my dd's teeth are decayed and I am so worried.

[chocolateicecream]

I have come back from taking my dd to a dentist appointment today and feel completely fed up.

My dd is 6 and has horrible teeth that are covered in black spots. She has already had to have one tooth removed because it was significantly decayed, resulting in several painful abscesses. Another two teeth are rotting and she currently has an abscess on the surrounding gum.

Every time we visit the dentist we are in and out in five minuets. The first thing that she said to me today was 'so how is the sugar going?'.
I quizzed her about the state of my dd's teeth. The dentist is convinced that her decay is down to too much sugar in her diet. She advised me that my dd should not go any less than three hours between eating (so how does this work in pre-schools and schools where children receive snacks and there are no opportunities for them to brush their teeth).

The dentist asked if my dd was bottle fed, assuming that this was a possible cause of her decay. I explained that she has never had a bottle, and has only ever drank from a proper cup. The dentist then told me that breast milk is very sugary and this may have been the problem. The dentist then said that from birth babies should not go less than three hours between feeds. I did dispute this and her comeback was that she herself had always done this and that her children's teeth have no decay. If she thinks that I am responsible for allowing my child's teeth to rot then why has she never made attempts to refer me to the dental hygienist? I asked her why my dd's teeth are so bad when I know other children with nice teeth who's parents were far less strict over their dental health. She just answered 'It's caused by diet and bacteria build up'.

I have always made a huge effort to care for my dd's teeth. She was not allowed sweets until quite recently and still does not eat that many. Her teeth are brushed three times a day and she has a healthy diet (I am aware that sugar is in so many things). I know other mums who have given their children sugary drinks, frequent sweet/snacks etc. and their teeth are fine.

What I want to know is why are my dd's teeth so susceptible to tooth decay? Yes I know that bacteria damages teeth, maybe my dd's teeth cope less with bacterial exposure? I did have hyperemisis through my whole pregnancy, I often wonder if this has had an impact on her teeth. I am so worried because some of her adult teeth have erupted and that there is risk of damage to these teeth :( .

Can anyone else relate to this, or shed any light on this one??

Many thanks

Also I had loads and loads of antibiotics as a young child which was bad news for my adult teeth apparantly - I had molars erupt that had decayed seemingly due to the tiny holes in the gum that the sugars in saliva could have trickled through.

I had my first root canal treatment at 12

first visit around age 3 as thats when all teeth through but can go 'with' mum earlier to get used to environment/ride in chair etc.

dont know about passing on decay with spoon sharing but interesting thought. may be possible but would have to be happening at each meal to have an effect i would think.

dont know about any research but hyperemesis would most likely only affect your teeth. the only things that definitely affect the childs teeth are things like taking tetracycline in pregnancy and other severe illnesses. would have to find out if any such research has ever been done.

Breastmilk does not cause tooth decay
'One of the reasons for nighttime bottles causing tooth decay is the pooling of the liquid in baby's mouth (where the milk/juice bathes baby's teeth for long periods of time). Breastmilk is not thought to pool in the baby's mouth in the same way as bottled milk because the milk doesn't flow unless the baby is actively sucking. Also, milk from the breast enters the baby's mouth behind the teeth. If the baby is actively sucking then he is also swallowing, so pooling breast milk in the baby's mouth appears not to be an issue.'
From the above.
Some children are born with very weak enamel, chocolateiceream. If you have done all you can to prevent it, and it sounds like you have, don't beat yourself up about it.

If your dd doesn't have sweets/biscuits/squash in her diet then my bet is on the problem being dried fruits/fruit juices. How old is she? Make sure she is on a toothpaste with enough fluoride for her age group, that she brushes last thing before bed and spits the toothpaste out without rinsing.

Did you say you breastfed exclusively until age 3?

As far as I am away the sugar in breastmilk is offaet by all the anti-bacterial stuff in it making it roughly equivalent to water.

See here

karastarbuck, where is that article from? that may be true anecdotally but clinically we do definitely see a lot of decay caused by breastfeeding.

Yummy tummy, my link is referenced :-)

chocolateicecream very interesting article

yummytummy extended breastfeeding or just breastfeeding over formula?

Ok just seen that she is 6. In that case, unless she is still breast fed, discussing breast feeding is not going to help you now. You need to do what you can to protect the permanent teeth which are starting to erupt now. Please get the first molars fissure sealed, make sure she is on an adult toothpaste and spits but doesn't rinse. There is no point berating yourself now over what has happened with the primary teeth, focus on the new ones which start to erupt around 6 years of age.

I was also going to link to the KellyMom article but was beaten too it.

While I am not a dentist my father is and he has always been adamant that BFing is good for teeth - not as suggested by some posters.

If your DD is prone to weak teeth she could take a fluoride supplement and obviously you want to encourage her to still drink milk as much as possible now.

