Dental caries and tandem nursing

[Nitenites]

I am currently nursing my 2 1/2 year old ds and my 5 week old ds. A little background: ds1 had dental caries, and had his front, top four teeth capped at 16 months. He was an early teether (had his first tooth at 3 months), and we co-sleep and, until about 6 months ago, nursed during the night. I've really "been through the mill" with finding a dentist that is accomodating about our nursing relationship, and I've found (as I'm sure many of you have, as well) that I often know more about breastfeeding and its relationship to tooth decay than most dentists I've met.
I understand that tooth decay is caused by the bacteria strep mutans, and that weak enamel helps hasten decay. (There is a history of weak enamel in dh's family. Darn those genes!) I know that breastmilk alone does not cause cavities, but that breastmilk in combination with other foods creates the perfect environment for decay. Here's my issue: I'm wondering if by nursing ds1 at bedtime, and then by later offering the same breast to ds2, if I'm introducing strep mutans to ds2. I know that I shouldn't let them share the same cup or straw (later, when ds2 starts solids) or otherwise encourage an environment that can allow the exchange of bacteria, but other than sterilizing my breast (lol!), how the heck would I keep this from happening? Any thoughts? Should I just be extra vigilant about keeping ds2's mouth clean, by brushing well once he starts teething?

[Isabelrules]

Good question! I wish I knew the answer for you.

It looks like you know quite a bit about dental caries, because of your first. Would you mind if I asked YOU a question?

I am just now starting the process of educating myself about ECC and night caries (see my thread Help,my dd's teeth are chipping),
my dd is 14 1/2 months, and I know I should take her to a dentist soon, but I am wondering what lead up to your son getting his front four teeth capped. Were they really badly chipped? Or just a bit, and you knew it would get worse, as he had weak enamel? I am wondering if capping is the next step for us, and though I would rather not, I don't want to continue trying to combat something that is a losing battle! Thank you!

I hope you aren't passing anything from boob to mouth!

[simonee]

Nitenites,
I've wondered about this myself, as I'll be tandeming in a few months. After reading A LOT here and elsewhere, I've decided to do the following: have tissues and water handy all the time, and wipe my breast between nursers (esp when going from the toddler to the baby), and get baby used to oral cleaning by wiping his gums pretty much from the start. I'll just use a little washcloth, or also tissues, so when his teeth start to come in, they'll just get taken along in the wiping. Wiping is a good thing to do, anyway. I don't know if it will fully prevent bacteria from entering his mouth, but I guess it won't make it more risky than kissing, and I'm not going to restrict dd's kissing her little brother :)

It also seems that proneness to decay is a pretty random thing. There's some genetics involved, but there's plenty of mamas (and daddies) here with perfect teeth and their babies get decay anyway ~ or the other way around.

Isabelrules, often when all four front teeth need to be capped, the decay pattern will have started on the back, and from there the teeth literally rot through. This decay seems to have to do with food (including possibly bm) pooling there after baby falls asleep, esp if baby tends to sleep with the face a little bit downward, so some milk stays there instead of being swallowed (so, make sure your baby falls asleep face up, and/or wipe a bit behind those teeth once she sleeps). Often, the first "visible" decay is a yellow or brown line right at the gum line, and then it moves down and to the front of the teeth. Once it reaches the bottom of the teeth, which are very thin (as our nipples know :)), it basically "eats" the tooth away, till there's only little brown stubs left. As soon as most of a surface of a tooth is covered in brown (including the back, so you need a mirror to look), fillings don't really have an area to adhere to, so that's when a dentist will choose to cap the tooth. Also if the decay is deep enough to reach the inner part of the tooth, where the root is, because a dentist will have to drill a good part of the tooth away to clean out the root area.

Chipping is a different process ~ it's not so much the bacteria eating away at the tooth, but the outside of the tooth "breaking off" on its own account. If you get to it quickly (and it looks like you have), there's no decay going on yet, the tooth is "getting undressed" and is therefore vulnerable to decay, but the bacteria aren't necessarily finding their way in there yet.


hth. Please keep posting what happens ~ everybody can learn from it, and it's always good to get either the applause when all is fine or the support when it's not :hug
:love