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Across the top of every page: "Internal Deliberative – Confidential --- DRAFT NOT FOR ATTRIBUTION"

It includes plenty of "this needs changes" comments from reviewers.

Looking at their Summary, and reviewer comments there - it looks like a decent one-line summary would be: "If you are not getting well above the WHO's upper limit for fluoride, then there is no evidence of it having ill effects."

Bigger picture: A "too much is bad" conclusion would not make fluoride at all special. If a toddler gets into a bottle of adult iron supplement tablets, he can easily swallow an LD99 dose in <1 minute. Grab the kid and the bottle, and get them to a good emergency room as fast as you can. (IANAMD - depending on circumstances, you may want to immediately induce vomiting, or call the local poison control center, or ...)

So fluorid is in toothpaste? So non usage is associated with gum disease. Making this a 2nd order effect study of "will bacteria entering the bloodstream trough rotting tissue affect neural tissue?"
Wow... almost 1,600 pages. What a slog. I guess my question is to the OP: What is your purpose? Fear? Conspiracy? Troll? If you want that route, then include commentary on all the other poisonous things humans consume: Copper, Selenium, Chlorine, Sodium, even Arsenic, and etc. These are all elements or compounds or salts that are needed in the human body for it to live. Flouride is a monatomic anion of fluorine, a salt if you will, no different than Chlorine and Sodium as a salt. The data is incontrovertible that "Flouride" helps the human condition more that it hurts it.
I submitted the article but I’m not the author, the report was created by the U.S. Department of Health and Human Services.