Greetings,

I've been enjoying learning from you all and wanted to send along some
information on dental caries in young children.  My name is Kristen
Dillon, and I'm relatively new to the list. I'm a 1996 graduate of the
medical school at the University of California, San Francisco and will be
starting a Family Practice residency in Fort Collins, CO this June.  I've
been home this year with my (breastfed)  daughter, now 13 months.

I read the best introductory discussion of caries in young children in the
Jan/Feb issue of "New Beginnings," LLLI's magazine.  Titled "A Pediatric
Dentist's Perspective," it is posted on the web at:
     www.lalecheleague.org/bfdent.html

The dentist, Dr. Kevin Hale, discusses the origins of decay in young
children (often called "nursing caries" whether the children are breast-
or bottle-fed).  In general, breastfed children have less decay than those
fed abm, but some breastfed children develop severe caries in their first
year or two of life.  These children are susceptible due to the high-acid
producing strains of bacteria living in their mouths (often transmitted
from parents).  He doesn't discuss the role of prenatal fever and other
factors that may be thought to adversely affect enamel strength.

In children who are susceptible (about 20% of the population), he believes
that frequent and night-long breastfeeding contributes to decay.  Hale
writes about the case of a family (who also have an article in this issue
of NB) who chose not to alter their breastfeeding patterns and were able
to stop the stread of tooth decay with meticulous brushing and wiping of
the teeth and daily application of fluoride gel.

Overall, this article struck me as a balanced and scientific discussion of
the causes of dental caries in young children and an example of how
families and health care providers can negotiate about breastfeeding.
There are numerous references following the text.

Here are a few other references from my files:
 1. (MEDLINE result)
    Milnes AR.
      Description and epidemiology of nursing caries.
    Journal of Public Health Dentistry, 1996 Winter, 56(1):38-50.
      Pub type:  Journal Article; Review; Review, Tutorial.

 2. (MEDLINE result)
    al-Dashti AA; Williams SA; Curzon ME.
      Breast feeding, bottle feeding and dental caries in Kuwait, a country
      with low-fluoride levels in the water supply.
    Community Dental Health, 1995 Mar, 12(1):42-7.

 3. (MEDLINE result)
    Matee M; van't Hof M; Maselle S; Mikx F; van Palenstein Helderman W.
      Nursing caries, linear hypoplasia, and nursing and weaning habits in
      Tanzanian infants.
    Community Dentistry and Oral Epidemiology, 1994 Oct, 22(5 Pt 1):289-93.

 4. (MEDLINE result)
    Roberts GJ; Cleaton-Jones PE; Fatti LP; Richardson BD; Sinwel RE;
        Hargreaves JA; Williams S; Lucas VS.
      Patterns of breast and bottle feeding and their association with dental
      caries in 1- to 4-year-old South African children. 2. A case control
      study of children with nursing caries.
    Community Dental Health, 1994 Mar, 11(1):38-41.

 5. (MEDLINE result)
    Degano MP; Degano RA.
      Breastfeeding and oral health. A primer for the dental practitioner.
    New York State Dental Journal, 1993 Feb, 59(2):30-2.
      Pub type:  Journal Article; Review; Review, Tutorial.

 6. (MEDLINE result)
    Bernshaw N.
      Prolonged breastfeeding and dental caries [letter].
    Journal of Human Lactation, 1996 Dec, 12(4):277.
      Pub type:  Letter.