Global Fluoride Toxicology Landscape: Bibliometric Approaches and Scientific Mapping

This study analyzed research trends in the 100 most-cited articles on fluoride toxicology, a topic widely debated due to the toxic effects associated with levels deemed safe for human exposure. A bibliometric analysis was conducted using the Web of Science-Core Collection, extracting data such as citation count, authors, keywords, journal, publication year, country, and continent. After reviewing the studies, additional information-including study design, investigated organs and tissues, main outcomes, and fluoride levels-was obtained. The initial search retrieved 5983 articles, from which the 100 most-cited were selected, totaling 16 813 citations. The journal Fluoride published the highest number of articles (n = 9), with keywords like "fluoride," "fluorosis," "dental fluorosis," and "oxidative stress" being the most prevalent. India and China accounted for the largest share of publications. The most common study types were observational studies, literature reviews, and in vitro studies. Several studies reported fluoride's effects on dental and skeletal fluorosis, as well as damage to the brain, thyroid, gastrointestinal tract, heart, liver, kidneys, and specific cell types. This study highlights significant concerns regarding excessive fluoride exposure and identifies key research trends and gaps, particularly in the understanding of molecular mechanisms underlying fluoride-induced damage.