ed into the developing primary teeth (Gedalia et al., 1964; Hargreaves, 1972; LeGeros et al., 1985). Studies conducted shortly after the beginning of water fluoridation indicated that the greatest reduction in caries was seen in children who had the longest exposure to fluoridated water (Arnold et al., 1956; Blayney and Hill, 1964). This raised the possibility of a beneficial effect of prenatal fluoride for the primary teeth. The results of several studies suggested that the ingestion of supplemental fluoride during pregnancy was beneficial to the primary teeth (Feltman and Kosel, 1961; Glenn, 1981; Glenn et al., 1984; Hoskova, 1968; Kailis et al., 1968; Prichard, 1969; Schutzmannsky, 1971). In contrast, other studies have reported no effects or statistically nonsignificant effects of prenatal fluoride administration on caries in the primary dentition (Carlos et al., 1962; Horowitz and Heifetz, 1967; Leverett et al., 1997). The Leverett et al. (1997) study was the first prospective, randomized, double blind study conducted in this area and the authors concluded that “the data do not support the hypothesis that the observed low carie levels are attributable to prenatal fluoride exposure.” At this time, scientific evidence is insufficient to support a recommendation for prenatal fluoride supplementation. This is in line with the current recommendation of the American Dental Association. Further, when fluoride supplements are taken during pregnancy, the United States Food and Drug Administration prohibits making claims of benefit to the teeth of children.

The results from two studies indicated that fluoride balances in pregnant and nonpregnant women were not markedly different (Maheshwari et al., 1981, 1983). In the former study, 16 women aged 19 to 31 years were studied. Ten were in the second half of pregnancy, and six served as nonpregnant controls. The diets had a low fluoride content (less than 0.45 mg/day), which, as in some of the infant studies described above, resulted in negative fluoride balances. The average balances for the pregnant and nonpregnant groups were −0.32 and −0.15 mg/day, respectively. In the second study 18 women aged 19 to 33 years were supplemented with 1.0 mg/day so the average total intake was 1.35 mg/day. Seven of the women were not pregnant, six were in the second quarter of pregnancy, and five were in the fourth quarter of pregnancy. The higher fluoride intake in this study resulted in positive balances in each group. The differences among the groups were small and not statistically significant.

AI Summary: Pregnancy

There is no evidence at this time that the AI for women during



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