To be shocked that on demand breastfeeding caused tooth decay

[Ditheringdooley]

My 2 year old needs two teeth extracted and further fillings.

She was bf on demand and fed until 2 and in the night until at least 18m. I did attempt to brush her teeth when first teeth came in at 6m but not religiously and only did so after 12m but it was a horrific battle and she was still having feeds in the night afterwards.

Dentists say that this caused her teeth to rot and she needs extensive work- they suggest under general but I’m pushing for local as could not live with myself if she died under general because I had allowed her teeth to be effed up.

We did seek a referral to NHS over a year ago but never heard anything so will probably have to do this privately. Can’t wait for another potential delayed referral esp with current covid delays.

Any experience to share? I can’t believe this has happened to us. I thought ‘bottle rot’ didn’t happen to BF babies and with my second I will not allow bf at night past 6m.

Sorry to hear about your troubles with your daughter’s teeth. I breastfed all 3 of mine for over 2 years, all had similar diet, all fed at night for 2 years plus, only the middle one got caries. Our dentist said it was because he fed after his teeth were brushed, but the specialist who did the treatment said he was just unlucky, had weaker enamel and his adult teeth would likely be fine.

OP, I went through such a battle because the NHS hospital dentist wanted to take out multiple teeth that were not decayed just because DS had hypomineralisation.

I was fortunate to have my own private dentist, a friend who was a dentist and then a dentist from a different hospital on my side. It was very stressful and I was made to feel like a terrible parent by that dentist. I was fortunate the dentist at an alternative hospital agreed to only take the teeth that could be replaced by wisdom teeth and DS was fine.

Teeth are such an emotional thing that people will try and blame you for, even when there is an underlying condition.

But yes, stick with the private dentist who is extracting the minimum.

I’m a breast feeding fan, but it DOES contain sugars - anyone on here saying otherwise is in denial. My DM’s cousin BF her DS until he was going on 6(!) and he had lots of teeth out as a result - dentists know what they’re talking about!

OP, I wish you and your daughter well- it can’t be easy for you both and you obviously feel very guilty. Hope she’s ok.

Interesting. DD was early (35 weeks), had massive courses of antibiotics, had adenoids removed (snorer, glue ear) and had 1 decayed tooth and what the dentist described as 'weak enamel'. Cleaned her teeth well. Dentist v suspicious that I was feeding her loads of sugar (she was PFB and I was overprotective - vvv little sugar.) I felt terribly guilty!

@DishRanAwayWithTheSpoon I think your comment covered some of my question (about ye olde days).

From 6m-12m she didn’t really eat but did gum at foods and put them in her mouth (baby led weaning fail). Always refused to be fed. But that’s still enough to leave food on the teeth. I don’t know if they were dirty then, but a hygienist visit has been recommended now suggesting that my 2 min brushing is still not keeping her teeth clean enough.

They are also stained from iron supplements.

To be clear, when I say they came through brown they came through with brown patches of decay on them. I initially thought it might be excess fluoride but the first dentist told me clearly it was decay.

It wasn’t brown throughout like might happen with some medications I expect. But they soon crumbled away to little stumps.

For the dentists commenting, what is the key harm to future adult teeth (excluding ongoing oral hygiene- if you assume that can be got under control?).

It's not the bf - it was the not brushing. Or maybe just a natural weakness in the enamel or something like that?

@Ditheringdooley sometimes baby teeth that come through just aren’t good. My DSS had 6 baby teeth removed and crowns on his others at 6 years old,his teeth were ruined. Formula feed as a baby, but not huge amounts of sugar - he just had bad teeth.

Adult teeth were fine, no issues , no fillings, he had braces at 14 as he had an over bite.

But honestly don’t beat yourself up over it, and also from experience go for general rather than local, please.

My DS has hypomineralisation - his molars came through mottled and have decayed very easily, by 3 he had 3 fillings. He was bf at night until about 15 months - the teeth that have the fillings in hadn't come in by then so it's definitely not linked. We are strictler than almost everyone I know with sugar.

We were initially repeatedly quizzed about DS's diet, they didn't seem to believe that we were careful. It was only once DD reached maybe age 1.5 without similar issues they finally seemed to believe us and diagnosed hypomineralisation. He had a lot of antibiotics as a baby for ear infections and it's apparently linked. DD was still bf at night at age 2 - if it was the other way round and DS bf at night at that age they'd probably be blaming the breastfeeding in our case too.

Thanks to @VestaTilley and many others wishing my daughter well (sorry I can’t tag all, hard to go back through the pages but I appreciated those thoughts).

