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Dentist says my nighttime nursing of toddler is putting her at risk for cavities - help!

post #1 of 35
Thread Starter 

I just got back from the pediatric dentist's office. It turns out DD1 (almost 4yo) has 8 cavities, and DD2 (almost 21 months) has no cavities but has gingivitis. I know why DD1's teeth are the way they are, but honestly I was shocked. She's going to have to go the the hospital in October to have them treated and it's going to cost us (after insurance) over $200. NOT happy about the news about either kid. Oh, and the hygienist said I need to have DD1 start using fluoride toothpaste. I don't usually use it myself, and I'm concerned about using it with them. When he found out that DD2 is still nighttime nursing, he said he wants to see her in three months, not six. He says the sugar in the breastmilk is putting her at risk for cavities since with nighttime nursing we're not likely to be brushing her teeth after she nurses. Didn't tell him DD1 isn't weaned yet (1x or 2x daily) after getting a negative reaction from him about DD2's nursing. I looked online and found this article (http://www.naturalchild.org/guest/lisa_reagan.html) and several others that assert nighttime nursing and breastfeeding are not the primary risk factors. I need some help, maybe suggestions for a dentist in the Baltimore, MD area who takes Delta Dental of PA insurance and is more natural in his/her approach to dental care? Thanks.

post #2 of 35
I agree with the plan to get a second opinion. Unfortunately, I don't have any dentists to suggest.
post #3 of 35

You are right, breast milk alone is not cariogenic.

It sounds as though your dentist may be including night time breastfeeding into bottle rot diagnosis.Somehow dentists and doctors have twisted this to include breastfeeding. Yet in studies of dental enamel, breastmilk does not erode it, which leads to decay and caries. Teeth were actually placed in various solutions at a university lab study and there was zero erosion on enamel from BM, however cow's milk eroded it. AAP has stated that breastmilk is not cariogenic as well as various studies such as this one: http://www.ncbi.nlm.nih.gov/pubmed/10197331

 

Were you children low birth weight, preemie or did they have severe reflux?

Low birth weight and premature babies can have enamel defects which may put them at risk for decay. Per reflux, it can erode enamel leading to decay. I would imagine breastmilk is often blamed when stomach acid is the culprit.

Sucrose and  heat treated starches with sucrose (cereals) are very cariogenic.

http://pediatrics.aappublications.org/content/120/4/e944.full

 

If your child teethed on hard objects and damaged enamel, chips and such, the risk of decay is increased too.

My own adecdote, my son at 11 months teethed on the metal nozzle of the garden hose and chipped enamel on two teeth (one of my regrets). Almost two years later, the brown discoloration on the tip of one is completely gone and the other is nearly gone. I still BF on demand all night.

 

Regarding flouride, if your local water is flouridated with at least .3 ppm flouride, your child likely does not need additional flouride (per AAP). I, like you, do not use a flouridated paste for brushing my child's teeth.

 

I do feel it is important to get teeth as clean as possible before bed though, so if there is any way to increase the brushing per your nursling, it may be worth it.


Edited by Asiago - 8/21/12 at 1:23pm
post #4 of 35

Sugar is sugar. Be in lactose in breastmilk or fructose in dry fruits.

 

You can brush all you want, but you put sugar on their teeth whole night long, cavities will happen.

 

Cavities and gingivitis are not a local problem. These affect health of entire body and can lead to cardiovascular illness later.

 

So, stop feeding them at night.  They do not need food at night at this age.

 

Brush and floss twice a day.

 

Take them for dental cleaning every three months rather than 6. Yes, insurance will not cover extra cleanings, but it wills ave you money in the long run.

 

Fluride toothpaste is not needed if you have it in the water.

post #5 of 35

Quote:

Originally Posted by Alenushka View Post

Sugar is sugar. Be in lactose in breastmilk or fructose in dry fruits.

 

Just curious but where did you obtain this information?  I have often read the contrary that is why I am curious.

 

From what I have read:

Quote
Some assume that because breastmilk contains lactose, it can be as cariogenic as any sugar solution in a bottle. However, lactose is protected by the antibacterial and enzymatic qualities of breastmilk.18 Furthermore, lactase enzyme splits lactose into glucose and galactose in the intestines, rather than in the mouth.
 
 

 

Okay to examine the sugar issue further, This does give me pause, because this research would apply to milk suckled at the breast (I would assume). However, what about milk that has been pumped and the lactase has begun to break down the lactose? It would not be the normal pattern of digestion, as milk suckled at the breast. Hmmmmmmm. Although this scenario would not apply to night nursing. Still it does make me ponder, although for this particular case with the OP's question, it probably is not pertinent.

