Prenatal fluoride supplemetation

My first child has an enamel deficiency. I am pregnant again and hear that it is possible for me to take a fluoride supplement now to help prevent this from happening again. Would you recommend fluoride supplementation during pregnancy?

Question:

There is a great deal of controversy surrounding the issue of prenatal fluoride supplementation. This is primarily because the benefits from taking prenatal fluoride are uncertain.

It was previously thought that the placenta created a barrier to fluoride transfer, but studies have shown this to be false. However, the rate of transfer of fluoride to the fetus is still unknown. Studies have shown a rapid maternal clearance with only a slight increase in fetal blood fluoride concentrations. This may happen because the fluoride gets diluted in the amniotic fluid.

Since 1966, the Food and Drug Administration has banned the use of advertising and labeling of fluoride supplements for "prenatal use". It has also banned claims that these supplements will prevent or reduce decay in the offspring of women who use them. Please note that the ban does not prevent the prescription of fluoride supplements for pregnant women; it just restricts advertising claims.

While the primary teeth do begin the calcification process while in utero, the calcification process is not complete on any of the primary teeth until several weeks to several months after birth. In addition, with the exception of the cusp tips of the six year molars, almost no permanent teeth have started the calcification process in utero. There also is some controversy over what stage during calcification the fluoride supplements are most beneficial. Some researchers do not believe that the supplements need to be taken throughout the entire period of tooth mineralization in order to achieve the maximum benefit.

All this is not to say you absolutely should not take fluoride supplements during pregnancy. I mainly want to let you know that more research needs to be accomplished to determine the benefits, if any, and the best dosage for prenatal supplementation. Due to the unanswered questions, no dosage level for prenatal supplementation has been agreed upon yet. Note: The optimal fluoride supplementation in the water supply has been determined through numerous studies to be 1 ppm (part per million). This may help in determining prenatal dosages.

You should also be aware that fluoride supplements will not necessarily aid in enamel formation. Fluoride changes the chemical bonds in enamel to make it more decay resistant.

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