalized NTP findings in the lead (higher estimated fluoride exposure associated with lower IQ in children) has been there for almost 6 months, with other Wikipedia users refining it, and removing it in its entirety is clearly disruptive editing.

Let's focus on building a balanced representation of the evidence, not erasing inconvenient conclusions.

I’m fully committed to ensuring that both perspectives are represented equally and accurately in the lead.

I have further edited the relevant parts of the article to ensure a neutral point of view while preserving the integrity of the lead without removing entire sections.

If you continue to remove entire sections of the lead, sections that have been stable for a significant period, without engaging in collaborative editing as per Wikipedia’s standards, your actions may cross the line from disruptive editing to vandalism (WP:VANDALISM).

You even keep removing parts in the lead about the court cases, which are valid, and do not use court opinions to validate/invalidate scientific claims i.e. they comply with WP:MEDRS. This section only provide context for discussion surrounding water fluoridation in public policy, yet you also continue to remove this long-standing portion of the lead (further reinforcing the potential that your edits are falling into WP:VANDALISM).

Other users who have raised concerns have focused on refining and improving the lead rather than removing it entirely. I’ve incorporated many of these criticisms to refine and improve the article further.

Your approach, however, involves entirely removing substantial sections of the article based solely on your subjective belief that sources such as the HHS (a government entity) and JAMA Pediatrics are unreliable or biased. This is not only inappropriate but undermines the collaborative principles and integrity of Wikipedia as a platform. The NTP, being part of HHS, gives significance to these findings, and additional systematic reviews and meta-analyses also aid in giving more context/research on this subject, and it is a major point of concern for water fluoridation. The NTP, as part of the HHS, underscores the significance of these findings. Additional systematic reviews and meta-analyses provide further context and research on the topic, highlighting its relevance as a major concern in discussions about water fluoridation. MightyLebowski (talk) 23:14, 21 January 2025 (UTC)

Dismissing them based on subjective or WP:OR views about their reliability is inappropriate. No one is dismissing it, we arguing about how to present their findings. And, again, this "subjective, OR" talk is a fallacy. That's not what this is about.

I didn't remove the entire lead, I trimmed a problematic paragraph substantially, and moved it down to a more adequate place (by the "adverse effects" paragraph of the lead). A lot of the trimming was because it was FRINGE BS. But also, to whatever point we're going to have such long descriptions and discussions on a few studies on Fluoride exposure (which is not the same as fluoridation, the subject of the article - of course they are connected, but they are not the same thing), that should be done at the body of the article, not in the lead. To highlight these few studies is cherry picking, in the second paragraph of the lead is WP:UNDUE, and at such lengths goes against WP:LEAD. Not disruptive and certainly not vandalism. These were improvements, and everything has been argued here at talk, with explanations given at the edit summary.

Court cases have no bearing on any scientific discussion, and the claim that I removed from the lead Recent U.S. court rulings have raised concerns about the potential health risks of water fluoridation was very much fringe BS. As I said in my edit summary: Court rulings can't raise concerns about the potential health risks, because courts don't rule on scientific matters. If anything, these court rulings have raised concerns about the health risks to the teeth of vulnerable populations in jurisdictions that might stop fluoridating their water supply.[2][3] I am not against mentioning the court rulings in the article, or even in the lead, but the framing was completely backwards. It was WP:FRINGE anti-fluoridation BS. The rest of the paragraph was more argumentative pro-FRINGE stuff. The Guardian piece is mostly informed by the fringe Fluoridation Action Network, and by the lawyer in the recent court case, who has the same surname as FAN's Paul Connett. Coincidence? The way the NBC piece was used was distorted and non-sequitur. So stop with the vandalism accusations. You're failing WP:AGF by bringing WP:VANDALISM up. VdSV9•♫ 14:32, 22 January 2025 (UTC)

Nothing is fringe about Health and Human Services and the NTP. That's a ridiculous claim. It's not cherry picking to use a major government agency's findings, which is that:

"Higher estimated fluoride is consistently associated with lower IQ in children."

This is not cherry picking. It is not fringe. Any claim of that is fringe on your part. It's the findings of a major government agency.