Just thinking aloud here.... could pumped milk possibly be cariogenic? I would think the lysozyme, antibodies, and additional immunigenic components would destroy the pathogenic bacteria (strept mutans) that could lead to decay. I doubt my novice theory has any merit, hopefully it doesn't.

Needless to say caries or not, the advantages of breastmilk likely outweigh the few disadvantages.

 

Okay, I just realized that the lab study pertaining to the primary teeth immersed in breastmilk and other liquids, obviously utilized BM that was pumped.....so even then, the teeth in BM showed no signs of erosion or decay, even when placed in BM with Strep mutans.

 

OP you may find further suggestions posting in the Dental Forum here in MDC, and as per a dentist, maybe the Tribal area. Good luck


Edited by Asiago - 8/21/12 at 12:55pm
post #6 of 35

Lets say the studies are mixed at best. But...if kid is night nursing and has cavities and if some studies show that BM has mild cavity producing effec and the poor child now needs dental work....why risk it?

 

http://www.squintmom.com/evidence-based-parenting/breastfeeding/night-nursing-and-cavities/

post #7 of 35
The antibodies in breastmilk counter act the sugar, so just because it has sugar, does not make breastmilk equivalent to dry fruit. For example, although sugary, breastmilk is used for contact lens solution and conjunctivitis treatment, amongst many other things...

I hope this helps!
post #8 of 35
Lactase is an enzyme in the digestive system. I'm pretty sure it is not included in breastmilk. When the enzyme is not being made, that's lactose intolerance.

My son reacted badly to too much sugar in my diet when we were breastfeeding, so I cut back my consumption. Perhaps decreasing your own sugar intake would help the cavity situation. Although I would still get the second opinion.
post #9 of 35

I've had some experience with this issue. I partially agree with PP that sugar is sugar, however breastmilk is not the same as dry fruit, which sticks to your teeth. I also don't agree with "they don't need it at their age" line of thought. If they ask for milk, they obviously need it.

 

What worked for us is making sure that dk doesn't fall asleep at the breast. Also, make sure you don't share utensils, food etc., that's a huge risk as well. Ds had this problem, he had dental surgery at 18 months and we continued nursing, including at night, until he weaned at 4 y/o. After his surgery we followed these two rules and made sure he brushed his teeth at bedtime and he had no more problems.

 

HTH
 

post #10 of 35

Where are the cavities located on the teeth? I ask because DD2 nursing pretty much all night long. And while my milk is now dried up so it doesn't matter she did get one cavity a yr ago. BUT it was on the chew surface of her teeth and I am 100% sure it was from things like raisins and fruit snacks. Yes, I brush and floss her teeth. But have your child eat say a oreo and then brush. You will see how hard it is to get food (especially sticky food) our of the cracks of their teeth. We stopped eating stuff like that and no more cavities.

 

I would get a second option. I don't think in most cases night nursing causes cavities. 

post #11 of 35

There is no research that links to nighttime or extended nursing to caries. There is a lot of research that links bottle-feeding formula or cow's milk, nightfeeding formula, and babies using formula bottles to got to sleep with in a crib to caries. Lots. Most conventional dentists link the two practices when in fact they are not the same.

 

Genetics, diet, and toothbrushing habits are the biggest factors. My kids all nursed at night "forever" and used non-flouride toothpaste with zylitol until 3 and no cavities whatsoever. Our water supply has flouride. I however had a ton because allthough I was breastfed until 18m I always slept with a bottle of milk next to me until age 3 or so. Plus honey on my pacifier. Massive cavities. I have one cavity as an adult.

 

The kids switch to flouride-containing Tom's of Maine at 3, mostly because DH's family have lousy teeth and I don't have any real issues with it. 

 

Some kids are really prone to cavities even with the best dental care and diet. Genetics seems to play a big role.

post #12 of 35

It's really true.  Sugar is sugar.  And while dried fruit and gummy carbs that stick to the teeth more, as well as high-sugar fruit juices, are big offenders, breast milk also has a lot of 'natural' sugar in it.  And ingredients in the breast milk are not a sure and complete defense against cavities.   With babies, children, or adults, the frequency and duration that our teeth are in contact with food are factors in causing cavities.  Kind of the opposite of what the nutritionist tells you (small frequent meals throughout the day) is what the dentist advises.  For your teeth, they need a break, and they kiddies need to go off of bottles onto sippy cups or regular cups as soon as they're ready, as the bottles create an anaerobic (no oxygen) environment that the bacteria thrive in.  Well, we still use a bottle with water though. 

