to think this little girl badly needs to dental treatment. Should I say anything?

[ilovehugs]

A new family has moved in across the road. They have a little girl who my DD has made friends with. She is lovely. Bright, bubbly happy and healthy but has SEVERE tooth decay. My DD had tooth decay (now resolved for over two years) and sees a specialist dentist to give her teeth extra protection. As a result, I'm very clued up now on how painful and damaging, short and long term tooth decay of this level can be if left. All her teeth are badly decayed. She showed me her 'new tooth' today, which was her top front tooth emerging deformed with a black tip next to four black patches (teeth rotted away to nothing) flush with her gum. When she smiles, her bottom teeth are very obviously decayed also. Also her upper lip is constantly swollen from the infection. Her breath smells and I think it's probably because of the very severe decay. She is fiddling with her mouth all the time. The family is new to the UK and may not have had the knowledge of how to look after her teeth, they may not have had access to dentists. It really is very severe. I don't know if I should try and talk to the mum. I will probably really offend her. What should I do?

I think that you should be very careful in talking to the school about this child. They will talk to the parents if they feel it is necessary. Don't assume that it's caused by her diet/lack of dental care.

Some children have problems with the formation of enamel. It can be caused by prematurity, illness in the mother while pregnant, antibiotics or can be genetic. Obviously this means that their teeth are weak and prone to decay, however well their parents brush their teeth.

Tooth decay on the front teeth can be caused by breastmilk if the child has a lip tie. The milk gets caught in the little pocket and can rot the front teeth.

Anything on the teeth including milk turns to sugar so if you are BF throughout the night when the child has lots of teeth I think it makes perfect sense that there will be decay.

Yes, but what you 'think' has no basis in scientific proof, valiumredhead.

I don't have any links to studies which show breastfeeding may be a cause of decay

I know. That's because there aren't any.

There IS a link between nighttime feeding and tooth decay if the child has an upper lip tie. I was warned of this BEFORE DS3's teeth came in.

It frustrates me that I can get DS2's teeth filled as he is disabled (has had two done), yet I can't get DS1's done, and he has issues with weak tooth enamel.

I DO pay privately to have a coating put on his teeth every 6 months, but it is ££, and I am on benefits. It's crap that they won't look after EVERY child's teeth.

Am arguing with the NHS right now about dental treatment - 10yo DS1 has chipped his front ADULT tooth while playing football, and they are refusing to put a veneer on it, when it is affecting his confidence because it is so visible.

They have said that they refuse to do veneers on an under 18, I simply cannot afford the £££ to get it done privately, and they say that temporary fillings that will need replacing every 6 months will be fine. When they're NOT. It's very visible, and I'm worried that the chip (about 3mm deep) will cause the tooth to decay too.

X-post, mawbrown.

DS1's issues with weak tooth enamel were partly caused by me having extremely severe Hyperemesis when pregnant (I spent 19/40 weeks in hospital on a drip as I couldn't even keep water down, so he was malnourished at birth), partly genetics, lots of weak teeth in the family.

"There IS a link between nighttime feeding and tooth decay if the child has an upper lip tie."

I believe that's true, since the milk can pool there instead of draining back as it should.

Couthy: you should be able to get fillings for free for any child on the NHS. However I would agree with your dentist that 10 is too young for a veneer. A composite white filling should hold for 5 years or so. I wouldn't advise a veneer until 18 and that advice would be the same for a patient whose parents wanted private treatment.

I am repeating what my dentist told me :)

My dentist told me the same thing and asked very smugly if my ds had a favourite side - he did, but it was the opposite side to the decay, which blew his pet theory open slightly.

It's a myth - but worryingly it seems to be a myth peddled by several ill-informed dentists. But there is no established link between breastfeeding - nighttime or otherwise - and tooth decay.

Akiss - the thing is, the white filling is very visible, and is distressing DS1 to the point where my formerly very vain DS1 now refuses to look in the mirror, or even comb his hair, as he keeps saying "What's the point, I look awful anyway".

It's affecting him badly, hence wanting a veneer.

To be honest Couthy, if your dentist can't do a composite filling to match the tooth that stays in place longer than 6 months, I doubt their veneer placing skills would be any better. White fillings are much easier to match up than porcelain.

Ds lost part of his front tooth in a ruby match - the dentist has built it up and you can't see the difference in teeth at all. I was amazed as I was really upset.

