A pregnant patient reports at her first visit that she is a 'social drinker.' What is the appropriate response?

Correct answer: C. Counsel her that no amount of alcohol has been established as safe in pregnancy and discuss the fetal risks

• A. Documenting without counselling misses a preventable-harm opportunity that the dental visit is well placed to address.
• B. Deferring entirely abdicates a shared responsibility. Reinforcing the obstetric message adds value; it does not conflict with it.
• C. CORRECT. The CDC, the Surgeon General and ACOG are unambiguous: no amount, no type and no timing of alcohol consumption has been established as safe during pregnancy. Fetal alcohol spectrum disorders are entirely preventable, and the dentist is a legitimate member of the care team for this counselling.
• D. This is factually wrong. Risk continues throughout pregnancy — the brain develops across all three trimesters.

Note: Craniofacial features of fetal alcohol syndrome you may be the one to notice: short palpebral fissures, a smooth philtrum, a thin upper vermilion border, midface hypoplasia, and an increased incidence of cleft lip and palate. Screen with a validated tool such as T-ACE and refer supportively rather than judgementally.