Told to Wean? Dentist/Mom's opinion on BF/Dental Caries

[PB's Mom]

I am still nursing my almost 21 month old, and we went to the dentist today, because I saw some green spots behind his front top teeth. The dentist said that it was "nursing caries" and that I should stop breastfeeding. He said there is no reason to continue to breastfeed, and that if I don't, it will continue to get worse, even if he fixes them. I feel like such a horrible mother. According to him, I should have weaned by 14 months. He was very nasty about the whole thing. (Actually he was polite, but that look in his eye was like a sword through my heart.) I really believe that I have been doing the right thing by letting him nurse this long, but I find myself questioning it right now. The dentist's attitude was that he was really pissed off that I am still breastfeeding, and that this is all my fault.

There were other issues, such as the fact that the one tooth came in deformed and has chipped recently. He didn't even talk about that. When I asked, he said that it was also because of the breastfeeding. He concentrated only on the breastfeeding issue, and didn't even talk about anything else.

He wants to have him come in and work on his teeth in 2 visits. He said he would not sedate him. He would give him (can't remember what he called it) something, but that he would be awake, and he would not let me in the room, and that he would be strapped down and he'd be working on his mouth for 45-60 minutes. He also said that he would probably be terrified about going to the dentist or having anyone get into his mouth until he was about 4.5 years old.

What do I do? I'm just a mess right now. Feeling so guilty and so upset about having to put him through this.

[Rainbow]

My first thought is to get a 2nd opinion... 20 months is a long time to be strapped ina dental chair for 45-60 minutes wihtout mommy... and to blame bfing for everything? Get a 2nd opinion! I have a dentist friend on another board, I'll ask what she suggests for you!

Aly

[smiley]

PB's Mom, I have just in the last six months been through a very similar situation with my ds who is also 21 months.

At 15 months he chipped his tooth, and we brought him to a pediatric dentist who smoothed it down and made a VERY snide comment about nursing. I vowed never to see her again.

At 17 months we were out of the country and he chipped his tooth again. we saw a dentist there who filed it again, but mentioned that he had decay and it should get taken care of ASAP.

When we got back to America we went to a new pediatric dentist who dug out the decay and filled it in with composite white stuff.
She was very gentle, very patient and let us do this with NO anaesthetic and while I held him and dh sat next to us. We gave him Rescue Remedy and while he certainly didn't love the treatment he was okay with it and I'm glad we didn't sedate him (she says its just not safe at that age).

Re nursing she recommended that we try to brush his teeth very often, and, if possible, wipe his teeth down after he falls asleep at night (we don't do this -- it wakes him up).

At 20 months I noticed another spot on his tooth and she drilled and filled again -- this was much less deep and much more painless.

Her recommendations at this point were to eat cheese when eating crackers (kind of funny, but she says it helps).
She surmised that he gets these cavities not from the breastmilk per se but bc of a physiological thing -- he likes to pool all of his food (and breastmilk) in his mouth for a long time.

We are now very careful about no juice (always were), brushing teeth and making sure esp. to brush teeth before nursing so there aren't any other substances hanging out on the teeth with the breastmilk.

We went back today and his teeth look great and the dentist did a really fun, painless exam while I held ds (actually, her stuffed raccoon did the exam for her

Wow. Sorry this is so long, just wanted to let you know that you are not alone and that you should GET A NEW DENTIST NOW!!!!!

[Rainbow]

OK, this is a direct quote from a Dentist in missouri (if you live near there you should call her!) Here are her thoughts on the situation:

"Personally, I would not go to this dentist. I spent part of my residency in a pediatric office and working in a Children's hospital and this does sound a bit odd to me.

Strapping kids down is something I saw in videos at dental school...you know...how we did it in the old days. It was called a papoose board...and I don't think it's a good idea. The child will be scared to go to the dentist after something like that...it's best if the dentist tries to make it pleasant, and if a child that young needs work, IMO should probably at least use IV sedation. But, there are medications you can give, I just don't care for them. There are definitely different ways to think of it.