I didn't say that your edits went beyond trimming, it was Julius Senegal that delted it; they removed significant mentions of findings from systematic reviews, which are neither fringe nor undue given their relevance to the topic. Highlighting the connection between fluoride exposure and water fluoridation is directly related to the article’s scope, and the lead must reflect key findings per WP:LEAD.

Court rulings, while not scientific, are relevant context when they pertain to public health policy and concerns about fluoridation. Removing them entirely dismisses their importance without justification. Dismissing credible systematic reviews as "FRINGE BS" based on subjective interpretations does violate WP:NPOV and WP:MEDRS.

I maintain that completely removing significant content, even with summary explanations, undermines collaborative editing and misrepresents key findings. Let’s focus on improving the presentation rather than deleting critical information. MightyLebowski (talk) 20:01, 23 January 2025 (UTC)

PS: You don't even read what you have linked as "high quality" study. The last metareview itself stated clearly that 47 from 59 studies are of "high risk of bias". You have deleted this fact because it doesn't fit for you? --Julius Senegal (talk) 21:28, 21 January 2025 (UTC)

The fact that systematic reviews and meta-analyses include studies with varying levels of bias is precisely what makes them valuable. They assign greater weight to higher-quality, low-bias studies to ensure conclusions are grounded in the most reliable evidence. I’m genuinely curious how this key principle isn’t clear to you, as it’s fundamental to scientific literacy and understanding research methodologies. You keep erroneously saying that the mere presence of high-bias studies is enough to invalidate the entire review, which is far from the truth. MightyLebowski (talk) 21:39, 21 January 2025 (UTC)

PS: This (doi:10.1038/s41432-024-01022-6 is also a hint showing that the NTP report is far away from being a gold standard of whatsoever: The US National Academies of Science, Engineering and Medicine (NASEM) have twice peer reviewed the draft NTP review and requested revisions on the basis that the conclusions were not adequately supported by the evidence. --Julius Senegal (talk) 21:38, 21 January 2025 (UTC)

The article questions causation between fluoride and IQ, emphasizing insufficient evidence, but doesn't invalidate the NTP's findings. It is a commentary, not a systematic review or meta-analysis, and thus lacks the same evidentiary rigor. Ironically, while criticizing the NTP and JAMA reviews as low quality, you're attempting to refute systematic reviews and meta-analyses with a commentary, which undermines your argument. MightyLebowski (talk) 21:49, 21 January 2025 (UTC)

Lebowski you just reverted Julius, claiming that there was a long standing consensus. There has only been you browbeating everyone but no consensus. Please read WP:OWN DolyaIskrina (talk) 00:11, 22 January 2025 (UTC)

@MightyLebowski: The use of terms like "doubling intellectual disability rates" was drawn directly from the conclusions of these studies, not from biased or fringe sources. Are you pulling my leg, right now? The study mentions "doubling intellectual disability rates", as I said in my edit summary, like this: "For context, a 5-point decrease in a population’s IQ would nearly double the number of people classified as intellectually disabled." It says nothing about the possible effects of currently accepted fluoride concentrations in the water supply. If you are to take the effects found in the study of -1.5 IQ points per 1000ppm of Fluoride (or something - oh, wait, wasn't that on urine? whatever, doesn't matter), extrapolate to have an effect on low fluoride concentrations that have not been observed, you would get a, what, 1 IQ point drop? Not 5. Either way. That would be OR, since the paper doesn't say anything about fluoridation when it mentions doubling disabilities.

What you added was "evidence indicates even [the current proposed levels of 0,7 mg/l] may harm vulnerable populations and could have population-level effects, such as doubling intellectual disability rates." And that is the sort of distortion of evidence that I bet I would find on some anti-fluoride pamphlet-meme thing being shared by my uncle on WhatsApp or something.

Again, as I said in my edit summary. That is an outright lie and I am calling you out on it. Oh, but the terms are taken straight from the conclusion of the studies, you say? Are you kidding me, right now? That's completely disingenous. You took a few words from the study. Then added a bunch of words not from study and placed them in front of the words of the study to say something that study doesn't say.

