Q: My gynecologist recently prescribed prenatal vitamins for me to take throughout my pregnancy. Do you recommend taking a fluoride supplement as well?
A: The use of fluoride supplements during pregnancy is a controversial issue. Fluoride is obtained from water and other beverages, foods, prescription drops and tablets, and other sources. A major function of fluoride taken systemically throughout the body is the strengthening of developing teeth, from infancy to adolescence. Fluoride strengthens teeth by the formation of harder enamel (hydroxyapatite crystals are converted to fluorapatite) that is less vulnerable to damage from plaque acids.
Fluoride intake by a pregnant mother may have a positive effect on the unborn child. Several recent studies support the use of prenatal fluoride supplements. In the first study, pregnant women in their second and third trimester would take a daily 2.2-mg. tablet of sodium fluoride along with fluoridated water. The results demonstrated that 97 percent of the offspring of these women had absolutely no cavities for the first 10 years of their lives. These children also had no medical dental side effects from the prenatal fluoride treatment. Another study contained 1200 pregnant women; half were given a fluoride supplement and the other half were not. A five-year follow up of the offspring revealed that the fluoride group had only about half as many cavities as the non-fluoride group, and 96 percent had no cavities at all.
The use of fluoride in the form of supplements, in toothpaste, mouthwash and in drinking water has been clearly established for both children and adults. Recent studies concerning the use of fluoride for pregnancy and teeth are encouraging, and may provide a safe and cost-effective way of reducing cavities in children. I recommend that you talk to your gynecologist about the use of fluoride supplements during your second and third trimester of pregnancy.
Q: We have a 16-month-old, and she gets upset when we try to brush her teeth. What do we do? Do we try to continue the good habit we have started or should we hold off?
A: At your daughter's age, it is not uncommon for her to fight brushing teeth, because it is foreign to her and can be abrasive to her gums. What you can do is use a moist washcloth to clean her teeth, especially before bed. Do not allow her go to sleep with a bottle of milk or juice that leads to destructive "baby bottle cavities." After about two months, re-introduce the brushing with a child-sized toothbrush that has soft bristles. Also, experiment with different child-dosed toothpastes. Your daughter may just not like the taste of the toothpaste you are using. Always use a very small pea-sized quantity of toothpaste because high amounts can be harmful. Even when she does let you brush her teeth expect a little fight -- it's only natural. You may also want to consider giving her a small reward after each successful brushing.
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