Not having the mom in there...well, a lot of kids put up more fight and whine when their parents are in the room. They put on a show. We usually discus it with the parents, and make a decision. Usually they stay out. But NOT with kids that young. If I were to work on a child that young, I'd probably have the mom in the chair holding him. Or I'd have someone sedate him. My general plan is to try and work without sedation. Then try nitrous oxide (which wouldn't work most likely on such a small child). Then I would try IV sedation or general anesthesia depending on how much there was to do.

As far as the cavities...yeah they could be caused by breastmilk, but even more so by bottle feeding. If the child has a habit of falling asleep with a bottle or latched on to mom's breast...the sugars in the milk that pools up can cause cavities. Unless there is something else that I don't know about since I don't see a lot of babies...I don't see why she should stop breastfeeding...I would just want her to stop letting him fall asleep latched on and would want her to brush his teeth before he goes to sleep. They should really only go to sleep with water after their teeth start to come in.

So, if I were her...I'd look for a new dentist. That guy doesn't sit right with me. "

Hope this helps, good luck!

Aly

[joesmom]

It makes me so mad when I read about the way some doctors & dentists treat their patients. My son has mild dental problems- 3 yo, still BFing. We were treated HORRIBLY at the health department:mad: which provides free dental care in our area. This was a while ago, ds wasn't even 2 then. I was told to immediately wean, & blah blah blah. So I made an appt. with my childhood dentist, who said there is no correlation between BFing & dental caries. His wife nursed all their kids. He was very supportive & My son liked him a lot. At the health department, they made me hold him down & he cried & cried. The point is-finally!- that dentist was RUDE!: Find someone who respects you & your child! Even LLL stated BFing doesn't harm teeth. Take good care of your child's teeth, & of him. You are NOT hurting him at all!!


:cool: Jenny

[Smilemomma]

Hi PB's mom! I got your email and I swear I will answer you *in depth* (uh oh, flee while you can... ) tomorrow.

I'm so sorry, but it is 1:15 am now, I just finished answering a slew of stuff over on the Dental board (under the Health forum, lots of good info there), wah wah wah.

Seriously, I understand that you are very upset, I would be as well. Your post deserves a thorough and thoughtful reply, and I just couldn't do it justice right now.

See you tomorrow

[Smilemomma]

Hi, PB'smom!

First off, breathe! In, out. In ... out. Good.

To quote from an old archive (which I hope we can restore, I will try to recreate it now, *crossing fingers*) I think I am uniquely qualified to answer this because I am a dentist, in the field for over 20 years, and I am the attachment parenting momma of 3 babes, year old b/g twins and a 5 yo dd who nursed (and nightnursed like crazy) until age 3, when she self weaned (without a single speck on any of her teeth, too ) .


Congratulations on being such a good, devoted momma to your sweet boy. How he will bloom for it!

If there is any way I can help, please don't hesitate to post again. (Don't be scared, I'm not always this verbose! )

Blessings to you and your precious boy.

[PB's Mom]

Smilemamma,
Thank you so much for your post! I feel much better now. I am looking for a new dentist, but not much luck yet. I called LLL here and they said they discussed this at the last meeting, and there seems to be no dentist in the area to anyone's liking. I'm willing to drive or fly across the country if you know of anyone who you could recommend.

One question, do you have any suggestions on how the cavities should be treated? With a topial floride paste or with sedation or anesthesia? I'm not sure which would be least traumatic and also less risky.

I also posted a message to Dr. Sears on the parenting.com website. He recommended that I night wean, but I'm not ready to do that yet. I'm so glad you have given me the information that you have! I feel better equiped to continue with the night nursings and to limit the juice and start brushing more! Let me know if there is anything else I could do to help cut back on the potential for cavities.

Now the only thing I have to do is find a new dentist and decide on what type of treatment.

Thank you so much!!!!!!

[Smilemomma]

Dr. Sears said that? :

[mom2wavinbaby]

We're going through this right now!

