A number of reviews have demonstrated the benefits of topical fluoride in caries prevention. Placenta transfer of fluoride is possible although the mechanism is subject to controversy. Consequently, there is the possibility that fluoride could be incorporated into teeth developing in utero, so fluoride supplements taken during pregnancy could prevent caries in their children.
The aim of this Cochrane review was to evaluate the effects of women taking fluoride supplements (tablets, drops, lozenges or chewing gum) compared with no fluoride supplementation during pregnancy to prevent caries in the primary teeth of their children.
Searches were conducted in the Cochrane Oral Health’s Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) Medline, Embase, LILACS BIREME Virtual Health Library CINAHL US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform databases with no restrictions on language or date.
Randomised controlled trials (RCTs) of fluoride supplements (tablets, drops, lozenges or chewing gum) given to women during pregnancy with the aim of preventing caries in the primary teeth of their children were considered. Two reviewers independently screened the studies, extracted data and assessed risk of bias. Overall study quality was assessed using the GRADE approach.
- Only 1 RCT at a high risk of bias was included.
- 1175 children were born to participants, at 3 years 938 children were followed up (464 in fluoride group, 484 in placebo group). 798 children were followed up at 5 years (398 fluoride, 400 placebo).
- There was no statistical difference in decayed or filled primary tooth surfaces(dfs) or % of children with caries at 3 years or 5 years.
- 3 years, risk ratio (RR) = 1.46, (95%CI; 0.75 to 2.85)
- 5 years, RR = 0.84, (95%CI; 0.53 to 1.33)
- Incidence of fluorosis at 5 years was similar between the groups
The authors concluded: –
There is no evidence that fluoride supplements taken by women during pregnancy are effective in preventing dental caries in their offspring.
As the authors note, the theoretical weakness of mechanisms surrounding placental transfer of fluoride and concerns related to exposure during pregnancy taken together with a lack of recent studies and improved knowledge regarding topical fluoride raise important questions as to whether research on this topic should be given any priority.
Takahashi R, Ota E, Hoshi K, Naito T, Toyoshima Y, Yuasa H, Mori R, Nango E. Fluoride supplementation (with tablets, drops, lozenges or chewing gum) in pregnant women for preventing dental caries in the primary teeth of their children. Cochrane Database of Systematic Reviews 2017, Issue 10. Art. No.: CD011850. DOI: 10.1002/14651858.CD011850.pub2.