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.

My child needed 6 teeth out at 20 months. Under GA. Last resort but necessary as some had become stumps basically. He was fed (breast) on demand over night and milk pooling was the reason given along with weaker enamel (got teeth really early, 11 weeks or somethibg daft- they think this may be linked)

Good news is no effect on child, was eating as soon as they came round from the GA and hadnt affected speech patterns etc (in primary now)

Please do DM me if you'd like to chat about the process in more detail.

@ditheringdolley they do actually sound hypoplastic to me, i.e malformed.

There isnt much harm to adult teeth tbh. The only issue is that they are much more likely to end up crowded and need orthodontic work in the future

But that is balanced against the risk of pain/infection to the child leaving heavily broken down teeth.

Breast feed= breast feeding
Claire=caries

today=to say

Also just seconding that sedation is entirely innappropriate for a 2 yr old

Please dont get the dental work done under local. You dont want her developing a fear of going to see the dentist.

The local anaesthetic injections will cause distress and then she will have to deal with any bleeding after it.

General anaesthetic is pretty safe. She will be under for a short time and she wont have the bad memories that the procedure under local will cause.

Her dental hygiene also needs to improve. Have a look at tge child smile website.

Are you trying to undermine breast feeding. These messages might be harmful to women op.

@Floatyboat not in the slightest. I bf my daughter until 2 and will bf my next. I support anyone attempting to bf.

Your comment is anti-women (though I am sure you have the best intentions). There is nothing anti-bf about trying to access correct information. Women can weigh up things and be trusted to do so.

Although just to finish my thought, in my case, I believed in the protective effect of bf and if I had been formula feeding I probably would have thought that I was giving her ‘sugar’ at night and maybe I would have recruited someone to help me with the nighttime brushing. Or if I hadn’t been so knackered from the nightfeeds even when back at work I might have looked after her and myself better.

Messaging that indicates that bf is some magic answer to everything helps no one. It’s just milk - formula has dangers for children, especially relating to infection, but breastmilk doesn’t have superpowers. It’s just the (or should be) standard or starting point.

@2024R and @DishRanAwayWithTheSpoon thank you for comments and noted your comments on local/GA.

I do wonder how she would stay still. Not through the extractions themselves but through the carie restoration in particular- that seems fairly impossible to me.

Multiple treatments would be needed under local so we are talking about multiple distressing visits. There’s only so much a distracting balloon can do.

@2024R @Ditheringdooley
Further questions, if possible.

Once determined that extractions are needed (and she has had infections in the gum which are expected to recur, penicillin taken the first time, nothing the second) is it a question of it needs to be done urgently?

Does a further delay of months risk further harm? Is there nothing that can be done by a dentist to retard the development of caries? I assume that if there is any enamel weakness/ insufficiency that means that in the same amount of time she would suffer more harms than someone with normal enamel might.

I leave the toothpaste on her teeth and use more than the recommended ‘smear’ at this age in order to leave some fluoride on her teeth. What she eats can be changed (less white carbs) but not the snacking pattern/ repeated exposure.

@Torvean32 I can’t identify the website you mention.

I’m not sure what else to do to improve oral health.

We are now (and have been for a long time) brushing 2x with fluoride toothpaste. Sometimes has teeth brushed by carer after lunch if she thinks she may sleep to avoid afternoon nap with dirty teeth.
Have taught her to rinse before brushing (spitting out) to try to remove particles of food before as I don’t rinse the toothpaste after.

What are the safer snacks in terms of dental health?

The list of ‘healthier’ snacks here www.babycentre.co.uk/a569373/tooth-friendly-snacks-for-toddlers is literally the kind of thing that she eats (except cheese, which she won’t eat- rice or oat cakes with butter instead). Half her diet is hummus and cucumber or carrot.

Did she have reflux? Sometimes the acid in the mouth can weaken the enamel.

I would be more inclined to put this down to genetically not great teeth than anything else. I think the breastfeeding is a bit of a red herring.

I'd be inclined to take great interest in her teeth throughout childhood and beyond as it sounds like they're just not going to be strong solid ones.

There's nothing identifiable / outing about my post, anyone with any knowledge knows that dental extractions under GA are the no.1 reason why children in the UK are admitted to hospital. There are no end of articles in mainstream newspapers about this issue and the hundreds of thousands/ millions of child GA extractions per year. There are many , many repeat dental GAs

Obviously, 1 thing can't be identified as the sole cause of the OP's DD caries without clinical assessment, but if several dentists have analysed diet , oral hygiene and considered hypoplasia ( one would hope a specialist paediatric dentist can diagnose this clinically 🙄); then yes there must be some merit in the breastfeeding on demand cause.

Caries can be arrested with duraphat ( the only licensed medication ) but diet and Oral hygiene has to be good too. SDF Silver Diamine Fluoride is the new wonder medication for caries control. It stains caries black and isn't specifically licensed for caries control in the UK. It's extremely effective . It's also near impossible to get hold of in the UK currently.

Recurrent dental infections can affect the underlying developing permanent tooth bud , yes. The permanent tooth can then erupt looking hypoplastic too; not always, but probably best to not delay too long.

OP have a look at the 'delivering better oral health' published by gov.uk. There's a much more reliable source of evidence and extensive guidance within this document. Best wishes to you, you sound very sensible, put it all behind you once treatment is complete.

I thought this was one of those sticks used to beat breastfeeding mothers with? Full term breastfeeding is the right thing to do for children, and is not associated with decay. I breastfed my four children at night for years (2-3 years each) with no decay, and I know many others who have too with no problems. There are some well respected resources online that support night feeds in the long term, and that they don't cause decay. I would think that something else has caused it.

I dont understand how breast milk can pool & sit on teeth. When a child is latched on the nipple is are the back of the mouth, they suck and swallow immediately. No milk is coming out until they suck, and they need to be latched on with the nipple at the back to do that. I just dont see how its possible

With my first I was a member of a fairly pro breastfeeding forum. Lots of older babies and toddlers feeding, many past 2 years.

Decay in that distribution seemed to happen a lot in the toddlers who fed frequently overnight. No one would ever accept that pooled milk from the constant night feeders could be contributing but among an extended feeding cohort it wasn’t uncommon

“That distribution” meaning decay in that nursing caries distribution.

Despite everyone’s vehement defence of night time feeds and everyone saying the dentists were wrong and needed to become more educated etc it seemed relevant to me that the patterns of decay of these toddlers were all the same.

breastmilk doesn’t have superpowers

Got to be honest it is incredible as a substance due to it containing immunoglobulins and other bioactive ingredients.

Fortunately, we have a perfectly safe substitute that given in the developed world with clean water supplies, access to healthcare and vaccinations means that the immunological support needed from breast milk has become virtually nullified.