 

I'm a big breastfeeding proponent.  I'm still nursing my 15 month old 6 times a day.  He's a big lad, and has a voracious appetite.  I don't nurse at night unless he's teething ridiculously badly and needs it (my nurse-practitioner told me interestingly enough that the sugar in breastmilk (or any sugar I guess?) is actually pain-reliever).

 

However, now my son needs general anesthetic dental surgery on his four top front teeth in two weeks.  He got his teeth very early (had already 2 at 2.5 months, and since he was such a big baby, he was nursing really heavily at this age still.  So, that set him up to be vulnerable.  Even though we thought we were doing everything right brushing his teeth every night before he even got teeth, we used Weleda toothpaste, it just wasn't enough.  One dentist said we should've been wiping them down every 15 min.  Ha!  I cannot imagine pulling my voracious feeder off my breast every 15 min at that age.  He was a little velosaur raptor attacking me for milk!   Anyways, I guess we will with baby #2 on the way though, as the alternative of general anesthetic and dental work is heartbreaking.

 

That all said, we could also be very unlucky people in terms of mouth bacteria in our family.... but honestly, I night nursed like crazy for the first 9 months... and I did it lying down, which makes me wonder if maybe the milk didn't drain even more.  The boy just had such a big appetite, even when we started him on solids at 5.5 months, he was eating so much good nutritious filling food throughout the day (all whole foods, veg, salmon, baked chicken, only sugar from whole fruit), and still ravenous all night, gulping it down.  So, for baby #2, if they have the same appetite, I guess I'm going to load them up on solids and frequent nursing all day long, and then if they have to night-nurse, I'll wipe them down with wet cloth at very least afterwards.  They won't like it, but the alternative of cavities.... 'sucks'  (pun intended ;>).

 

Now we also brush before he goes down for each nap and bed at night, but I'm thinking we should move it to after meals, and after nursing sessions both.  It's a lot, and it takes both of us to brush his teeth.  I feel sorry for people who have to do it single-handedly!  It helps if it's just me if we're sitting on the floor together in front of a big mirror and he sees what I'm doing.  And I let him hold the toothbrush and play with it, and I brush my teeth in front of him, and let him brush mine.  (Oh, don't EVER share toothbrushes though, and REALLY try not to ever let your saliva enter his mouth, eg. sharing spoons, tasting his food and then giving it to him, kissing on the mouth, etc.  I know this could be hard at mealtime, but there's a large consensus that our bacteria in our mouths can spread cavities to them).

 

p.s. our water is flouridated, but we do use fluoride toothpaste now 1x a day.  The tiniest bit since he still doesn't spit.  And we use non-fluoride toothpaste the other times we brush each day.

 

p.p.s. the first dentist we went to when our son broke his front teeth told us they broke easily due to cavities as they were so weak and they'd have to be pulled and I shouldn't be breastfeeding him period at that age.  I said that there were other health factors to consider besides his teeth, and we argued about that a bit.  We then went to a homeopathic dentist since I'd read so many people online raving, and we were curious.  At that point, the cavities were so bad, that he practically just breathed and his teeth were crumbling away.  The homeopath said he had cavities because he needed more calcium and she gave me a homeopathic solution that had been diluted so many times that it didn't even contain a single molecule of actual calcium anymore.  She told me to give it to him daily and come back and see her in 3 months, and everything would be fine now that we were starting with the drops.  Let me tell you that 3 weeks later, we had been using that damn homeopathic stuff every day (excuse my language but it makes me so mad) and his teeth were crumbling away alarmingly fast.  Not only that, but he was at risk then for infection as there wasn't much tooth left for some of them.  A tooth infection for a baby or toddler carries a small but very serious risk.  I really feel it was such negligence for this homeopathic dentist to say that.  I don't pretend to know that all homeopathic dentistry is rubbish, but I was so upset at having tried to put some faith in her knowledge and profession and realizing after that it put us at risk.  Then finally, I researched like crazy, and we found the former head of the Ontario Dental Association, and his colleague, with ~70 years + experience between the two of them.  The one who is doing the surgery for us has done surgery like this all his career, and we'll be getting it done at a children's hospital with a pediatric anesthesiologist.  We opted to go this route instead of pulling them as when you pull, the permanent teeth come in even later and he'd be without his top front four til he was maybe 7 or 8.  A long time not to be able to eat an apple or corn on the cob... and potential speech problems.... It still might be the case when they do the surgery that they find that the cavities have spread too much to the roots, and if possible they'll try a pulpectomy (baby root canal) to save them, but that's a matter of personal dentistry opinion whether it's worth it to do.  Pulling them or going the restoration route is also a personal choice.  We agonized over it for many weeks.  Incredibly tough decision.  Anyways, this is all to say, give the teeth a break at night if and when you are able.  It's cruel on one part, but evolution just wasn't perfect to us, and what's good for some parts of our bodies, isn't good for others (our teeth).  Good Luck with it all, and of course, after all I've said, your personal circumstances may be different, and some of this applies differently for you!  I just share this all from my experience, for what it's worth for others.  :)

