68 l © 2025 American Dental Association
Section 2: Safety
39. Does fluoride at the levels found in water fluoridation affect human
reproduction, fertility, or birth rates?
Answer
No. According to the best available scientific evidence, water fluoridation does not have an adverse
effect on human reproduction, fertility, or birth rates.
Fact
European Scientific Committee on Health and Environmental Risks Critical Review
In 2011, the European Commission requested that SCHER perform a critical review of fluoridating
agents of drinking water. A portion of that report looked at reproductive issues. The report concluded
that there was no new evidence from human studies indicating that fluoride in drinking water influences
male or female reproductive capacity.43
NRC Report
In its 2006 report,26 the NRC indicated that since 1990, the quality and number of reproductive and
developmental studies using laboratory animals had improved significantly. These high-quality studies
indicated that adverse reproductive and developmental effects occurred only at levels of fluoride
much higher than 4 mg/L.26 The NRC also indicated that a few studies conducted with human populations
have suggested that fluoride might be associated with alterations in reproductive hormones and fertility.
However, the report continued on to explain that limitations in study design, such as the lack of control
of reproductive variables, make these studies of little value for risk evaluation.26
Journal of Epidemiology and Community Health Study
A study examining the relative risk of stillbirths and congenital abnormalities (facial clefts, Down
syndrome, and neural tube defects) found no evidence that fluoridation had any influence on the
rates of congenital abnormalities or stillbirths.316 The study, conducted in 2003 and published in the
Journal of Epidemiology and Community Health, analyzed data from two population-based registries
to identify all stillbirths and congenital abnormalities occurring in northeastern England between 1989
and 1998. It then compared the rates of stillbirths and specific congenital abnormalities in fluoridated
and non-fluoridated communities. The study found no significant association between the occurrence
of stillbirths or specific congenital abnormalities and fluoride levels in drinking water.316
A study examining the relative risk of stillbirths and congenital abnormalities
(facial clefts, Down syndrome, and neural tube defects) found no evidence
that fluoridation had any influence on the rates of congenital abnormalities or
stillbirths.316
Section 2: Safety
39. Does fluoride at the levels found in water fluoridation affect human
reproduction, fertility, or birth rates?
Answer
No. According to the best available scientific evidence, water fluoridation does not have an adverse
effect on human reproduction, fertility, or birth rates.
Fact
European Scientific Committee on Health and Environmental Risks Critical Review
In 2011, the European Commission requested that SCHER perform a critical review of fluoridating
agents of drinking water. A portion of that report looked at reproductive issues. The report concluded
that there was no new evidence from human studies indicating that fluoride in drinking water influences
male or female reproductive capacity.43
NRC Report
In its 2006 report,26 the NRC indicated that since 1990, the quality and number of reproductive and
developmental studies using laboratory animals had improved significantly. These high-quality studies
indicated that adverse reproductive and developmental effects occurred only at levels of fluoride
much higher than 4 mg/L.26 The NRC also indicated that a few studies conducted with human populations
have suggested that fluoride might be associated with alterations in reproductive hormones and fertility.
However, the report continued on to explain that limitations in study design, such as the lack of control
of reproductive variables, make these studies of little value for risk evaluation.26
Journal of Epidemiology and Community Health Study
A study examining the relative risk of stillbirths and congenital abnormalities (facial clefts, Down
syndrome, and neural tube defects) found no evidence that fluoridation had any influence on the
rates of congenital abnormalities or stillbirths.316 The study, conducted in 2003 and published in the
Journal of Epidemiology and Community Health, analyzed data from two population-based registries
to identify all stillbirths and congenital abnormalities occurring in northeastern England between 1989
and 1998. It then compared the rates of stillbirths and specific congenital abnormalities in fluoridated
and non-fluoridated communities. The study found no significant association between the occurrence
of stillbirths or specific congenital abnormalities and fluoride levels in drinking water.316
A study examining the relative risk of stillbirths and congenital abnormalities
(facial clefts, Down syndrome, and neural tube defects) found no evidence
that fluoridation had any influence on the rates of congenital abnormalities or
stillbirths.316
