Can breastfeeding lead to tooth decay? By Dr. Aarti Sharma Kapila

Breastfeeding is one of the most personal decisions that a mother makes for her baby. It’s an enjoyable and powerful bonding time. It strengthens the immune system of the baby and helps fight infections and reduce health risks such as obesity, asthma, ear infections etc.

In addition to these benefits, the physical contact of the mother and baby during this activity makes the baby feel secure. But have you ever wondered if breastfeeding affects the dental hygiene of your child?

Dr. Aarti Sharma Kapila, dentist talks about her experience which made her look for answers to this question. “One of my regular patients was looking worried on one of her visits to my clinic. When I asked her what was bothering her, she said, “my baby falls asleep as I am nursing him. I wonder if that will affect her teeth in any way. Will it lead to cavities?”

She was a new mom and her anxiousness was valid and I wanted to give her accurate answers.
I embarked on this project, dug deeper and found some answers with my research,” says Dr. Aarti. Here’s what she found out:

It is often said, feeding the baby milk especially while lying down can lead to tooth decay or baby bottle syndrome. Some people are known to saying that breastmilk too causes tooth decay. However, a usable link has not been made between breastfeeding (nighttime or daytime) and dental cavities. Therefore, it is possible that breast fed babies get cavities, but the reason could be poor oral hygiene, not breastfeeding.

Breastfeeding a baby is very different to bottle-feeding a baby. There exists a major difference between feeding through a bottle and sucking on the breast. During bottle-feeding the milk is released into the front and around the teeth, whereas during breastfeeding, the nipple is drawn far back into the mouth and the milk is released into the throat, motivating the baby to swallow the milk. When a baby falls asleep with a bottle in the mouth, the silicon nipple will continue to leak any remaining bottle contents slowly into the baby’s mouth, while the breast will not release milk unless vigorously sucked. Also, when a baby is breastfed, the milk does not pool inside the mouth. Whereas, in bottle feed the liquid can stagnate inside the mouth when the baby falls asleep.

The belief that breastfeeding a baby to sleep can lead to dental caries is based on only three articles by Bram and Maloney, Gardner, Norwood and Eisenson and Kotlow which were done in the late 1970s and early 1980s. The authors used case reports for just nine babies in total, two of whom were also bottle fed. Nine case reports represent a very low or negligible level of scientific evidence and not one of them included any kind of experimentation or trials. The inferences in these articles were based on this very small figure of case reports and on the dentists’ own insufficient understanding of the process of breastfeeding a baby.

Research by Dr. Brian Palmer and Dr. Harold Torney in their study of tooth decay in children showed that breastfeeding does not contribute to tooth decay. Many studies published later essentially showed that the antibodies in breastmilk help to inhibit bacterial growth (including Steptococcus mutans that is the bacterium that actually leads to tooth decay). Lactoferrin, a protein in breast milk, inhibits the growth of and kills S.mutans. Studies conducted by Rugg-Gunn and colleagues stated that S.mutans are not be able to use lactose, the type of sugar found in breastmilk, as freely as sucrose, which is found in some milk formulas. Research conducted by Erickson and her co-workers’ and Ribeiro and Ribeiro 8 showed that milk formulas reduce PH and dissolve the enamel of the tooth, thus leading to decay.

Factors leading to tooth decay:

Factors excluding the method of baby feeds that could also cause tooth decay in baby teeth are as follows:
• Sugar intake of the child either through formula feeds or regular baby food
• Strep mutans, a tooth-decay causing bacteria, can be passed on to the child by kissing on the lips, sharing of a toothbrush, drink or spoon with them by the parent or caregiver.
• Salivary disorders
• Stress to the mother during pregnancy
• Maternal smoking during pregnancy
• Poor dietary habits
• Poor oral and overall hygiene
• Family genetics

Babies who are solely breastfed, however, are not resistant to decay as a number of other causes may affect a baby’s possibility of tooth decay.

Even though a few studies may initially cause anxiety among mothers about the results of longer-term and night time breastfeeding, traditionally children who nurtured at night through breast feeding had little or no decay until the advent of decay-inducing foods. Human milk rarely causes to decay. On the contrary, it has a few tooth-strengthening assets. While parents need to be aware of the dangers of sugar-based foods and drinks along with the benefits of regimented oral hygiene and dentist visits, it’s important not to ignore the many health and emotional benefits of breastfeeding a baby.