 

p.p.s. the dentists we're seeing now cleaned out the cavities and applied some sort of topical solution to arrest and slow down the cavities before his surgery date.  We weren't crazy about that, but again, given the alternative... the worry about infection, losing the teeth altogether, etc., we're appreciative that we live in this day and age where we have these kind of advances.  For the cleaning out of the cavities, they put him in a papoose, and we sang to him and were his cheerleaders through it.  He screamed and cried and it was hard hard hard.  As soon as it was over, he took a moment, then looked around the room, and started smiling and exploring the office.  I nursed him for a couple minutes, and he was happy as a clam! 

post #13 of 35
Quote:
Originally Posted by JudiAU View Post

There is no research that links to nighttime or extended nursing to caries. There is a lot of research that links bottle-feeding formula or cow's milk, nightfeeding formula, and babies using formula bottles to got to sleep with in a crib to caries. Lots. Most conventional dentists link the two practices when in fact they are not the same.

 

Genetics, diet, and toothbrushing habits are the biggest factors. My kids all nursed at night "forever" and used non-flouride toothpaste with zylitol until 3 and no cavities whatsoever. Our water supply has flouride. I however had a ton because allthough I was breastfed until 18m I always slept with a bottle of milk next to me until age 3 or so. Plus honey on my pacifier. Massive cavities. I have one cavity as an adult.

 

The kids switch to flouride-containing Tom's of Maine at 3, mostly because DH's family have lousy teeth and I don't have any real issues with it. 

 

Some kids are really prone to cavities even with the best dental care and diet. Genetics seems to play a big role.

 

I agree with this.

 

My kids both nursed to sleep, and occasionally in the middle of the night until they weaned right around age 2, and still don't have any cavities at 7 and 3.

post #14 of 35
............

Edited by 1babysmom - 3/23/13 at 5:58pm
post #15 of 35

I know this is taboo to say, and I fully support night nursing and extended nursing... but all the kids that I know that nursed into toddlerhood and beyond had dental issues with their milk teeth.  My son self-weaned at 31 months and had minor cavities.  He got them filled without even numbing cause they were that minor.  He was only 2.5 at the time!  I felt pretty awful but was glad I caught it.  He nursed at night, but not a lot.  I have 2 other friends who nursed older children.  My one friend also nursed until just after 2.5 (but he child night nursed a lot) and she has had a lot of dental issues.  She has some gold teeth by age 3.  My other friend nursed until age 4 (I don't know if/when he weaned cause we moved and lost touch), but by age 4 he already had 2 root canals and many fillings.  Both of these friends did not give juices or sugary foods and brushed often.  I have dozens of friends with kids that did not do extended night nursing and not one of them has had to have a filling.  Not even ones who don't practice proper dental hygiene.

 

I know what the articles say.  My experiences and the experiences of my friends have been different.  Do I personally believe extended night nursing leads to more cavities?  Yes.  From what I have seen I do.  Once my 1 year old gets more teeth (he only has 5 front ones) I will clean his teeth after night nursing.  I recommend to friends if they extended nurse and night nurse to do dental checkups at least twice a year starting at age 2.  I know not all dentists will see kids before 3 or 4, but I would look for one who does.  Not that it will necessarily be bad for their dental health, but it's something to keep up on imo to do what you can to make sure.  After all I have seen, I personally see it as being in a higher risk group.

post #16 of 35
Quote:
Originally Posted by AbiJoy View Post

I know this is taboo to say, and I fully support night nursing and extended nursing... but all the kids that I know that nursed into toddlerhood and beyond had dental issues with their milk teeth.  My son self-weaned at 31 months and had minor cavities.  He got them filled without even numbing cause they were that minor.  He was only 2.5 at the time!  I felt pretty awful but was glad I caught it.  He nursed at night, but not a lot.  I have 2 other friends who nursed older children.  My one friend also nursed until just after 2.5 (but he child night nursed a lot) and she has had a lot of dental issues.  She has some gold teeth by age 3.  My other friend nursed until age 4 (I don't know if/when he weaned cause we moved and lost touch), but by age 4 he already had 2 root canals and many fillings.  Both of these friends did not give juices or sugary foods and brushed often.  I have dozens of friends with kids that did not do extended night nursing and not one of them has had to have a filling.  Not even ones who don't practice proper dental hygiene.

