Send to

Choose Destination
Can J Public Health. 2017 Sep 14;108(3):e229-e239. doi: 10.17269/cjph.108.5951.

Fluoride exposure and reported learning disability diagnosis among Canadian children: Implications for community water fluoridation.

Author information

Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Edmonton, AB; Department of Community Health Sciences and O'Brien Institute for Public Health, University of Calgary, Calgary, AB.



Recent studies have connected increased fluoride exposure with increased risk of neurodevelopmental-related outcomes, such as ADHD (attention deficit hyperactivity disorder) and lower IQ in children. Our primary objective was to examine the association between fluoride exposure and reported diagnosis of a learning disability among a population-based sample of Canadian children aged 3-12 years.


We analyzed data from Cycles 2 and 3 of the Canadian Health Measures Survey. Four measures of fluoride exposure were available: 1) urinary fluoride (μmol/L), 2) creatinine-adjusted urinary fluoride (μmol/mmol), 3) specific gravity-adjusted urinary fluoride (μmol/L), and 4) fluoride concentration of tap water (mg/L) (Cycle 3 only). Diagnosis of a learning disability (yes/no) was based on parental- or self-report. Associations were examined using logistic regression (where possible), unadjusted and adjusted for covariates.


When Cycles 2 and 3 were examined separately, reported learning disability diagnosis was not significantly associated with any measure of fluoride exposure in unadjusted or adjusted models. When Cycles 2 and 3 were combined, a small but statistically significant effect was observed such that children with higher urinary fluoride had higher odds of having a reported learning disability in the adjusted model (p = 0.03). However, the association was not observed in models that used creatinine-adjusted urinary fluoride and specific gravity-adjusted urinary fluoride, which are believed to be more accurate measures due to their correction for urinary dilution.


Overall, there did not appear to be a robust association between fluoride exposure and parental- or self-reported diagnosis of a learning disability among Canadian children.

[Indexed for MEDLINE]

Supplemental Content

Loading ...
Support Center