I have breastfed both mine and am a big bf advocate. I fed ds until age two on ds until three. To date ds who received identical care has never had tooth decay. Dds situation was complicated. She had adult dosages of a suglar based laxitive following her last surgery at eight months. She also had illness, vomiting a allot of well intended fruit snaking added to the mix. I was told the pattern of decay showed it was the night bf at an older age. At first I disagteed, but I know think that it was enough to tip the balance in favor of decay with everything else going on. She was older and of course latched herself on. Her mouth in relation to my nipple by that stage meant more milk was getting on her teeth. When she was younger it would have gone down the back of het throat more iyswim. I do agree with the argument that our ancestors whose sceletons are found with perfect teeth would have been breastfed on demand for many years, but their teeth didn't have to contend with all the sugar, starch and in our case medicines. It pains me deeply to say it, but in my dds case I truely belive the extended night feeds tipped the balance to decay. You could see the pattern. Text book bottle decay but no bottle ever touched her lips.

It's my fault (combination of bf at night/ being lax with crap/ not insisting on teeth cleaning when he complained - was going through Stuff at the time. Not an excuse, but a reason.) They aren't getting worse, with regular brushing and strong toothpaste, but not better either!

Crunchyfrog My DS2 recently had a dental checkup. The dentist praised his healthy teeth in a way that flattered DH and I. We looked at each other shamefaced and confessed that we frequently forget to brush his teeth in the morning, only doing it in the evening. And then he takes juice to bed. (He was BF till 3.5) The dentist said "Errrrm oh well some children have very resistant tooth enamel." It does depend on the child. Don't blame yourself.

long ago the only sugar our ancestors came in contact with were from fruit ( also dried like sultanans to keep and honey) dental disease in form of decay was a disease of rich only, toothache from tooth badly worn due to gritty flour and gum disease due to no oral hygenie affected everyone but most ancient skeltons have badly worn teeth a few bny defects evidence of teeth knocked out in a fight but little decay

I am also a dentist and agree with AKissisnotacontract I have filled numerous childrens teeth on NHS sometimes you can not but that is often due to dental anxiety or simple refusal to open mouth for long enough to fill, with patienvce this can be mostly dealt with over a few visits to build confidence but you may not get filling done the day they come in with pain if very nervous

Couthy - I had a chipped front tooth and had a white filling - it looks INCREDIBLE. I have absolutely perfect teeth and always get comments on them. I had it done in 2005 and it is exactly the same now as it was then. Even studying my teeth with a magnifying mirror you can't see it.

My dentist very strongly advised against a veneer as you totally ruin the tooth forever. With this method he didn't have to damage my tooth at all.

Oh and it cost me 27 quid.

boo my ds's is the same - you can't even see the join, it's amazing.

white fillings on front teeth better than veneer even really thin ones remove a tiny bit of tooth tissue

veneers not recommended for under 18's as if put on early, the gum line shrinks back leaving visble edge at gum level gums recede to permenent adult level ( barring gum disease) at about 17-18 so one placed earlier would end up looking awful, I have done loads of white fillings on front teeth on NHS it would be a very rare exception when someone other than patient or another dentist would know

I would prefer my own DD to get filling to replace chip rather than veneer

Hopefully her school will deal with it - if they are on the ball.

Dentists go into primary schools twice a year to do a check and apply a fluoride varnish, but that may be a bit too late for this girl by the time they come round. They do send home a note saying that dental attention is needed if they think so. The teacher should pick up on it and ask the school nurse to check.

Nothing - its not your child and you would seriously offend her!

Brilliant. Attitudes like that is what leads to cases like this

ok, firstly extended breastfeeding can be a cause of dental decay, it is something i have seen occurring in some patients. it is not the only factor of course but can definitely play a role.

also i dont know if you have a community dental service in your area? these services are primarily for children, anxious patients and physically and mentally impaired children and adults. you need to be referred by a gdp or even a gp or hv can refer you. school inspections are no longer carried out, only in sn schools.

however, if this girl could somehow be referred to the CDS then it would most likely be a case of extractions under GA and then any other treatment as needed.

unfortunately there seems to be very little public awareness of the CDS and as a rule most nhs practices do not have the time or the patience to deal with treating young kids. this is why the specialist service exists.

anyway the point is it may be worth trying to find out from the pct whether there is a CDS in your area.

ok, firstly extended breastfeeding can be a cause of dental decay, it is something i have seen occurring in some patients. it is not the only factor of course but can definitely play a role.

Yep - that will be why no study ever has been able to link the two then.