 

I know what the articles say.  My experiences and the experiences of my friends have been different.  Do I personally believe extended night nursing leads to more cavities?  Yes.  From what I have seen I do.  Once my 1 year old gets more teeth (he only has 5 front ones) I will clean his teeth after night nursing.  I recommend to friends if they extended nurse and night nurse to do dental checkups at least twice a year starting at age 2.  I know not all dentists will see kids before 3 or 4, but I would look for one who does.  Not that it will necessarily be bad for their dental health, but it's something to keep up on imo to do what you can to make sure.  After all I have seen, I personally see it as being in a higher risk group.

 

Well, now you know at least 2 that didn't have issues - my kids, who at 3 and 7 have never had a single cavity between them.

 

I just don't think that it makes sense from an evolutionary perspective for night nursing to be that harmful.  I don't doubt that what you have observed is true; I just wonder if it's really the norm.

post #17 of 35

From evolutionary perspective, a point to consider is that the bacteria that are involved in causing cavities haven't always been with us. 

post #18 of 35
Both of my kids nursed well into toddlerhood. One slept through the night early, but the other nursed every hour and a half 24 hours a day until she was 2. I never worried about their teeth, and neither has ever had a cavity at 4 and 11. So there are two more cavity-free extended nursers, or maybe one depending on whether the good sleeper counts. But even with her, I would nurse her to sleep and not brush her teeth afterward and she'd sleep through the night.

There's a lot of information out on both sides of this issue. You've got some from your dentist, and I'll link you to a couple of articles that have been in Mothering.

http://www.mothering.com/community/a/big-bad-cavities-breastfeeding-is-not-the-cause
http://www.mothering.com/community/a/busting-breastfeeding-myths

Also, you might find our Dental Health forum helpful: http://www.mothering.com/community/f/308/dental

(I apologize if any of these come up as the mobile site. I'm using a tablet.)

My personal feeling is that genetics have a lot to do with cavities, and also that it's easy to introduce bacteria that can cause problems to a baby's mouth. Maybe once the bacteria have been introduced, the sugars in breastmilk are a bigger problem? I don't know. I know plenty of nursing mothers with babies with no cavities other than me, but on the other hand I've known plenty of nursing moms with toddlers who have needed dental work too. It's a lot to think about but read what you can find and hopefully you'll find a way you're comfortable handling this. smile.gif
post #19 of 35

I have 4 kids. The olders all  have nursed until around 3 (the baby just turned one). My eldest's teeth were just fine. He had to have a 2 year molar pulled when he was around 6, but hasn't had any other teeth issues. Ds2 had to have his top 4 teeth pulled around 2 yrs and he has a cavity in one of his canines we've been trying to keep under control until he loses the baby tooth. Ds3's upper teeth were disintegrating even as they erupted. We put off getting what was left pulled until just after his second birthday because I didn't want him going under anesthesia before then. The baby's teeth are great so far. No signs of any issues.

 

The difference, imo? Ds1 was born in a town where the water wasn't flouridated. Ds2 & ds3, it was. Ds4, I bought a filter that removes fluoride. I drink a lot of water, so they got a massive amount in utero, where those teeth develop. I believed it was cavities with ds2 (& got the speeches that nursing was causing it), but ds3's teeth were falling apart practically before they were even up. Cavities can not account for that. They were incredibly streaky, aka fluorosis.

post #20 of 35

My son had 4 fillings filled/crowned at 2.5 years (a few months ago).  I wasn't even planning on taking him to the dentist until he was 3, but I saw a brown spot on his tooth and panicked.  I've done a bit of research on it since I never trust things doctors/dentists say about breastfeeding, and from what I understand, night nursing is fine as long as there are no preexisting teeth issues, but once there is a bit of decay, it can make it worse.  

 

I don't think night nursing caused my son's issues - his dad, aunt, and grandma have horrible teeth - but it might have made them worse.  I still night nurse him because he is so attached to nursing that I am taking baby steps: I chose to cut out nursing to sleep first.

 

I really appreciate the poster who described lots of friends who night-nursed and had kids with teeth issues, since I have always been curious about that and I don't think anyone is being clear - I think that doctors overstate the risks and pro-breastfeeding people understate them.  However, every thing I have learned indicates that this is a REALLY complicated issue possibly involving: maternal nutrition while pregnant, genetics, bacteria introduction, ingestion of certain types of food, esoteric nutrients in child's diet, frequency of eating, thoroughness of brushing, and many more factors.  Like much of parenting, you have to go with what makes you most comfortable for your kid.

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