Preventive Agents

Fluoride

Large studies demonstrate safe use in pregnancy.  The American Academy of Pediatrics (AAP) and the American College of Obstetrics and Gynecology (ACOG) recommend that it is safe for pregnant women and children to drink fluoridated water.

The American Dental Association (ADA) reaffirmed the safety of exposure to fluoridated toothpaste and drinking water in pregnancy in response to a 2024 study published in JAMA which found a possible association between prenatal fluoride exposure and increased risk in neurobehavioral problems in children. The ADA states that review of the current peer-reviewed research affirms the safety of prenatal fluoride exposure, and that the 2024 study failed to show statistical significance in most of the behaviors studied, and the study is small, and not appropriate to apply to the general public.

• Inhibits bacteria growth and strengthens enamel
• Used topically to prevent dental caries

Xylitol

No direct studies in pregnancy have been performed, but studies where it has been used as an intervention have not demonstrated harm.

• Used in gum, xylitol:
  • Decreases level of mutans streptococci in saliva and plaque by interfering with cellular metabolism
  • Selects for less virulent strains of mutans streptococci
• In addition, chewing sugarless gum stimulates saliva which assists with neutralization of acids and remineralization of tooth enamel.

Chlorhexidine

Vaginal application studies have shown no harm to the fetus. No studies of oral use are available, but exposure would be similar when used as a mouthrinse. Absorption from the gastrointestinal tract is poor.

• Used as mouthwash to decrease periodontal and cariogenic bacteria
• Reduces gingivitis and plaque deposition