11 June 2021

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Fluoride supplementation during pregnancy: is it effective in preventing dental caries in children?

Alessandra Abbà

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Dental caries in infants and children is one of the most prevalent dental problems of this period with 50% of children have one or more decayed primary teeth by the end of toddler age. Their manifestations can range from demineralization to loss of tooth structure or complete destruction of the crown. 

Consequences related to this condition may involve permanent dentition with an increased risk of  dental caries in permanent teeth and even disease related to their eruption. 

Genetic predisposition, poor hygiene habits, bad eating habits with excessive sugar consumption, the presence of organisms like streptococci and many other factors are the main responsible of dental caries. Even fluoride and vitamin d can play a decisive role in the etiopathology. Fluoride supplementation for women during pregnancy may be an effective way to increase fluoride intake and to prevent dental caries in the primary teeth of their children.

The aim of this study is to compare the effects of fluoride supplements (tablets, drops, lozenges or chewing gum) with no fluoride supplements during pregnancy.

Search methods: the following databases have been surveyed: Cochrane Oral Health's Trials Register; the Cochrane Central Register of Controlled Trials in the Cochrane Library; MEDLINE Ovid; Embase Ovid; LILACS BIREME Virtual Health Library; and CINAHL EBSCO. Randomized controlled trials (RCTs) of fluoride supplements administered to women during pregnancy were selected for the study. 

Results: Only one RCT met the inclusion criteria for this review. 

-at 3 years old: no statistical difference on decayed or filled primary tooth surfaces (risk ratio (RR) 1.46, 95% confidence interval (CI) 0.75 to 2.85; participants = 938, very low quality of evidence) 

- at 5 years old: no statistical difference on decayed or filled primary tooth surfaces (RR 0.84, 95% CI 0.53 to 1.33; participants = 798, very low quality of evidence). The incidence of fluorosis at 5 years was similar between the group taking fluoride supplements and the placebo group.

Conclusions: there is no evidence that fluoride supplements taken by women during pregnancy are effective in preventing dental caries but further studied are needed mainly in those areas where children are at higher risk. 

Fluoride supplementation (with tablets, drops, lozenges or chewing gum) in pregnant women for preventing dental caries in the primary teeth of their children  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6485723/