I was going to let this one go, but it's been on my mind since the first
posts (a dentist who told the mom of a child with caries to stop nighttime
feeds), so here goes.  If you want to skip to the truly relevant BF part, go
to "F"

A.  While breastfeeding at night probably causes very few of the cases of
nursing bottle caries that occur (look at the name!), any type of feeding
that leaves sugars on the teeth overnight is a risk factor.  I unfortunately
don't have easy access to the article sited about BF and caries, but if it
refutes this, I apologize.

B.  Just as dentists were accused of perhaps "looking at the world through
the teeth" (my honest apologies if I am misquoting), a non-BF advocate would
probably say the same of our BF perspective if reading some of the posts on
our list.(Not that the BF perspective isn't the right one!  :)  )

C.  My dental training in med school was almost nil, so I wouldn't be
surprised if BF and BM aren't given much time in a dental school curriculum.
That doesn't excuse ignorance, but perhaps the dentist in question just needs
some education.

D.  I was discussing the whole issue with a friend who is a dentist, and her
first comment was "that dentist sounds crazy", followed by "I wonder if the
patient perhaps misunderstood" which sounded familiar after the recent thread
about how patients often leave us with a different message then the one we
thought we gave.

E.  While baby teeth do fall out, caries in them are not benign, and can lead
to mouth and jaw infections, mouth pain, poor self esteem, and can even
require surgery under general anesthesia.  I've done too many pre-op
physicals on these kids to take the disease lightly.  Granted, these kids had
multiple risk factors for bad tooth disease, not just night time bottles or
breastfeeding.

F.  Most practically, as LC's, RN's, MD's and all others I'm leaving out, you
can help keep these kids from being told by the dentist that nursing is a
problem, by helping teach the parents about good tooth hygiene for their
babies.  I would guess many of you get calls from moms when the babe's first
tooth comes in and the moms get bit the first time.  This is a perfect time
to spend just a minute going over tooth care.  Tooth and gum care should
include brushing or wiping the teeth and gums as soon as the teeth begin to
emerge, with a soft toothbrush or cloth, with either water or non-fluoride
toothpaste (no fluoride until kids can spit most of it out).  Even if the
child has fallen asleep nursing, a quick wipe with a washcloth will help (as
my dentist friend says), before the child is put down, and hopefully will
keep the child out of the treatment chair at the dentist. As I mentioned,
most MD's have minimal training in dental care, and it's often not mentioned
at well child care, (and I won't even go into dental insurance issues, proper
age of first dental visit, etc!!) so your instruction to the parents could
make a big difference!!

Sorry so long!

Shauna Farmer, MD, in Rome, GA, where there is only one dentist who sees
Medicaid and who is soon retiring, and lots of kids with bad teeth

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