Wow, how timely that I came upon this message topic now!
My DD will be three in March--when she was two, her pediatrician took one look in her mouth and said she had dental carries. He was/is very pro-bf, so didn't want to alarm me, but told me to see a ped. dentist.
We went to our first appt. with a ped. dentist when DD was about 28 months, who had a great rappore with my daughter. However, we were shocked by what she told us....eight cavities, two teeth possibly needing extraction. And told me that nursing to sleep had caused this, and that I should wipe her mouth after each session, no matter what time of the night. She recommended doing all the work at the hospital under general anesthesia (including X-rays!), and also suggested we might need a "baby bridge" if the two teeth did indeed need to be pulled. Ugh. And thousands of dollars.
Although we liked her rappore with DD< we didn't like her suggested treatment. We sought out another ped. dentist (boy, did both of these dentists have LONG waiting lists for appts!), who was quite the opposite (or so it seemed). His rappore with DD at first wasn't as good, his office wasn't as "cool" and the waiting room toys weren't as appealing--but he was, in the end. He said it was very rarely caused by bf-ing. That genetics, or something during my preganancy could have caused a weakness in her tooth enamel. In fact, he was surprised when I said she was bf, since it looked so classic "bottle-mouth" to him. Anyway, his suggested treatment was to get her more familiar with him and the office...to make a visit there every week to two weeks, and do a little at a time. At her second visit, he was able to take X-rays with no problem (DD lay on my husband, who was lying in the chair--I'm pg so couldn't be in there). He thinks he might not have to pull those two teeth afterall
He also gave her a little laughing gas to see how she would be with the mask, breathing, etc...and she was fine.
Our next visit is next week, when he'll try to start with the fillings.

Sorry this was so long, but my point is to find someone who you are comfortable with--and don't give up trying to find them. Ask your dentist. Ask friends and family to ask THEIR dentists, LL groups, Mommy and Me groups, whatever. We're pleased with our choice, and pleased that we will be with DD at all times.

Good luck! It's such a hard thing to go through--I know!

[gilnikche]

PB's Mom,

Hello! I am in California too. I have had a lot of experience checking out dentists in the last year for my son. There is a lot of ignorance out there(I am speaking of the dentists).

May I ask where you are in California? Perhaps I can be of help in locating a good one If you do not want to post your city on the boards, then please feel free to send me a private message or e-mail. Just click on my profile on the bottom of this box for the links.

[Raven1]

Late to this one (hey, what am I NOT late to this time of year?
I have not read all the replies(no time!) but just to comment on the initial post;
I find it very hard to buy that nursing, even nightnursing, causes dental problems. My rationale is 3 fold:

1. extended bf and co-sleeping are the overwhelmingly prefered/historically common activities among humans(our industrialized societies being the notable exceptions). My logic tells me that something which is natural, meaning which has evolved/been designed as normal, is inherently harmful. Were human children intended.evolved to suffer from extensive dental damage by doing what comes naturally/is otherwise vital to their survival? I call this my "common sense test" for any "new" or commonly accepted doctrine; does it make sense if it goes against our natural inclinations/habits/history/evolution(as far as can be discovered)? Or is it something so out of touch with those factors as to be ridiculous. (Hint; this idea fails with flying colors, lol!)

2. Both my children were bf and co-slept(always falling asleep while nursing) past 2 yrs(my son till well past 3, my dd is already past 2). neither of them has ever had cavities as a result(my son had his first and so far only cavity at 7, a tiny one in a rear("6 yr") molar, and imo, it resulted from poor brushing/eating habits he picked up from a cousin DD's teeth are perfectly sound. This despite no flouride use in our family (in water, paste, rinses, treatments, etc. At most, tiny quantities in bottled juices and canned foods now and then, AND very little dental care; ds's first visit was at 7, to repair the cavity I diagnosed; dd has not yet gone). AND both DH and I had TONS of cavities as kids/teens, despite tons of flouride/dental care. So how can it be genetic?

3. I wonder if many dentists don't extrapolate what they know/suspect re formula to breastmilk. The 2 are not the same. Formula is VERY high in refined sugars, (second ingredient in most cases; up to 50% corn syrup/sugar) whereas breastmilk has none, only whole milk sugars. One is cow milk/soy; the other human milk; very different composition all the way around.