Check her brushing technique using disclosing tablets and consider a electronic toothbrush which might help get in the nooks and crannies...

Hope that helps and good luck with the adult teeth :)

Dental decay occurs due to the interaction of 3 factors: sugar, bacteria and susceptible teeth. Before you read further, please understand that what I am about to say is generic information. I've not examined your child or her background or diet.

You reduce the sugar by having no more than 5 episodes of ingestion of carbohydrates in a 24 hour period. Carbs are most snacky things, including fruit. Read labels, look for glucose, sucrose, fructose, corn syrup. Lok at breakfast cereals, all pre-packaged foods, drinks. It's frightening. Outside of those 5 episodes it is water only to drink and protein / fat based snacks (cheese, meat). 5 episodes is 3 meals and 2 snacks, not unreasonable. Keep a diet diary for 2 week days and one weekend day. Note down everything she eats and drinks and the times. You might well be surprised what you find. A particular problem which is harder to overcome is if you child has to take a lot of sugary medications. But that can be overcome..

You reduce the bacteria by brushing properly, I think flossing is unrealistic in a 6 year old. Get disclosing tablets. if your DD can spit out, with her decay experience I would recommend adult tooth paste. Get a timer or better still an electric toothbrush.

Now...the contentious bit: susceptible teeth. This is the part where we have discussions about weak enamel, childhood illnesses, problems in pregnancy come in. Yes, they have a role to play. But unless there is some very unusual genetic defect in the enamel (e.g. amelogenesis imperfecta), good diet and oral hygiene will over come these issues. Sometimes the anatomy of the teeth makes them more vulnerable, like deep pits and fissures. If spotted early enough these can be protected with fissure sealants.

Sadly OP, a situation has arisen where one or more of these factors has not been addressed sufficiently. Your dentist should be helping with appropriate advice and preventative treatments. If she is not, change dentist.

The obvious question is what now? There are two priorities....1. preventing pain from existing disease and 2. preventing further disease. The latter is covered above. The dentist should be applying fluoride varnish 2x a year at least, and prescibing a fluoride mouthwash. In terms of preventing pain, the only reliable way with baby teeth that are decayed is to remove them. But many decayed baby teeth do not cause pain. Take DD to a sympathetic dentist who can refer you a paediatric dentist, either NHS or private. It might be that the best course of action is a planned GA and removal of any teeth that are likely to cause pain in the future. Drastic, but very effective and far less traumatic that having repeated episodes of pain and extractions with local. If DD is 6, some of her baby teeth are designed to be there for another 6 years. That's a long time to worry about the next tooth ache.

phewwww. Long one. Feel free to PM me.

I was told by more than one dentist that hyperemisis CAN affect the development of your child's milk teeth.

My DD has very little enamel on some of her milk teeth and sadly had to have one removed last year. We are pretty good with dental hygiene and our dentist is ahppy with what we are doing. DD sis 9y now. Her adult teeth that have come through so far don't seem to be affected. Dentist has said that it is just the way her teeth are. It's not our fault, it;s just what has happened. We hope it continues that her adult teeth are ok, but we do our best in the mean time.

The teeth are already formed very early in foetal development and a maternal health problem of any kind during pregnancy can affect the health of the teeth as they grow.

Thanks for the posts, all very helpful and interesting.

I do wonder why so much effort has been made with my dd has teeth, and yet, others have given their children sugary drinks etc, and their children's teeth are fine? There must be a bit more to it. It just seems unfair.

My dd was BF until she was 5 and a half. I don't think that this is to blame for her tooth decay.

Wow, bonzo77, many thanks for the very informative post. We did invest in an electric tooth brush and we use a timer which seems helpful. My dentist did suggest a fluride mouth wash. I am quite alarmed at the ingredients in them. However, we are using an alcohol free one now (diluted) once a day. Thanks for the kind offer bonzo77, I may like to contact you :).

'The teeth are already formed very early in foetal development and a maternal health problem of any kind during pregnancy can affect the health of the teeth as they grow'.
Yes, that does play on my mind spenditwisely. I was seriously ill 5 months prior to conceiving my dd (so not a long time ror my body to recover). I became pregnant and suffered with hyperemisis throughout the pregnancy. I do wonder that my developing baby's bones took priority over her teeth.

The primary central incisor starts its initial calcification at around 14 weeks in utero, the primary molar at 19 weeks io. The permanent teeth don't begin calcification until after the baby is born.