To wean the baby from the breast because of uncorroborated worries of tooth decay would be denying a baby and his mom – the benefits from continued breastfeeding and may result in the needless introduction of feeding bottles.

The World Health Organisation recommends that infants be solely breastfed for the first six months of his/her life to reach optimum growth, development and health and then sustained breastfeeding for up to two years together with complementary foods.

It is also extremely important that Moms also maintain good dental hygiene. As magical as it sounds, motherhood can also be extremely exhausting and tiresome. Moms need to keep themselves hydrated, making sure they are taking in enough water or fluids, especially when they are breast feeding their babies. A dry mouth is an open invitation for cavities. Despite the hectic schedule that motherhood creates, it is important that moms carefully follow the regimental brushing their teeth twice a day. Moms who are pro-active with their dental hygiene will automatically ensure that they do not transfer cavities or germs to their babies.

“I have heard many moms blaming breastfeeding for tooth decay. But after my research, I can confidently say that breastfeeding does not tooth decay,” concludes Dr. Aarti. As mentioned above, there are several other factors that contribute to it. Primarily, the sugar intake, family genetics and poor oral hygiene by members of the family, specially the mother can lead to deterioration in the baby’s dental hygiene.

These studies have shown that mothers do not have to be in a hurry to wean off their babies and start bottle feeding for the fear of tooth decay. Both the mother and the baby can continue to enjoy the benefits of breastfeeding without worrying about tooth decay.

Don’t forget to download and utilize our free Patient Next Door app onto your smartphone. With it, you can share the healthcare journey of you and your child with people who are facing similar conditions.

The app isn’t just free, it is ads free!

As always, we here at Patient Next Door love serving you and hope you will join us in aiding others in finding resources and hope.

We care about you.

Disclaimer:  The article above may be controversial. As such we wish to state here that the opinions expressed in this post are the personal views of the author. They do not necessarily reflect the views of PatientNextDoor. Any omissions or errors are the author’s and PatientNextDoor does not assume any liability or responsibility for them.

– References
1. Brams M, Maloney J 1983, ‘Nursing bottle caries’ in breastfed children. J Peds 103(3): 415-416.
2. Gardner DE, Norwood JR, Eisenson JE 1977, At-will breast feeding and dental caries: four case reports. ASDC Journal of Dentistry for Children44 (3):186–191.
3. Kotlow LA 1977, Breast feeding: A cause of dental caries in children. ASDC Journal of Dentistry for Children44 (3): 192–193.
4. Arnold R, Cole M, McGhee J 1997, A bactericidal effect for human Lactoferrin. Science 197:263–65.
5. Mandel ID 1996, Caries prevention: current strategies, new directions.JADA127:1477–88.
6. Rugg-Gunn A, Roberts GJ, Wright WG 1985, Effect of human milk on plaque pH in situand enamel dissolution in vitro compared with bovine milk, lactose, and sucrose. Caries Res 19:327–34.
7. Erickson PR, McClintock KL, Green N, et al 1998, Estimation of the caries-related risk associated with infant formulas. Pediatr Dent20:395–403.
8. Ribeiro NM, Ribeiro MA 2004, Breastfeeding and early childhood caries: a critical review. Jornal de Pediatria80(5 Suppl):S199–S210.
9. Erickson PR, Mazhari E 1999, Investigation of the role of human breast milk in caries development. Pediatr Dent 21:86–90.
10. Palmer B 1998, The influence of breastfeeding on the development of the oral cavity: a commentary. J Hum Lact14:93–98.
11. Berkowitz R 1996, Etiology of nursing caries: a microbiologic perspective. Public Health Dent56:51–4.
12. Bowen WH 1998, Response to Seow: biological mechanisms of early childhood caries.Community Dent Oral Epidemiology 26(1 Suppl):28–31.
13. Palmer B 2000, Breastfeeding and infant caries: no connection. ABM News and Views, The Newsletter of the Academy of Breastfeeding Medicine6(4):27 & 31.
14. IidaH, Auinger P, Billings RJ, Weitzman M 2007, Association between infant breastfeeding and early childhood caries in the United States. Pediatrics 1(120): e944 -e952.

Facebook Comments
Share & Like: