Fluoride is a category C drug. It may be prescribed for topical use to the pregnant patient with severe gastric reflux caused by nausea and vomiting during early pregnancy. The gastric fluids erode tooth enamel resulting in tooth sensitivity and increased potential for decay. Application of topical fluoride to the exposed dentin may reduce the sensitivity. As topical fluoride gel may cause nausea, fluoride varnish application may be better tolerated.

While there have been recommendations in the past for systemic prenatal fluoride supplementation to impart caries protection to the unborn child, there is insufficient evidence to support this. The American Academy of Pediatric Dentistry does not support the use of prenatal fluoride supplementation.36