The Kelly mom article states that exclusive breast feeding won't cause caries but that if breast milk is given as well as foods it can:

'Much research indicates that it's the other foods in baby's diet (rather than breastmilk) that tend to be the main problem when it comes to tooth decay. The 1999 Erickson study (in which healthy teeth were immersed in different solutions) indicated that breastmilk alone was practically identical to water and did not cause tooth decay - another experiment even indicated that the teeth became stronger when immersed in breastmilk. However, when a small amount of sugar was added to the breastmilk, the mixture was worse than a sugar solution when it came to causing tooth decay. This study emphasizes the importance of tooth brushing and good dental hygiene.'

Anecdotal experience but I'm sure some people do have naturally stronger teeth and others less so. I'm 38 and have never had a filling, DH on the other hand has teeth mostly held together by fillings - he's had plenty in the 19 years we've been together and in that time we've mostly eaten the same stuff and I'd say he's probably more fastidious about brushing etc than I am. I also didn't eat dairy products until about 8 years ago (allergy that disappeard when pregnant!)

One thing I would say though, soya milk can be full of sugar, especially the sweetened ones (often they use apple juice) so if you are drinking a lot of that it may be a factor...

1. your dentist sounds rubbish to borderline incompetent. Throwing the text book repeatedly at you is not helping the child that is in the middle of this. You need a new dentist who is more supportive, and more creative/informed with ways to solve the problem. It sounds like you've gone as far as you can with the "don't feed your baby coke from a bottle" lessons in the bleedin' obvious.

2. Can you get referred to dental hospital/ local specialist centre? IME they are more knowledgeable and confident with work on DC teeth (and were also very kind).

3. I feel for you. My DD also has ratty teeth (no abscesses thankfully). We had a private dentist through DH work, who referred us to a 'highly regarded' paediatric dentist, who came back with a quote for six (six!) extractions under GA (with the bill to match). It was very upsetting. Like you, I have always taken care of Dds teeth. brushed twice a day, eating only at meals, good diet.

I went back to NHS dentist, and got referral to the specialist dental unit, where they did fillings (agreed with my DH that the other dentist was a lunatic ) without anaesthetic. My DD was fine - a bit anxious but certainly not in agony. I felt crappy, and raised the same points again and again with the dentist - "why are DDs teeth so decayed, given her diet and brushing". It's easy to buckle under the acusations of being an incompetent and oblivious mother, but like you, it was clear that she was being punished disproportionately. She's had a few more small fillings at her regular dentist - all in her baby teeth thankfully.

Changes we've made: dentist suggested that we could skip rinsing after brushing - that rinsing could wash off the protective fluoride. we spit but don't rinse. I find her teeth do need extra brushing compared to her siblings to come up clean.

I've got two younger children (5 and 3) and I'm always surprised when the dentist declares their teeth 100%. In particular, the baby is a real brush refusenik! I have to headlock him to get it done often. What's different? Two things. Firstly, DD seems to have some kind of cows milk intolerance - has steadily refused milk/cheese since weaning. Other than that, her diet is good (eats greens, yoghurt, eggs etc). And I also had horrible hyperemisis when I was pregnant with her. Hospitalised twice, vomiting green bile - it was not great.

DD is 7 - I forgot to say.

Footprints: can I ask where you find sugar free yoghurt? As I don't eat yoghurt and the searches I did in the supermarket only showed ones packed with sugar I don't know of a brand I can recommend to my patients. Thanks.

Any yoghurt will have sugar in as milk is full of sugar (lactose)

DD likes Greek yoghurt. It's creamier and less 'tangy' than natural yoghurt.

To be fair, she has it on top of muesli with a bit of banana and honey - but I still think it's less sugary than commercial yoghurt and commercial cereal - and I'm grateful she'll eat at least some dairy!

In principle Mullerlights are sugar free - but I'm not keen on giving sweeteners to kids.

Having good or bad teeth is pot luck. I brush regularly and visit dentist twice a year, dh does nothing and I am the one with fillings galore! Dd had her first filling at age 5 and I felt awful about it. Her baby teeth seemed a disaster but she has lovely adult teeth with 1 filling and the dentist always compliments her on her teeth. I'm sure she had a coating put on her teeth to protect them. My memory is fuzzy but get a new dentist and ask them about this.

chocolateicecream - your hyperemesis may well have affected dd's teeth - as bonzo said calcification happens in utero and as far a I remember from what my paed. said, physical trauma,a damaging medication or nutritional deficiency in the mother can affect the baby's teeth. She said that you can tell when it happened by which teeth are affected (incisors come first etc).

My dd's are a nightmare because of medication I took in pregnancy.

And wise advice from Footprints about not rinsing toothpaste is very important.

Bonzo's analysis of the breastmilk studies is also interesting - a small amount of sugar turns breastmilk corrosive. When did you introduce solids to her and did she chew a lot? I'm asking because the action of chewing releases acids in the mouth which protect the teeth (I heard somewhere - don't quote me though).

spend thanks for the credit but it was akissisnot who gave that useful info.