Give Your Child Cavities?
By Dr. Linda Folden Palmer
Breastfed children have far
fewer dental cavities than those who are bottle-fed. This includes
nursing caries as well as other cavities. The unfortunate term
“nursing caries” refers to a typical pattern of dental
decay seen when juice, formula or breast milk sits in the mouth
frequently for extended periods. Nighttime snacks are highly cavity-causing
because saliva is not very mobile during sleep, leaving baby without
its rinsing and antibacterial qualities. Juice bottles by far
promote the greatest number of nursing caries.
Both breastfed and bottle-fed infants
have a need for comfort nursing. The only way bottle-fed infants
can find this comfort is to “nurse” their bottles
very slowly when allowed to lie and hold their own bottles, causing
formula to sit against their teeth for long periods. Nursing caries
are more common in bottle-fed infants, especially in those who
have nighttime bottles at older ages. Among breastfed infants
who develop nursing caries, most are those who comfort nurse for
long periods during the night after teeth have developed. And
among these, most are those who have frequent snacking and sugary
foods or juices in their diets.
In cavity-prone families, or when
any evidence of decay has been detected in an infant, night nursing
and bottle practices can be gently reduced (not necessarily eliminated)
once several teeth are present. A squirt of water into the mouth
or stirring the child enough to cause some extra swallowing after
nursing will help to clear the mouth of milk. Juice bottles should
never be given at night.
Heredity and environmental
Still, there will be genetic tendencies or other unknown factors
that will make some children more susceptible to bacterial presence
and destruction in their mouths no matter what measures are taken.
Although damage to baby teeth does not affect adult teeth, a strong
tendency for decay will likely carry over to adult teeth. Caries
in baby teeth can serve as a warning that good preventive measures
must be taken with permanent teeth.
milk has immune factors that reduce the presence of unfriendly
bacteria, and laboratory tests show human milk does not encourage
cavities. On the other hand, formula is definitely cavity-promoting.
Formulas with sugars other than lactose are the worst. Although
Streptococcus mutans bacteria is generally thought to be the chief
cause of dental decay, the candida yeast that builds up on pacifiers
has been found to promote cavity formation to a great degree.
Because of this candida and the high incidence of nursing caries
from bottles or nighttime breastfeeding, dentists and thus pediatricians
commonly recommend throwing out bottles and pacifiers at 12 months
of age and weaning breastfed infants prematurely. But we must
remember that permanent teeth are not harmed by baby teeth cavities.
Consider the whole child
Babies naturally experience hunger and need comforting during
the night. Withholding response to these needs can possibly be
more harmful to a child than any risk of damage to temporary teeth,
although your dentist may feel that teeth are the primary concern.
While dental treatments in infants are certainly traumatic, the
mere possibility of infant caries (about a 14 percent chance)
is not enough of a worry that I would withhold or withdraw important
feeding and comforting from any infant, especially before any
such symptoms have occurred. Feeding and comforting practices
can be modified when needed to protect teeth without blunt, drastic
Nursing mothers may be prone to
cavities related to nursing (maybe these are the true “nursing
caries”). Especially during the first months of breastfeeding,
nursing mothers often find a need for midnight snacks. This food
sitting against the teeth in a sleeping mom may cause some cavities
in her teeth, which have mildly reduced calcium content (no matter
how much calcium supplements) until after the end of lactation.
Preventive measures should be taken in a cavity-prone mom.
A.A.al-Dashti et al., “Breast feeding, bottle
feeding and dental caries in Kuwait, a country with low-fluoride
levels in the water supply,” Community Dent Health (England)
12, no. 1 (March 1995): 42-7
R.O. Mattos-Graner et al., “Association
between caries prevalence and clinical, microbiological and dietary
variables in 1.0 to 2.5-year-old Brazilian children,” Caries
Res 32, no. 5 (1998): 319-23.
N. Kanou et al., “[Investigation
into the action condition of outpatients. II. Correlation between
the daily habits of eating and toothbrushing and the prevalence
of dental caries incidence],” Shoni Shikagaku Zasshi (Japan)
27, no. 2 (1989): 467-74.
A. Mohan et al., “The relationship
between bottle usage/content, age and number of teeth with mutans
streptococci colonization in 6-24-month-old children,” Comm
Dent Oral Epidemiol 26, no. 1 (Feb. 1998): 12-20.
K.L. Weerheijm et al., “Prolonged
demand breast-feeding and nursing caries,” Caries Res (Holland)
21, no. 1 (1998): 46-50.
L. Lopez Del Valle et al., “Early
childhood caries and risk factors in rural Puerto Rican children,”
ASDC J Dent Child 65, no. 2 (Mar-Apr 1998): 132-5.
A.L. Hallonsten et al., “Dental
caries and prolonged breast-feeding in 18-month-old Swedish children,”
Int J Paediatr Dent (Sweden) 5, no. 3 (Sep 1995): 149-55.
M.I. Matee et al., “Mutans
streptococci and lactobacilli in breast-fed children with rampant
caries,” Caries Res (Tanzania) 26, no. 3 (1992): 183-7.
P.R. Erickson and E. Mazhari, “Investigation
of the role of human breast milk in caries development,”
Pediatr Dent 21, no. 2 (Mar-Apr 1999): 86-90.
C. Sheikh and P.R. Erickson, “Evaluation
of plaque pH changes following oral rinse with eight infant formulas,”
Pediatr Dent 18, no. 3 (May-Jun 1996): 200-4.
D. Birkhed et al., “pH changes
in human dental plaque from lactose and milk before and after
adaptation,” Caries Res 27, no. 1 (1993): 43-50.
P. Ollila et al., “Prolonged
pacifier sucking and use of a nursing bottle at night: possible
risk factors for dental caries in children,” Acta Odontol
Scand 56, no. 4 (Aug 1998): 233-7.
Excerpted from Baby
Matters: What Your Doctor May Not Tell You About Caring for Your
Baby by Dr. Linda Folden Palmer.
Dr. Linda Folden Palmer consults
and lectures on natural infant health, optimal child nutrition
and attachment parenting. After running a successful chiropractic
practice focused on nutrition and women’s health for more
than a decade, Linda’s life became transformed eight years
ago by the birth of her son. Her research into his particular
health challenges led her to write Baby
Matters: What Your Doctor May Not Tell You About Caring for Your
Baby. Extensively documented, this healthy parenting
bookpresents the scientific evidence behind attachment parenting
practices, supporting baby's immune system, preventing colic and
sparing drug usage. You can visit Linda’s web site at www.babyreference.com.