Should Pregnant Women Take Fluoride Supplements?

Should Pregnant Women Take Fluoride Supplements?

Pregnant Women and Fluoride Supplements
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Fifty years ago you could have walked into a pharmacy and seen fluoride drops that were specifically targeted toward pregnant women. The packages claimed that fluoride drops, when taken during pregnancy would help keep their children cavity-free.

That all changed on October 20, 1966 when the FDA cracked down on the fluoride supplement makers.  They banned them from making claims that fluoride would benefit unborn babies’ teeth due to a lack of clinical evidence to substantiate that claim.

Source: Food and Drug Administration: Statements of general policy or interpretation, oral prenatal drugs containing fluorides for human use. Fed Regist Oct. 20, 1966

You may be wondering what we’ve figured out in the past 50 years about taking fluoride supplements during pregnancy.

Should Women Take Fluoride Supplements During Pregnancy?

Pregnant Women and Fluoride SupplementsThe answer is no — there is no evidence that taking fluoride supplements during pregnancy helps improve the baby’s chances of having healthier teeth.

Since fluoride supplements taken by the mother can cross the placenta, there is a chance that the well-meaning mother-to-be could actually cause their baby to get dental fluorosis.

The Evidence Against Taking Fluoride Supplements During Pregnancy

Here’s three different credible sources that all agree that there is no benefit derived from taking fluoride supplements during pregnancy.

A Clinical Trial

This clinical trial took 1400 pregnant women and divided them into two groups.  One group received 1 mg of fluoride per day during the last six months of their pregnancy while the other group received a placebo.  The kids were followed until age 5.  No noticeable difference in the amount of cavities was noted between the two groups.

A Scholarly Article

This scholarly article from the journal Pediatric Dentistry states, “Although fluoride crosses the placenta, prescribing fluoride supplements to pregnant women is not recommended because there is little evidence that fluoride provided to the mother during pregnancy reduces caries prevalence in their offspring.

A Statement from the American Academy of Pediatric Dentistry

This guideline from the American Academy of Pediatric Dentistry states, “The AAPD does not support the use of prenatal fluoride supplements to benefit the fetus.”

Conclusion

Although 50 years ago many people thought that taking fluoride supplements during pregnancy was good for their baby’s teeth, it turns out that modern science has debunked that myth.

There is no reason to take fluoride supplements during pregnancy.  And there’s actually a good reason not to: dental fluorosis.

Do you have any questions or thoughts regarding fluoride supplements and pregnancy?  I’d love to hear what you have to say in the comments section below.  Thanks for reading!

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7 COMMENTS

  1. Great article, Tom! The best way to keep a child’s teeth healthy is to establish good habits at an early age, not just by taking a supplement and hoping for the best. That’s one of the main reasons why we put together our Mom’s Guide to Caring for Little Teeth.

    I do have a question, though. I personally am against taking fluoride supplements, but the ADA seems to support fluoride supplements for children. Is that still supported by the dental community as a whole, and what are some of the main differences between that and prenatal fluoride supplements?

    • Thanks, Hannah. I was going to put this in my future article on fluoride supplements, but it grew into its own article. To summarize, the dental community does support fluoride supplements for children who live in areas that don’t have fluoridated water. The American Academy of Pediatric Dentistry has these guidelines on fluoride therapy. If you look at the bottom of the page, you’ll see a table that every dental student has to memorize for exams – telling us the strength of fluoride supplements that we should prescribe to children living in areas without fluoridated water.

      Personally, I believe that many children don’t need fluoride supplements – you really have to look at more than just the water fluoride levels. You also need to look at what their oral hygiene is like, what their diet is like, and how much fluoride they’re getting from other sources.

      I hope that helps, Hanna – Thanks for your comment! Let me know if you have any other questions.