It is ironic that I am being accused of misusing WP:OR, [...] Whatever it is that you said after that doesn't change the fact that you were misusing OR, and I explained to you why. You pointing to some other thing you did does diddly-squat for you.

I'm not saying the studies fall under FRINGE (I'm not saying they don't either, as several issues with them have been demonstrated). I'm saying that the way you are pushing their conclusions very much is. Anti-fluoridation is a WP:FRINGE ideology, and that is what you're pushing. And I think you know it. So just stop.

Yes I'm angry. But I'm right to be. VdSV9•♫ 01:57, 22 January 2025 (UTC)

I can only echo VdSV9's and DolyaIskrina's statements.

As pointed out most studies are of very low quality. Most of reviews don't show anything significant. But just highlighting one side and trying to pretend that this is now the state of knowledge brings me to the assumption that a certain anti-fluoridation-agenda wanted to be spread here. --Julius Senegal (talk) 20:10, 22 January 2025 (UTC)

You just don't understand the scientific literature, plain and simple. You refuse to accept or acknowledge that the point of systematic reviews and meta analyses is to evaluate both high and low bias studies (studies of varying quality), and give more weight to the high quality ones for its conclusion. Refusing to accept this basic fact shows indicates that you most likely are not acting in good faith here. Refusing to accept a major government organization's findings of:

"Higher estimated fluoride is consistently associated with lower IQ in children."

indicates that you're not interesting in having a discussion about improving the information of this article, but are likely acting based on an agenda. You have repeatedly engaged in WP:OR in order to discredit the findings of a major government agency (HHS, NTP). MightyLebowski (talk) 20:05, 23 January 2025 (UTC)

Your argument misrepresents the study’s findings. The excerpt explicitly states that even small IQ shifts, such as the reported 1.63-point decrease per 1 mg/L of urinary fluoride, can have significant population-level effects. While the "doubling intellectual disability rates" example refers to a 5-point decrease, the proportional effect (~33% increase for 1.63 points) is clear. You know this and are intentionally taking the study out of context. Dismissing these findings as fringe or distortions ignores the evidence and undermines constructive, policy-based editing. If you are unwilling to engage honestly with the research, you are not contributing to the collaborative integrity of this platform.

So, will you acknowledge that the review's calculation indicates a 4.89 IQ drop at a population level for 3 mg/L of fluoride in urine, and at a population level, that it indicates approximately a doubling of intellectual disability rates? I mean, it seems duplicitous to deny basic findings from this review and HHS's findings. Keep in mind, this is not 3 mg/L of fluoride in water, it's in urine, and because people have exposures from various sources (water, toothpaste, mouthwash etc.), this is a relevant statistic (a nuance captured in the NTP's review):

"However, because people receive fluoride from multiple sources (not just drinking water), individuals living in areas with optimally fluoridated water can have total fluoride exposures higher than the concentration of their drinking water."

If anyone is fringe here, it's you, denying findings from the 2025 review and a major government agency that higher estimated fluoride exposure is consistently associated with lower IQ in children. MightyLebowski (talk) 20:32, 23 January 2025 (UTC)

You have literally distorted evidence and included claims not found in the source material, as I have demonstrated above. And now you're actually insisting on it. That's not constructive, policy-based editing, that's WP:FRINGE POV pushing.

So, will you acknowledge that the review's calculation indicates a 4.89 IQ drop at a population level for 3 mg/L of fluoride in urine, and at a population level, that it indicates approximately a doubling of intellectual disability rates I acknowledge that's what they report. But nowhere have they stated that "even current proposed levels" could have such effects, as you wrote. Even if they did, that would be undue to be in lead, being a very controversial claim from one study. Very precious of you to say You know this and are intentionally taking the study out of context while you are the one doing exactly that. VdSV9•♫ 13:08, 24 January 2025 (UTC)

Removal of Long-Standing Lead Content Addressing Major Government Findings on Fluoride Exposure and IQ/Neurodevelopment

I want to address the repeated removal of long-standing content (~5 months) from the lead by Julius Senegal, which violates Wikipedia's principles of collaborative editing. Instead of refining or improving the content, entire sections are being removed, which undermines the integrity and neutrality of the article.

