Fluorosis and cognitive development among children (6-14 years of age) in the endemic areas of the world: a review and critical analysis

The fluoride contamination in water is still a live discussion among the scientific community, because of its beneficial and injurious health effects inflicted on the human population. The magnitude of groundwater fluoride contamination is aggravated by increasing anthropogenic activities. Groundwater is supposedly the main source through which people are highly exposed to fluoride, compared with other sources of exposure. Among human populations, fluoride-related health issues span from mild effects on teeth and bones to severe kidney problems, neurotoxicity, and even cancer. Nowadays, fluoride toxicity is gaining much attention in the endemic areas due to its adverse impact on the children's cognitive function, since children are more susceptible to fluoride toxicity as compared to adults. The primary mechanism behind the neurotoxicity of fluoride is still not clearly understood. However, knowingly, fluoride disrupts the biochemical mechanism and thus alters the normal functioning of the brain. Several human studies are suggestive of lowering children's IQ who was exposed to fluoride during their childhood. The conclusive findings of past research suggest that the fluoride concentration in potable water tends to grossly affect the children's IQ level. However, the body of proof is limited, because most of the studies are concentrated in few countries, and have their own limitations and data gaps. The grave implications of fluoride toxicity, therefore, demand extensive and properly designed research to bridging the data gap in developing countries. Furthermore, spanning research work across all the endemic areas of the world could generate larger database, helping resolve the issue on a large scale.