Severe
dental caries which occurs in very young children is referred to as baby
bottle tooth decay, implying a strong link with artificial feeding
practices. Cause
of Caries To
understand the risks, we need to know what causes tooth decay. The
bacteria Streptococcus mutans, which is found in about 20% of children
younger than fourteen months, causes most cavities. The bacteria feed on
the sugars that are present on teeth. They metabolize the sugar and
secrete acid as a waste product. It is this acid which erodes the tooth
enamel. In other words, a cavity is no more than an unchecked infection. Bacteria
from their mothers' mouth often colonize babies' mouths. If a mother
holds a pacifier in her mouth or shares a spoon with her child, bacteria
may be transferred form her mouth to that of her child.
For families with a history of dental problems, every effort should be
made to avoid these practices. Other
factors in tooth decay: Breastfed
children can and do have caries, but at a greatly reduced rate compared
to children who are bottle-fed from birth. The fact that some breastfed
children do have problems with decay probably correlates
more with inherited weaknesses in the enamel and general care of the
teeth. There
are several other factors associated with dental caries: defective
tooth enamel; maternal stress during the pregnancy, limited intake of
dairy products during pregnancy; and an illness in the mother during
pregnancy. Research
has shown that factors present in the saliva may be protective. The
absence of these substances is associated with increased rates of dental
caries. Tooth
decay was rare in ancient times. Before
the use of the baby bottle, dental decay on baby teeth was rare. Dr.
Brian Palmer and Dr. Harold Torney, two dentists, found in studying
skulls from 500 to 1000 years old that the decay rate was less than 0.2
percent. Dr. Palmer concluded from his extensive research that
breastfeeding does not cause tooth decay. An important issue remains
that all mammals breastfeed their young, but humans are the only mammal
out of over 4,000 species that show extensive decay Breastfeeding
is the normal way to feed an infant through most of our evolutionary
history, breastfeeding routinely lasted for years, [including
nighttime]. How could we have survived as a species if breast milk
harmed our teeth? Decay has only become common as more and more refined
starches and sugars have entered our diets (e.g. the Native Americans,
who now have Americanized diets in recent generations, developed
terrible dental problems). How
does bottlefeeding makes tooth prone to caries? There
is a fundamental difference between the way children feed from a bottle
and from the breast. To begin with, the position of the nipple is
entirely different in these two scenarios. The human nipple is drawn far
back into the child's mouth, well beyond the front teeth. The bottom
front teeth are covered by the child's tongue during suckling. By
contrast, the bottle nipple is much closer to the child's front teeth.
Liquid
pools continually from the artificial nipple, little or no sucking is
required. This liquid leaves a constant coating over the teeth. If this
coating consists of a sugary liquid, any bacteria already present can
have a feast. In contrast, milk will stop coming out of the human nipple
when the baby ceases to suck at the breast.
The
child may swallow the last mouthful of milk and keep the nipple Protective
role of breastmilk:
Other
foods: Foods
other than those obtained from breast or bottle also play an important
role in dental caries. Sticky sugary foods like candy or raisins may be
difficult to remove from tooth surfaces. Foods that are high in
carbohydrates such as breads also provide an ideal substrate for growing
bacteria. Different
studies: In
La Leche League International's 1997 Facts about Breastfeeding, a
Swedish study is summarized. "The children who still breastfed at
one year of age, remained caries-free until age three, had at age two
received more help with toothbrushing, used fluoride toothpaste more
frequently, and consumed caries-risk products and nocturnal meals less
frequently than children who had developed carious lesions at the same
age. It is not breastfeeding per se that causes dental caries but rather
that other caries-promoting habits co-exist in these children."
(Wendt, 1996) Researchers
from the University of Athens surveyed 260 children between the ages of
3 and 5 living in Greece. Children that were breastfed for more than 40
days were less likely to develop cavities than those who were breastfed
for a shorter time, the researchers found. Because of that, the
researchers suggest that breastmilk may contain antibodies that inhibit
the bacteria that causes tooth decay.
The
children who were at the highest risk of developing tooth decay were
those who fell asleep with a bottle in their mouth. The researchers also
found some children did not develop cavities, even though they often
fell asleep with a bottle, leading the researchers to suggest that there
may be a genetic factor linked to the risk of tooth decay. Other
benefits of breastfeeding: As
the breastfeeding baby grows into a toddler and continues to nurse, the
maxilla develops into a wide arc because of the tongue and nipple
pressure applied on the palate. This helps in giving the Prevention
of caries: The
following steps are recommended to prevent nursing caries:
Breast
milk alone doesn't foster the bacteria that causes decay. In fact, as a
living substance, it has antibacterial qualities, but it can't overcome
the presence of bacteria-feeding starches and sugars. Based on what we
know about the mechanics of breastfeeding, as well as the composition of
human milk, it seems unlikely that breastfeeding would contribute to
tooth decay. The caries rates of breastfed
children versus artificially fed children bear this out. The idea that
nocturnal breastfeeding contributes to dental caries is unfounded. It is
a lovely way to coax our children to sleep. It is For more information, please contact: Breastfeeding Promotion Network of India (BPNI) /IBFAN South Asia BP-33,
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