The National Toxicology Program (NTP), part of the U.S. Department of Health and Human Services (HHS), has published clear findings:

"Higher estimated fluoride exposures are consistently associated with lower IQ in children."

This is a significant conclusion from a major government organization and is directly relevant to the topic. Removing all mention of this in the lead appears to be an effort to bury critical findings, which is neither neutral nor constructive. This behavior is contrary to WP:NPOV and WP:LEAD, which require that significant, well-sourced findings be reflected in the lead.

Furthermore, repeated accusations of "fringe" are unwarranted and misleading. Findings from systematic reviews and meta-analyses conducted by the NTP and published in reputable sources cannot be classified as fringe under WP:FRINGE. Dismissing these findings reflects a fringe perspective in itself, denying credible, peer-reviewed science. Notice too that Julius didn’t remove mentions of the NTP's review from the body of the article, yet still claim it’s "fringe" or "unreliable", which is hypocritical and a basic violation of WP:LEAD (the gravity of the findings, the fact that they come from a major government agency etc.). This is also Twilight Zone-level reasoning, as the NTP is a major government organization and indisputably not fringe. They also claim "cherry picking", despite the abundance of systematic reviews and meta-analyses, including those from government agencies, consistently reporting similar findings.

I made a deliberate effort to follow WP:NPOV by incorporating Jullius' perspective and clearly present contrary information, but these collaborative edits were rejected, and they instead removed the entire portion of the lead, including the NTP's key findings.

I encourage those involved in these edits to engage collaboratively and focus on improving the article rather than removing essential, well-sourced content. Persistent removal of key findings without consensus or justification undermines Wikipedia's standards for verifiability, neutrality, and good faith editing. Per WP:STATUSQUO, the onus is on those seeking to remove long-standing, stable content to first achieve consensus on the Talk page before making significant changes to the article, especially when it's based on baseless claims of "fringe" and "low quality" directed at Health and Human Services/National Toxicology Program/JAMA peer reviewed scientific findings. See also WP:BRD. MightyLebowski (talk) 23:22, 23 January 2025 (UTC)

Certainly HHS would not be considered WP:FRINGE. Need to find a different argument to remove it.

Thanks Jtbobwaysf (talk) 00:08, 24 January 2025 (UTC)

Thanks for the input, Jtbobwaysf. I saw that you reverted the content against the status quo though, so I'm a bit confused on your agreement here, but at the same time undoing the revert of removed content that has been there for months. Should the status quo not stay there pending this discussion? You also said in your revert edit summary that Julius has made an attempt at discussion, but did you mean to say that I've made an attempt here? Julius has not engaged in this topic yet. MightyLebowski (talk) 00:48, 24 January 2025 (UTC)

Oh yeah, I just looked closer at your revert edit summary, and it looks like you accidentally reverted my edit that restored existing content with the comment "not really his job since it is existing content". Could you please undo your revert to bring it back to where it was? MightyLebowski (talk) 01:03, 24 January 2025 (UTC)

The HHS isn't considered FRINGE, but if they publish something, say, in defense of homeopathy of some other fringe idea, that idea doesn't all of a sudden stops being fringe because of one publication. Same goes for anti-fluoridation ideology. That's the rationale for my arguing with FRINGE. Add to that the several reliable sources with expert criticism of the papers being suggested here. All that makes it very much UNDUE to have it featured so prominently in the lead. So, significantly trimming what was in the lead, moving it down to the "side-effects" paragraph, and instead of highlighting those studies' findings in a sensationalized manner, to put them in a more appropriate context of "There is ongoing discussion" as it is now, very much is refining [and] improving the content.

Our lack of interacting with how these are mentioned further below in the article is not relevant to this discussion. Sure, there probably are improvements to be made to the body of the article, but the lead jumped out as particularly problematic, and that's what we are discussing now.

Toxicology 101: everything is toxic, at certain doses and at certain concentrations. Of course Fluoride is going to be toxic in high doses, just like everything else. No one here is denying that.