  2. Dear Dr. Tom,
    Thank you so much for the informed outcomes. I lived in Hawaii while pregnant with my first baby and the well-meaning mid-wives prescribed two flouride tablets to be taken every day of my entire pregnancy along with iron and a prenatal. This wonderful child was born with very weak teeth and Tourette Syndrome. He is bright and kind but his teeth require constant care and rinsing. My other child does not have these and I was not prescribed fluoride during pregnancy when we moved to another state. I mentioned this to a dentist looking at my son and he scoffed at me and said that was a myth about pregnancy. So I am so glad you write about such important information.

  3. This is a very rare article – to see a modern dentist discussing pre-natal fluoride supplementation. Dr. Tom is wiling to take comments to, and respond to some of them. That’s good.

    While the supplements are not recommended anymore for pregnant women except by those in a semi-underground group, what is recommended is for pregnant women to drink fluoridated water and brush with fluoride toothpaste. In a way that is like taking a fluoride supplement. But is that necessary? I understand the desire to avoid tooth decay in pregnant women. But I think there are alternatives that also do prevent tooth decay that are not nearly as toxic. I like Xylitol toothpaste.

    Fluoridation has always been a trade off between reduced tooth decay and increased fluorosis.
    And it’s gotten really political. Toothless infants get no benefit from fluoridated water – according to the CDC that says the recommended amount is only .01mg for them. No additional benefit from ingesting more for that age group. But if they are fed infant formula prepared with fluoridated tap water they get a big dose and have an increased risk of fluorosis in permanent teeth. In 2006 the CDC & ADA admitted that.

    But maybe you know what happened after that. This became a powerful campaign point for fluoridation opponents, especially since the ADA was advising caution. So public health dentists formed a committee and a 2011 ADA Journal article said fluoridated water could be recommended for infant formula preparation. No explanation was offered in that article, or since. They never said parents should be informed so they could make a decision themselves.

    Why did they do that? To take heat off the issue. More mild fluorosis, no matter how disfiguring, is OK for them. The vast majority of public health dentists would rather see babies overdosed for no benefit plus an increased risk for one reason – so that the public does not get alarmed. So pediatricians do not know about this on purpose. All attempts to inform parents and doctors are strongly opposed by dental associations and others worried about the image of fluoridation.

    So parents seldom get any advice from doctors and dentists on this risk. We have no idea what else, besides fluorosis, might be risky about this practice for babies who get the big doses. And the risk is even greater in parts the country with higher than optimum amounts of fluoride in the water. But in those areas, parents are ignorant unless somebody by chance informs them or they happen to read the annual water quality report from the local utility.

    I welcome your comments, Dr. Tom.

  4. My mom took these in 1968. (Not sure if they were drops or pills.) I am curious if you know if the fluoride supplements back then were the natural calcium fluoride that can be found in food from the soil, or sodium fluoride, which is a by-product of aluminum manufacturing? I can’t seem to find any info saying which type of fluoride was used back then.

  5. In 1978 while pregnant with my first child, I read an article in Parents Magazine about fluoride supplements. The article indicated that if you took the supplements during the three or four week period during pregnancy when the fetus’s teeth were being formed, your baby would have healthier teeth. My husband and I had both had poor dental health so I thought I should do whatever I could for my baby.

    I took the pills during the prescribed period which I can’t remember now. I also don’t remember how much I took. I really didn’t think much about it after that and consequently, I forgot all about it when I became pregnant a second time.

    Now my children are 35 and 38. Both of my children had dental checkups every six months, regular cleanings and fluoride treatments during childhood. It’s fair to say that as adults, my younger child had better dental hygiene than my older. In fact, my older child just went to the dentist for the first time in about 15 years.

    My first born is still cavity-free at 38. He brushes daily, never flosses and had a major build-up of some kind of plaque on his teeth which took the dental hygienist many hours to remove and still no cavities. My younger child had four cavities by the age of 20. This is the one with good habits and regular dental care, even as an adult.

    I do believe the difference is the fluoride during pregnancy. Again, I didn’t take it the whole time I was pregnant, just for a few critical weeks. I can’t prove anything but that’s my story.

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