I have had several requests from lactation consultants/specialists about
problems of caries in regards to their own children or for moms they are
trying to help. All have been exclusively breastfeeding. I have sent them
the following note.
__________________________________
Dental caries and breastfeeding:
I do not know of any research refuting the claim that breastfeeding can cause
dental caries- skull research is needed - see following notes.
In talking with Pedodontists, they have told me that mothers usually bring
the children in with what they think is a chipped tooth, but is usually due
to decay that has undermined the enamel and THEN breaks off and the mother
thinks it chipped first. Normally more than one tooth would be affected.
First teeth erupting - front teeth and last baby molar - are the ones
usually affected.
Following is statement by Pedodontic Assoc followed by my recommendations -
hope it helps for better understanding! If my recommendations are followed,
hopefully child may never have another cavity (if some have not already
started).
Source: "Pediatric Dentistry, Journal of the American Academy of Pediatric
Dentistry", Special Issue: Reference Manual 1995-96, Vol 17, No 6 (Supplement
to the Dec. issue)
"Breast-Feeding"
Revised: May, 1994
The American Academy of Pediatric Dentistry has, as a primary goal, the
promotion of optimal health for children. In this regard, the Academy
recognizes the distinct nutritional advantages of human milk for most
infants, and endorses the position of the American Academy of Pediatrics on
the promotion of breast-feeding. While the superiority for most infants of
human milk over bovine milk or commercially available formulas is clear from
a nutritional and immunologic perspective, the specific advantages of
breast-feeding from the standpoint of oral health are unknown at this time.
(The last part of this statement will NOT be valid after I give my
presentation at the ILCA Conference.)
The risk of devastating nursing-pattern dental decay exists for the
breast-fed child as it does for the bottle-fed child, and is related to
extended and repetitive feeding times with prolonged exposure of erupted
teeth to fermentable carbohydrate without appropriate oral hygiene measures.
(See recommendations at the end)
The potential for beneficial effects of breast-feeding on dento-facial growth
has not been clearly demonstrated and merits further investigation. (I will
present indisputable evidence at the ILCA Conference that breastfeeding is
ESSENTIAL to the TOTAL oral and general health of the individual.)
The American Academy of Pediatric Dentistry recognizes the need for further
scientific research on the oral effects of breast-feeding and the consumption
of human milk. Health professionals should counsel nursing mothers to
encourage optimal infant nutrition and oral health through appropriate
feeding habits and preventive dental care.
___________________________
"Baby Bottle Tooth Decay"
Revised May, 1993.
Introduction
A child's bedtime or nap time use of a bottle containing juice, milk,
formula, or any other liquid sweetened with fermentable carbohydrates
increases the risk of severe dental caries due to prolonged contact between
cariogenic bacteria on the susceptible tooth surface and the sugars in the
consumed liquid.
Inappropriate bottle feeding of children can lead to Baby Bottle Tooth Decay
(BBTD) depending on the contents as well as the frequency and duration of use
of the bottle.
The risk of potentially devastating nursing-pattern dental decay exists for
the breast-fed child as it does for the bottle-fed child, and is related to
extended and repetitive feeding times with prolonged exposure of erupted
teeth to fermentable carbohydrates without appropriate oral hygiene measures.
Recommendations:
1 - Infants should not be put to sleep with a bottle containing a liquid
other than water at bedtime. Ad libitum nocturnal breastfeeding should be
avoided after the first primary tooth begins to erupt.
2 - Parents should be encouraged to have infants drink from a cup as they
approach their first birthday. Infants should be weaned from the bottle at
12-14 months of age.
3 - Consumption of juices from a bottle should be avoided. When juices are
offered it should be from a cup.
4 - Oral hygiene measures should be implemented by the time of eruption of
the primary tooth.
5 - An oral health consultation visit within six months of eruption of the
first tooth is recommended to educate parents and provide anticipatory
guidance for prevention of dental disease.
"Infant Oral Health Care"
Revised May, 1994
The infant oral health care visit should be seen as the foundation on which a
lifetime of preventive education and dental care can be built, in order to
help assure optimal oral health into childhood. Oral examination,
anticipatory guidance including preventive education, and appropriate
therapeutic intervention for the infant can enhance the opportunity for a
lifetime of freedom from preventable oral disease.
Recommendations:
1 - Infant oral health care begins ideally with prenatal oral health
counseling for parents. A postnatal initial oral evaluation visit should
occur within six months of the eruption of the first primary tooth and no
later than twelve months of age.
2 - At the infant oral evaluation visit, the dentist should:
a) - Record a thorough medical and dental history, covering the prenatal,
perinatal, and postnatal periods.
b) - Complete a thorough oral examination;
c) - Assess the patient's risk of developing oral and dental disease, and
determine an appropriate interval for periodic reevaluation based on that
assessment.
d) - Discuss and provide anticipatory guidance regarding dental and oral
development, fluoride status, non-nutritive oral habits, injury prevention,
oral hygiene, and effects of diet on the dentition.
3 - Dentists who perform such services for infants should be prepared to
provide therapy when indicated, or should refer the patient to an
appropriately trained individual for necessary treatment.
________________________________________
My added notes and recommendations:
Because of communications will mothers who have exclusively breastfed and
whose children have caries, it must be accepted that breastfeeding has the
POTENTIAL of causing caries. (Research of ancient pediatric skulls should
shed some light on this topic. The research may lead us to suspect "modern"
nursing mothers are doing something different if caries are not found on
ancient skulls!) Breastfeeding is not discouraged however, because the
benefits of breastfeeding far outweigh the disadvantages. Mothers must be
educated to the potential for caries however. EXPOSURE TIME to fermentable
lactose MAY be the cause.
Here are some possible reasons for caries:
1 - Contact time - IF milk "pools", the lactose in the milk "could" ferment
and cause decay. Remedy for this would be - when teeth start coming in - wipe
gums gently with soft gauze or small soft tooth brush after each feeding or
at least three time per day (Theory is that it takes bacteria 24 hours to
organize and cause damage). As the infant grows he/she will emulate the
parents. Do the parents watch their sugar intake and do they brush and floss
daily???
2 - Less saliva flow - some chewing gum advertisements state their gum helps
prevent decay - not from what is in the gum, but from the act of chewing the
gum which stimulates more saliva flow - which helps cleanse the teeth.
3 - If the infant is more prone to be a mouth breather due to congestion,
etc. -
this dries the mouth more - decreasing the cleansing action of saliva
4 - Grooves in teeth can vary in depth. The deeper a groove the more prone
the tooth is to decay.
5 - Medications given in a sugar base may also contribute to decay.
6 - Is there anything other than lactose in human milk that can ferment and
cause decay?
Two other points:
1 - During pregnancy, if the mother has an illness with high fever, or if
the infant has an illness with high fever during early development of the
teeth, then there is a possibility that the teeth could have hypo(less)
calcification. These teeth would be more prone to break down and have decay.
Usually called "soft teeth".
2 - It is critical that tetracycline medication not be taken during pregnancy
or early development of the teeth. This has the potential of causing
permanently stained teeth.
Teeth DO NOT ERUPT with decay in them!! A form of sugar IS the causative
factor!
Brian Palmer D.D.S.
4400 Broadway, Ste. 514
Kansas City, MO 64111
USA
eMail - [log in to unmask]
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