|
You don’t see it coming, even when it is staring you in the face. Early childhood tooth decay (known in medical literature as Early Childhood Caries, or ECC) is the last thing that most new parents are looking for.
My daughter was diagnosed with early childhood tooth decay around 15 months, when I took her to a pediatric dentist to ask about two sets of teeth that appeared to be fused together. I ~ What to Do If Your Nursing Child is Diagnosed With Tooth Decay
~ Surviving a Dental Procedure With Your Toddler learned that fused teeth are, apparently, quite common (news to me!), and in the process of examining her mouth, the dentist noticed decay on her top front teeth. I was heartbroken, especially when the dentist insisted that nighttime nursing was the culprit.
Sorting out the issues related to nighttime nursing and tooth decay caused an enormous amount of stress and anxiety for me – even more so than anticipating my daughter's upcoming limb lengthening surgery! I felt vulnerable. Here I was, happily planning on child-led weaning, confidently going against societal norms to support my toddler’s need to nurse, and WHAM! Suddenly, there are People Out There (i.e. dentists and well-intentioned imaginary bystanders) who insist that I am harming my child by nursing her at night! The dread that I felt when thinking about having to extract her top four teeth several years ahead of schedule was, for a moment, immobilizing. And then, in the Journeymama spirit, I scrambled to get more information, which I share below. I hope that you or someone you know will benefit and learn from our ordeal.
What is the role of nighttime nursing and tooth decay?
After reading everything that I could find on this subject, my understanding is the following:
The bacteria that cause tooth decay, s. mutans, feed on sugar. Breastmilk contains sugar but also contains a buffer, lactoferrin, that makes decay less likely. In fact, studies in 1998 and 1999 by Dr. Pamela Erickson, et al, published in Pediatric Dentistry, showed that breastmilk alone does not cause tooth decay. Therefore, infants who have only had breastmilk and water in their mouths are not at risk, even after their first teeth erupt (contrary to the “party line” of the American Academy of Pediatric Dentistry, which advocates night-weaning after the first teeth appear). This is the good news, which gels with the perspective of evolutionary biology; why would humans be designed or evolve in such a way that mother’s milk caused baby teeth to rot? It just doesn’t make sense!
Now, the bad news: The Erickson research showing that breastmilk alone does not create conditions for decay also showed that breastmilk mixed with other sugar led to more decay than the sugar alone. Since it is virtually impossible to guarantee the removal of all microscopic food particles, we have to be honest with ourselves and assume that for babies and toddlers that eat or drink foods other than breastmilk, having breastmilk in the mouth at night probably doesn’t help teeth that are actively decaying. That said, it is critical to approach the subject of night-weaning from a holistic perspective that takes into accounts the needs of the child as a whole person, not just a set of teeth.
As you will learn from reading the resources below, tooth decay in childhood can be caused by unlimited combinations of many factors. It is never accurate to say that nighttime nursing is the “cause” of tooth decay, because there are too many potential causes, including weakened enamel due to genetic predisposition, stress during pregnancy, mom’s diet during pregnancy, mom’s antibiotic use during pregnancy, exposure to pesticides, and so on. There are parents who nurse at night for years and don’t do a great job with brushing and whose kids’ teeth are perfect, and there are those who wean early, are diligent about brushing from the very beginning and whose kids’ teeth are in trouble.
Finally, most of the resources below promote the theory that early childhood tooth decay is a bacterial infection. Streptococcus mutans is a bacteria whose decay-causing properties are activated when the mouth environment becomes more acidic (corresponding to a drop in pH). There is, however, an alternative explanation for tooth decay that blames dietary factors instead of s. mutans; processed sugar and other damaging foods change body chemistry to prevent remineralization of damaged tooth enamel. S. mutans can gain a foothold because the nutritional deficiencies allow for this.
Highly recommended background reading on early childhood tooth decay:
Journeymama Links
A final note on preventing tooth decay from happening in the first place…
Brush baby’s gums from the very beginning! It’s never too early to help her become comfortable with your finger or a tooth brush in her mouth. By the time her teeth are appearing and/or she is consuming any foods other than breastmilk and water, introduce Spry Infant Tooth Gel with xylitol. Try to make mouth-cleaning positive, fun and interactive from day one.
Back to Breastfeeding
|
