On Monday, the U.S. Department of Health and Human Services released a report recommending water fluoridation levels be lowered.

The HHS released their final Public Health Service (PHS) for fluoride, calling for a change from the recommended 0.7 -1.2 milligrams per liter to a maximum of 0.7 milligrams of fluoride per liter of water. This is the first major change to fluoride levels since 1962.

The HHS says the change is in response to growing cases of dental fluorosis, which causes yellowing and pitting of the teeth. A 2010 U.S. National Health and Nutrition Survey found that approximately 41% of 12-15 year olds suffer from dental fluorosis, a consequence of fluoride overexposure. Although the department says the issues with water fluoridation are simply cosmetic, a number of recent studies have called in to question the effectiveness of the treatment.

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A recently published study found an association between widespread exposure to fluoridated water and increased Attention-Deficit Hyperactivity Disorder (ADHD) prevalence among U.S. children.

The study comes from the Department of Psychology at Toronto’s York University and was published in the Environmental Health journal. The researchers studied data on ADHD among children age four to seventeen collected in 2003, 2007 and 2011 as part of the National Survey of Children’s Health, as well as state water fluoridation data from the Centers for Disease Control and Prevention (CDC) collected between 1992 and 2008 . It is the first study to analyze the relationship between exposure to fluoridated water and ADHD prevalence.

The York University study came on the heels of another study published in the BMJ’s Journal of Epidemiology and Community Health, which confirmed Fluoride’s negative effect on the thyroid gland and a possible connection to depression, weight gain, and other negative health effects. Researchers with the University of Kent in England examined thyroid activity for those in areas with fluoridated water and those without. The team examined 95 percent of the English population in 2012 and 2013 and found high rates of underactive thyroid were 30% more likely in areas with high fluoride concentration. An underactive thyroid can lead to depression, weight gain, fatigue and aching muscles.

The researchers reference a previous study that found exposure to water fluoridated at relatively low concentrations and a reduced IQ among children. Based on that study they believe “it is plausible that fluoride is also contributing to attention-related symptoms given its association with lower IQ.”

For more on the history of Fluoride, health issues, and conflicts of interests with the CDC, check this article.