Make sure mom isn't feeding the child medicines - infant and child syrup 
medications are full of sugar. Tooth brushing is extremely important, 
especially at night before sleep. One family in my practice arrested 
'nursing caries' completely by discontinuing infant acetaminophen and 
brushing twice a day with a high xylitol toothpaste (Squigle) ( no 
financial interest in this product). If a medication is vital to the 
child's health, careful brushing after each dose might help.

If the cavity bacteria is allowed to stay in the mouth, it can run 
rampant and infect the permanent teeth too. Pulling the baby teeth 
removes the spacing effect they have for the permanent teeth, so there's 
no really great solution other than trying to get rid of the germs. The 
xylitol may do this, there's some research that it selects for less 
sticky strep mutans variants, which are less able to form biofilms and 
secrete acid that etches away tooth enamel.

There's also Dr. Kotlow's observation that a tight superior labial 
frenulum may allow milk to pool around the upper incisors. Releasing a 
tight labial frenulum may help too.

Catherine Watson Genna BS, IBCLC  NYC  www.cwgenna.com

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