These studies are about Fluoride exposure and IQ, not about fluoridation of water supplies. Of course those are connected, but mention of their findings here need to be properly contextualized, otherwise we'd be fearmongering. A LOT of those studies - many of the Chinese ones in particular, but not exclusively - are of low quality, lack adequate controls, and they evaluate places where the community water supply has very high natural levels of Fluoride - so not about water fluoridation, which is when Fluoride is added in a controlled manner to the water supply. And they have found a correlation, but there has been no evidence of causation.[4]. We don't know if those populations have a lower than average IQ because they live in remote villages with poor nutrition, poor access to education, if the high Fluoride in their waters has damaged their nervous systems, or if there is another concurrent cause. There could even be some drawer effect in place, here.

Some of the studies claim to have controlled for things like that, but there are just too many confounding factors, so it very much looks like a case of GIGO, and

MightyLebowski has been shown to have distorted the findings and language of the study, right above you can see him insisting on doing unreasonable extrapolations of the study findings that should go be nowhere on wikipedia, but not only that, he has put them prominently in the second paragraph of the lead.

The way this whole was being framed, someone reading the second paragraph of lead would come out with the impression that "BUT NOW WE KNOW BETTER, FLUORIDE IS SCARY AND FLUORIDATION IS ON THE WAY OUT" (of course I'm exaggerating) which was completely inappropriate. The monograph doesn't provide a risk-benefit analysis. The monograph does not address whether the sole exposure to fluoride added to drinking water in some countries (i.e., fluoridation, at 0.7 mg/L in the United States and Canada) is associated with a measurable effect on IQ (quote from the monograph, page 3) as was being claimed before.

The fact that this has stood for months is only evidence that we need more well-informed, properly critical, editors with eyes on the page, and that a lot of the science editors are stretched too thin. VdSV9•♫ 14:12, 24 January 2025 (UTC)

Your arguments ignore key points: the NTP/JAMA findings are based on systematic reviews and meta-analyses of low-bias studies (there are multiple kinds of studies, but reviews give more weight to high quality ones for the final conclusion), not "GIGO". Fluoride exposure and fluoridation are connected, as acknowledged even in your comments, making these findings highly relevant (most studies are about water fluoridation). The lead summarizes significant research and reflects WP:NPOV and WP:DUE; burying these findings minimizes their importance. Dismissing evidence as "fearmongering" is unsubstantiated and undermines constructive editing.

You're still claiming that peer reviewed scientific research from the NTP is "fringe" (ridiculous). That clearly shows bias on your part.

At this point, you're just being hyperbolic/conspiratorial. Nothing is being distorted, and studies show low levels of fluoride can have an impact, particular with prenatal exposure, but the main focus is on the NTP and JAMA reviews.

The generic "poison is in the dose" argument shows a lack of understanding of toxicology (oversimplifies it). Some compounds e.g. lead have no safe exposure level (but we tolerate it nonetheless). There is a difference between an LD50 and "here is the dose that can give you cancer". Some compounds are more toxic than others in different concentrations.

It's peak comedy that you claim to be well-informed on this subject but dismiss the NTP and JAMA reviews as "GIGO" while ignoring how systematic reviews prioritize high-quality, low-bias studies. Claiming "no evidence of causation" shows a clear misunderstanding of how these reviews synthesize consistent associations to draw meaningful conclusions (causation with a coefficient of 1 or -1 is practically impossible outside of deterministic relationships, like a gene directly causing a genetic disease). MightyLebowski (talk) 15:09, 24 January 2025 (UTC)

It's truly a peak comedy if "your" papers themselves claim that they have used mostly highl risked biased studies, so yes, GIGO is a true statement. Those reviews did include them ALTHOUGH they are crap. A good review would have ignored them.

The NTP report failed to pass the peer-review process twice because it relied on crap studies.

This is all knwown, but you are simply ignoring that. --Julius Senegal (talk) 15:23, 24 January 2025 (UTC)

The NTP explicitly states that its conclusions are based on high-quality studies, noting 18 of 19 such studies found an inverse association between fluoride exposure and IQ. Low-quality studies were excluded, and systematic protocols ensured only robust evidence informed their "moderate confidence" conclusion. The claim of reliance on "GIGO" studies is clearly false:

"A strength of the findings across 18 of 19 low risk-of-bias studies was the consistent inverse association between estimated fluoride exposure and IQ scores across studies of varying study designs, exposure assessment measures, and study populations."

