the pineal melatonin system as well as the thyroid-stimulating hormone-growth hormone connection. It has been said in this regard “every molecule of AlFx is the messenger of false information” (Strunecka and Patocka 2002, p. 275). This may be an accurate synopsis of the AlFx effect at a single synapse, but the brain is a highly redundant and dispersed communication system containing millions of synapses. Because of this, observable alterations in mental or motor actions might require the formation of a multitude of false messages in a number of brain circuits acting over a prolonged period of time. Thus, the number of false messages required to disrupt an “action pattern” in the brain probably will vary according to the nature of the ongoing activities.

An especially important neurochemical transmitter that reaches almost all areas of the brain is ACh. As discussed above, some studies show that NaF and SiF inhibit cholinesterases, including acetylcholinesterase. The progressive accumulation of ACh at synaptic locations produced by the diminished esterase activity leads to a number of complex effects that can be summarized as an initial increase in stimulation of the target cells but ultimately leads to diminished stimulation—even a blockade of all activity. This earlier dialogue properly emphasized the behavioral importance of cholinergic activity in the brain and body more generally.

Long et al. (2002) reported changes in the number of acetylcholine receptors (nAChRs) in the rat brain due to fluoride. Rats were administered NaF in drinking water at 30 or 100-mg/L for 7 months. Decreased numbers of nAChRα7 subunits were found in the brains of rats from both treatment groups, but only the brains of the 100-mg/L group had diminished nAChRα4 subunits of this receptor. These results are of interest because changes in the nicotinic receptors have been related to the development of Alzheimer’s disease (Lindstrom 1997; Newhouse et al. 1997) and, in frontal brain areas, to schizophrenia (Guan et al. 1999).

FINDINGS

Human Cognitive Abilities

In assessing the potential health effects of fluoride at 2-4 mg/L, the committee found three studies of human populations exposed at those concentrations in drinking water that were useful for informing its assessment of potential neurologic effects. These studies were conducted in different areas of China, where fluoride concentrations ranged from 2.5 to 4 mg/L. Comparisons were made between the IQs of children from those populations with children exposed to lower concentration of fluoride ranging from 0.4 to 1 mg/L. The studies reported that while modal IQ scores were unchanged, the average IQ scores were lower in the more highly exposed



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