Further, the position of the nipple and the results of nursing to sleep differ widely between the 2; in bf, the child must exert suction to extract milk, in ff, much less effort is required to draw out the milk. Hense, you tend to get pooling(the culprit by all accounts, alomg with sugar on the teeth, which I have already mentioned) with formula/to bed with a bottle, not with bf. When a bf child falls asleep/stops sucking, the flow of milk stops as well; not so with bottles, as a rule.
The nipple positioning also differs dramatically; bottles washing the front teeth in milk(due to the less suction required/shape and composition of the nipple) while bf channels the milk down the throat, instead.
Finally, breastmilk is proven to contain anti-microbal properties which inhibit the growth of/kill microorganisms(such as those which "cause" tooth decay). If anything, it would tend to be protective.
Sorry you are getting the big guilt trip from this dentist; I agree, get another opinion/another dentist. And avoid traumatic prcedures as far as possible until the child is older. Unless the decay is so severe that the permanent teeth are at risk, why bother with radical eforts? They will just be falling out in a few yrs, ya know? If they are not going to get worse enough to affect the adult teeth, it is a waste, imo. (I knew a woman who took her 4 yr old in and they found 15 cavities, none of them visible to the naked eye, mind you This woman had them all filled, despite the fact that her dd was already loosing those very teeth!)
Anyway, JMO. Best wishes, and DON'T blame yourself! Chances are your child's decay would be worse had you not bf so long!
Kim, mom to Forest, 9 and Lily, 2

[Raven1]

>My logic tells me that something which is natural, meaning which has evolved/been designed as normal, is inherently harmful.< Okay, I obviously MEANT to say/write NOT!!! LOL! Man, is it Christmas yet?

[bluemoon]

We are going through this too. My daughter is almost 20 months and her front tooth looks chipped and is starting on the underside to look grayish black. Then her two bottom teeth look deformed and the dentist said they came in that way. I have a post under poor poor teeth. we are searching for the right dentist and its so hard. Every dentist refers us back to the pedatric dentist we went to. They were rude and brisk and totally blamed breastfeeding at night. We went to a new dentist today but he won't do the work says its too hard. he told us to just have the work done by the other people.
We started to gently night wean. I am just encouraging her to try other ways to get to sleep. She cries sometimes and then other nights she falls asleep while we read or sing. While I never would have thought we'd be weaning I do feel it is best for us, she was an all night dawdler and now she maybe breastfeeds once a night. Its been 6 days i think.
Anyways just wanted to let you know you are a wonderful mother and you are not alone.For some reason or another this is happening to us and we will get through it and so will our children.Best of luck an I am eager to see how it goes for you.

[Gaia Mama]

I can't thank all of you enough for all your insight, esp. Smilemomma. If I had not read all of your posts yesterday re: dental carries, I would have been far less prepared to deal with the horror that was my ds's first dental appointment. The ped. dentist told me more times than I could count that I had to stop breastfeeding my 27 month old since he had dental carries - flipantly explaining that "it nutritionally had no value". I explained that not only was it generally valuable nutritionally and immunilogically, but specifically manditory in my son's case since he was allergic to dairy. Then he came up with some line (wanted to use a different word here but don't want to offend) that I could pump and feed it to him in a cup! I tried expaining how ridiculous that was but he ignored me. Anyway, he basically said that he would not treat him if I continued to BF and I said, fine, I will get another opinion. Thank God for you women. Off to find another dentist!

Kim

[mom2wavinbaby]

reply to bluemoon

You poor thing. I hope you can find a better dentist--keep on searching.
Your child's teeth sound just like my daughters...her two teeth were "arched", looked chipped,. or like they were wearing away at the ends. In fact, in the last two weeks, one has definitely worn much further down than the other.
As you'll see in my posts, we are now happy with our dentist. But we have along road ahead of us.

I'd say it took almost 5 months, maybe more, of hunting to find this dentist, but it's worth it.

And although I did wean my DD at 2 1/2, it was not because of her teeth, but because of my own discomfort (both physical and emotional) of bf-ing her in my second trimester of pregnancy. Fortunately, she was down to only 3 times a day total, and went very, very well.

I wish you lots of luck. I know whatyou are going through.

