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I'm just wondering how other mamas here deal with brushing their children's teeth at night, especially if they nurse to sleep. Do you brush their teeth before they nurse? Doing that would seem to defeat the purpose to me, as the breast milk would just get right back onto the teeth and stay there all night, right? And trying to do it after they nurse, well, that would wake them up again. And then if they nurse all night too, as DD does…

Or maybe I'm not clear on exactly when we need to brush our DC's teeth - is it only to get off actual food particles after a meal of solid food, and teeth don't need brushing after a meal of breast milk? If she eats solid food and then and nurses afterward, should I brush her teeth in between the meal and the nursing? And wouldn't the toothpaste then make the milk taste funny?

I don't usually brush DD's teeth at night because of this, but now I'm getting worried that I'm setting her up for a bunch of cavities. Perhaps my concerns are a bit over the top, like thinking that the toothpaste will make the milk taste weird, but I know I hate to eat after brushing my teeth and imagine that the same thing could be true for DD.

How do you do it? What's the timing of your evening eating/nursing/sleeping routine?
 

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Breast milk alone has been shown to not cause cavities. Breastmilk + food does though.

We brush very well then go nurse to sleep.

-Angela
 

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We brush before starting dd's nighttime routine, which ends with nursing to sleep and night nursing (she HATES tooth-brushing so we put it at the very beginning of our evening "wind down" routine). We brush again in the morning while getting dressed to deal with whatever sugar is left on her teeth from the night nursing.

DD is probably 90% breastfed (at 16mo) but we do use a flouride free baby toothpaste in the evenings (it's mostly simethicone, the stuff that relieves gas). DD likes the taste so it makes toothbrushing a little easier, and it's supposed to help remove the plaque that can build up. So even though she's mostly getting breastmilk, I think a good toothpaste can't hurt. Especially on days when she has some dried fruit or other sticky solid.

But then, my family has a horrible dental track record and I'm hyper-vigilant about keeping dd's teeth in good condition!

And to be fair, there are several studies out there (like "Comparison of the cariogenicity of cola, honey, cow milk, human milk, and sucrose" published in the October volume of Pediatrics and availabe through PubMed) that do show a link between breastmilk and dental caries. Although the benefits of breastmilk far FAR outweight the risk of increased caveties (since good dental health can take care of that problem...the researchers in each case stress the importance of breastfeeding and are really very clear that brestmilk is still best) it's important to know that breastmilk isn't totally "innocent" when it comes to dental problems. So keep brushing!
 

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I think my dd is going to be a dentist. She takes a bath every evening and then brushes her teeth. If I forget, in a fit of lack of sleep induced zombieness, to give her her toothbrush with a tiny bit of tooth paste on it, she will throw a full out tantrum right there on the bathroom floor.


She's got all her teeth on top and only two on bottom. She loves to brush her own teeth, but she always lets me get in there when she's done to give them another once over and make sure they've all been brushed.


Then she nurses to sleep and usually nurses once or twice overnight.
 

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We have cavity problems here, and our dentist says that breastmilk is not a problem, but 1) food particles + breastmilk is so a very good brushing before bed is crucial, and 2) dd needs to have at least one time during the day where she doesn't have anything in her mouth for several hours to allow her normal mouth flora and ph to balance out.

So we brush, then bedtime story, then nurse to sleep. And we're slowly nightweaning as well. In the middle of the night, I try to wipe off her teeth with a spiffies wipe if it isn't waking her up to do so. Without cavity problems, I wouldn't bother with the wiping. We use fruit flavored toothpaste, and dd's drinks water after. She's never complained about the taste. (DD is two.)
 

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My boys are older (almost 3 and 5), but when they were little, I too brushed once well before nighttime, and that was it til morning. No cavities here yet (knocking on wood!), but my sisters daughters nursed the same amount my boys did (lots), and they have had SO many cavities and problems with their teeth, and she brushed their teeth consistently, & the girls ate practically no sweets.,,
 

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We brush my daughter's teeth as part of our bedtime routine. It's important to me that she brush and then have only water (sippy cup near bed) or breastmilk after that.

It's my understanding that the significant factor in breastfed children with dental caries is, as other people have said, the combination of breastmilk in a mouth that contains food particles. Beyond that, I've read that studies reviewing the characteristics of those children at risk for developing "nursing caries" indicated that food choices typical of nursing toddlers tend to be particularly problematic when combined with nighttime nursing (again, making it important to brush before nursing at bedtime.) Evidently, many toddlers who EN tend to favor starchy/salty foods, which can create a film that sticks to the teeth and reacts relatively aggressively with breastmilk in the mouth of a night-nurser, accelerating the rate of decay.

I have read that there IS a correlation between breastfeeding past 18 months and early decay (dental caries) but the factor of particular food residues present in an uncleaned mouth is the significant part of that equation. On the other hand, it's my impression that before 18 months, breastfeeding is considered to be protective and/or non-cariogenic. (We cleaned her teeth before night-nursing in those earlier months, too, though.)

Here are some links that might help.
KellyMom.com article: "Is breastfeeding linked to tooth decay?"
http://www.kellymom.com/bf/older-baby/tooth-decay.html

Pub med link to a search of terms "caries, breastfeeding, decay") http://www.ncbi.nlm.nih.gov/entrez/q...arch&DB=pubmed
(or just search those terms yourself at http://www.pubmed.gov if the link has expired)

Your own oral health is a factor, too. And genetic traits such as weak enamel (I think the kellymom.com article mentions this factor) are going to impact this issue. If the child in question has reflux, that's another factor. (All of this weighs into the issue of using toothpaste or just water, or using toothpaste with fluoride.)
 
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