Preventive Agents

Fluoride

Large studies demonstrate safe use in pregnancy.

  • 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

References

Ly KA, Milgrom P, Rothen M. Xylitol, sweeteners, and dental caries. Pediatric Dentistry. 2006: 28: 154-163.

American Dental Association Council on Access, Prevention and Interprofessional Relations. Women's Oral Health Issues. 2006.

Motherisk. Toronto, Ontario, Canada at www.motherisk.org (which included referencing National Collaborative Perinatal Project, 1959-1974, Record Group 443, National Institutes of Health.)

Briggs GC, Freeman RK, Yaffe SJ. Drugs in Pregnancy and Lactation, Ninth Edition.  Lippincott Williams and Wilkins, Philadelphia, PA 2011.