[Gaia Mama]

Thanks for your encouragement mom2wavinbaby. I think I may have found a good dentist - we go on the 2nd of Jan. to meet him. The funny thing is, I don't even know how bad my son's teeth are since the first horror of a dentist never even explained it to me (and ds). I have noticed a small gray spec on the front of his tooth but that is all for now. I assumed it was dental caries since it fits the description I have read, but I don't know if it is an "early" stage, later stage or what.

As an aside - I love your clothes! I bought several shirts from you at a LLL conference in Philadelphia last year! Too cute. I got the ones that said "Pumped Up on Breastmilk!" Good to meet you again.

Peace -
Kim

[dotcommama]

should i night wean?

Hi there - I am sort of jumping in with my first post in a long time.

I recently took my 18 month old son to the dentist and the dentist said he has the start of two cavities in his front teeth. The dentist says it's from breastfeeding during the night and from falling asleep breastfeeding.

Although I agree that bf does not necessarily cause cavities. I do often seem milk sitting in his mouth when he pulls off so I do feel that the cavities he has may be caused by that milk sitting against his teeth during the night. The dentist told me to night wean and get him to fall asleep without nursing to prevent further damage.

Should I night wean? Will it help prevent further damage? :

I really don't want to have him damage his teeth further and if night weaning him will prevent further damage then at 18 months I think I would be willing to give it a try. I'm not sure he's ready to find an alternate method of falling asleep though.

The other thing the dentist gave me was super floridated toothpaste to use at night - though she said if I nursed him after brushing his teeth than it's useless anyway. Is this toothpaste safe? Has anyone heard of such a thing?

Thank you for you help!

[momacat]

We have gone through the entire decay thing with our twin sons....They just had their decay worked on this month in the hospital. Each of them had I believe 14 teeth worked on....It may have been 18, but I cannot remember right now. Their decay was horrible. One thing that helped slow down the decay was brushing teeth at *least* twice a day.....AND not offering anything other than breastmilk, or water, after the teeth were brushed at night. Once we got that routine, we saw that some of their decay turned grey, and then black, which meant that the decay was no longer in the active phase. which is usually a brown color. They still nurse occasionally during the night now, but now that they are 3 1/2, I feel comfotable saying not until morning. At 18 months, I would have had a very difficult time night weaning.....Mainly because their need to nurse was so strong. So, if I were you, I would not night wean, but I would become very careful about teeth brushing, and offer no other foods after the teeth are brushed at night. We did not start this routine until their decay was very serious. While we brushed their teeth, we didn't say no to sips of juice, or regular milk before bed.

{{{{Hugs}}}} for you and your little one.

[PB's Mom]

UPDATE: Well, we found a different dentist!!! Our pediatrition did some searching for us, and found a "breastfeeding" friendly dentist here in San Diego. He was very nice, and although I don't think he is in favor of night nursing, he didn't offer his personal opinion (he said he "doesn't go there"). Anyway, he stuck to the facts and said that he would probably have had the cavities even if I hadn't nursed him.

I talked to my Uncle about how to treat the cavities (he is a pediatric dentist in Missouri) and he recommended general anesthesia. He said 1.)my ds would probably be traumatized by being awake, and that 2.)sedation is actually more of a risk than GA. He said a lot of dentists won't do GA because they have to spend a whole day going to the hospital, and they can't treat as many patients (and can't make as much money).

This new dentist I found has an office right next to Children's hospital, and they have an anesthesiologist who is triple board certified, come over from the hospital and do everything right there in the office. He said he has had 100% success with GA. Never any problems. So I feel comfortable with this. I saw many children crying and screaming in that office, and my guess is that they had unpleasant experiences. (This dentist will also will treat with no medication, if that's what the parents want.)

All we have to do now is come up with some money and make an appointment. We have new insurance starting in January, so I don't know how much will be covered.

I thought about night weaning, but my ds has some molars coming in right now, along with a little cold, and 15 relatives visiting. So, I don't think right now is a good time to try that. Seems like every time I've ever thought about weaning, something stops me. (plugged ducts were common when he was little.....all I had to do was think the word WEAN and I'd get a plugged duct.) So, I figure there is a reason why I should continue to nurse on demand. I guess someday I'll look back and figure it out. In the meantime, I just have to keep the cavities away.

Thanks for everyone's insight!!!!! I'll keep you all posted.

Mary