- NTP Review

You clearly didn't read the review and don't understand basic scientific concepts (based on your false claims). MightyLebowski (talk) 15:35, 24 January 2025 (UTC)

As per VdSV9.

There is no consensus. Claiming that it was stable for 5 months is a blatant lie looking at the history.

Not many users have this site on their observation page. And an obvious wrong content doesn't make it right, so don't go back to WP:LAWYER, or as seen on that page Gish gallops.

Me, and other users have repeatedly shown to you what was wrong. You ignored it.

Me, and other users have tried to show why those both papers are flawed, with references. You ignored it.

So stop claming that YOU would "deliberate"ly follwow NPOV. Instead, you are insulting me and trying to keep all criticism out of the articel to only present your POV, also only showing cherry-picked outcomes of those studies.

You even didn't know that the IQ thing is an old debate. However, lacking scientific consensus due to the high biased studies is not given. You are not even allowing to show that experts from the American Dental Association cleary state that there is no fuzz about those reports (like here). Instead, anti-fluoridation claims are well hidden but prominently placed in the lead and elsewhere.

So who is truly ignoring the facts? --Julius Senegal (talk) 14:36, 24 January 2025 (UTC)

The ADA is not a scientific body conducting original research; their opinions do not override systematic reviews and meta-analyses from the NTP and JAMA Pediatrics. Your repeated dismissals of these studies as "biased" ignore the fact that systematic reviews weigh low-bias studies more heavily, ensuring robust conclusions. The IQ debate’s age does not diminish its relevance, and your insistence on labeling well-sourced findings as "anti-fluoridation" is unsubstantiated and biased. The lead reflects significant, well-sourced content per WP:NPOV, and removing it without consensus is disruptive.

"trying to keep all criticism out of the articel to only present"

That's wrong, I added this to the lead:

"Nonetheless, other studies have reported inconsistent or inconclusive findings regarding fluoride's impact on IQ, particularly at levels below 0.7 mg/L. Scientists emphasize the importance of further research to clarify these associations."

You're the one push your point of view.

Scientific consensus doesn’t come from the ADA’s opinions, it comes from systematic reviews like those from the NTP and JAMA Pediatrics, which actually analyze the evidence. Ignoring these because they don’t fit your narrative isn’t how science works.

Also, I never insulted you. It's quite ironic that you have authoritatively demanded "high quality research" while saying the ADA and "expert" opinions should be included i.e. not peer reviewed research.

Expert opinion ≠ peer reviewed scientific research. MightyLebowski (talk) 15:25, 24 January 2025 (UTC)

PS: Even in Canada there is biased data floating around, also regarding urine samples (doi:10.1111/cdoe.12954). --Julius Senegal (talk) 15:18, 24 January 2025 (UTC)

They are experts, yes, deal with it.

"That's wrong, I added this".

You did this after other users tried to change it and you have reverted them. In addition, more improtantly, I am referring to other papers you are ignoring them, but did not even know them.

"Scientific consensus doesn’t come from the ADA’s opinions"

Scientific consensus doesn't come from two biased reviews which themselves claim that the used highly biased papers from China.

"I never insulted you"

You did. Don't use now again another gish gallop. There is many corrections from your cherry pickings truly showing that I am not the one who has issues with understanding how science works.

So yes, your POV pushing and avoiding of critisim is disruptive. --Julius Senegal (talk) 15:34, 24 January 2025 (UTC)

Okay, now you're definitely engaged in filibustering: WP:FILIBUSTERS and going in circles, refusing to directly respond to me in a polite and substantive manner:

Example, you said:

"They are experts, yes, deal with it."

I previously said:

"Expert opinion ≠ peer reviewed scientific research." (no direct response to this, circular reasoning on your part) MightyLebowski (talk) 15:43, 24 January 2025 (UTC)