Exposição ao flúor e desordens cognitivas em crianças: revisão integrativa

Abstract

The incorporation of fluoride in drinking water and in oral health products has been associated with the reduction of caries disease, however, there is a worldwide concern about the possible toxicities of fluoride in the neurocognitive development of children. The aim of this study is to present current evidence about fluoride exposure and the occurrence of cognitive disorders in children. It is an integrative review developed in eight databases (Biblioteca Virtual em Saúde, PubMed, Scientific Electronic Library Online, Web of Science, Scopus, OpenThesis, OpenGrey e fluoridealert.org) through a search strategy involving key descriptors and terms. A calibrated evaluator selected observational studies that assessed the outcome of interest in individuals between 2 and 15 years old, published between 2012 and 2019, without language restriction. Initially, 768 studies were found, but only 24 met the inclusion criteria and were analyzed and synthesized, with 19 cross-sectional studies and 5 cohort studies. In general, 3 studies evaluate dental fluorosis, 19 fluoridated drinking water and 2 both methods in relation to cognitive disorders. The presence of moderate or severe dental fluorosis and the consumption of drinking water with an inadequate fluoride concentration (greater than 1,5 mg / L) was associated with the appearance of cognitive disorders. However, the reviewed publications have methodological limitations relevant to the studied outcome. There was no consistent evidence found of cognitive disorders associated with adequate fluoride exposure in the current revised publications.