She initially screamed when we arrived today, only one of us allowed in so my husband went in with her as I’m in third trimester with baby2. She soon warmed to the dentist when she complimented her sparkly shoes.

What was heartbreaking was when we left she said ‘my teeth are nice now’ am- she doesn’t realise that her smile has been affected. I worry about her being teased at school etc so hope we can improve the cosmetic appearance as well as obviously her oral health. My poor girl.

bad eater and for a long time was anemic (family history) affects appetite

Has she been tested for coeliac. Malabsorbing and poor enamel. What is her growth like?

I bf both mine until 18 months. They are now 12 & 9 and there's not one cavity between them.

I've never heard this link before. And frankly I don't believe it.

I wouldn't treat a two year old with a local anaesthetic. The thought of getting the needle in the right place alone! I've filled teeth in three and four year olds who are well behaved. I really think sedation would be kinder to all concerned. I have to say that this extent of decay in a child this young is very unusual. I can recall one case of a child of two who had every tooth in her mouth decayed including the erupting molars. OP says that the erupting teeth are brown. This is really rare and it would be worth keeping a food and brushing diary. In the case of my patient this didn't flag anything, but something may stand out. I think the lack of brushing and nighttime breast milk is significant. A baby can hold the last mouthful of milk in its mouth. Although the milk shoots to the back of the mouth, babies can still get it round their teeth. I remember my babies opening their mouths and I could see milk in there.

That's interesting. The only one of mine with any decay in baby teeth was the premature one.

Indeed. Despite near perfect brushing routine with an electric brush, drinking everything through straws, and never having the kind of sweets, lollies etc which are decay inducing, DD ended up with some decay on one of her back teeth. I never knew that could be a preemie issue.

I wasn’t breastfed but my baby teeth came through brown and I had a number taken out (under GA) before I was 5. The reason given was my body had a problem with calcium - I don’t know precisely what it was but I have always had very weak teeth and nails as an adult despite eating a lot of dairy and really taking care of my teeth.

@perfumeistooexpensive not brown throughout, someone used the term mottled above which is a good description. They had a surface brown on them and either they immediately crumbled away or they developed in a misformed way (pitted, not a full tooth).

I think that other teeth look mineralised but not sure if that is further potential decay. First dentist said that fluoride treatment would not help. Have not raised it with pédiatric dentist yet.

DD’s hypomineralisation was treated with fluoride gel every evening in tooth trays. She is now an adult and has had no fillings. She has eaten lots of sweets, fizzy drinks etc and had no problems.

It's nonsense

@Stripesgalore thanks- I will ask about hypomineralisation / hypoplasia.

It may be, and this is wild speculation, that they don’t want to use fluoride gel on baby teeth for some reason and want to wait for adult ones. DD also had dental sealants put on once she’d finished with the tooth trays, but she had the gel for a long time first - having new impressions done as her teeth grew in more.

@Gwynfluff - growth has slowed but seems in line with average height Mum, tallish Dad. She’s average to small. I will ask for an initial test when we next see the GP. Thanks for the suggestion.

This is really common on the tongue and lip tie group I’m on. Tongue tied babies (on Facebook) basically the breast milk pools in the areas where the mouth is restricted.

OP. I wouldn't be surprised is your baby has teeth that have a mineral deficiency. The times that you couldn't brush and were bf at night would have a far greater effect on them than those with well formed teeth. Always use a fluoride toothpaste and the crucial thing is not to rinse the mouth afterwards. Let the fluoride do its work. It sounds bad but with my children and dgc, the more they screamed, the easier it was to brush their teeth. Even if you find that they've clamped their teeth shut, getting some toothpaste in the mouth is better than nothing. I was a child in the pre fluoride days and we all had tooth decay despite brushing. Children's teeth are much better than they were back then. If you feel you are being judged by other parents, just say it's a mineral deficiency from when the teeth were formed and that should squash any criticism.

You might find this useful with all of the terms and the difference between hypoplasia and hypomineralisation OP.

www.thed3group.org/the-basics.html?page=the-basics.html

Hypoplasia - an abnormal amount of normal enamel
Hypomineralisation- a normal amount of abnormal enamel!

Which one it is changes what treatment to offer.

I don’t think they do local anaesthetic on 2 year olds
As far as I know it’s general anaesthetic or nothing

Please don't have her teeth extracted under a local, it can be really distressing for an adult, let alone a small child, to experience this. If they offer you a general for her, please consider it.