Breastfeeding, Bottles, Pacifiers and Your Baby’s Teeth

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How you feed your baby affects not only overall health but also your child’s risk of tooth decay. Some babies continue to suck — on a bottle, pacifier or other object — long after it’s needed for nutrition. This habit also can affect how your child’s teeth line up.

But following simple tips about feeding and mouth care can help to prevent tooth decay in young children.

The process of tooth decay begins with feeding. Milk, juice and other carbohydrates that nourish your baby also can “feed” the bacteria that cause cavities. As they eat, the bacteria produce acids that attack the minerals in teeth. Children usually acquire these germs from their mothers early in life.

Some studies have raised concern that breastfeeding — particularly prolonged breastfeeding — may lead to early childhood caries. Other studies have found no such link.

Eating foods that contain sugar can speed up tooth decay. Decay also occurs earlier and is more severe in children who eat or drink often during the day, with little time between snacks.

Tooth decay speeds up the most at night. That’s because saliva flow slows down at night and during sleep. Saliva helps to protect teeth against decay. Any food or drink consumed just before sleep or during sleep can stimulate the decay process.

The American Academy of Pediatric Dentistry fully supports breastfeeding. But it says that breastfeeding a child throughout the night “should be avoided after the first primary tooth begins to erupt.”

Cavities serious, even in baby teeth

A recent national health survey sponsored by the Centers for Disease Control and Prevention reports that about 23% of U.S. children ages 2 to 5 have had some tooth decay. Dentists call it early childhood caries.

Why worry about cavities when a baby’s first teeth will fall out anyway?

Early childhood caries can destroy teeth rapidly. It can put your child at higher risk of having cavities throughout life. Decay often causes pain. It can lead to a dental abscess, root canal treatment or tooth removal. Some treatments may need to be done in a hospital under general anesthesia.

If baby teeth are removed or lost early, nearby teeth can move into the empty spaces. This can cause the adult teeth to come in crooked or crowded.

The first sign of early tooth decay may be small white spots or lines on your child’s teeth. If you see them, contact a dentist as soon as possible. You need to act before decay becomes worse.


Preventing early tooth decay

Keeping your child’s mouth healthy can almost always prevent tooth decay. This requires healthy eating, regular brushing and flossing, and visits to the dentist.

You can take steps to protect your child’s teeth through proper care:

  • Clean your baby’s teeth and gums with a clean, damp cloth, gauze pad or soft toothbrush at least twice a day.
  • Take your baby to visit the dentist as soon as the first tooth comes in, or no later than the first birthday.
  • If you have had cavities yourself, take special care to avoid sharing your mouth’s bacteria with your child. This can happen in many ways. For example, you may taste the child’s food, then use the spoon to feed your child. Or you may allow your child to suck on his or her finger after putting it in your mouth.
  • Make sure your local water contains enough fluoride. Fluoride helps prevent tooth decay. If your water doesn’t have enough fluoride in it, ask your dentist or pediatrician how to manage your child’s fluoride needs.

Following these feeding guidelines can help to prevent tooth decay:

  • If you can, breastfeed your baby for at least a year. That’s what the American Academy of Pediatrics (AAP) recommends.
  • Establish sleep routines early in your baby’s life. According to the AAP, by age 6 to 8 weeks babies should learn how to get to sleep on their own without being rocked or fed. By age 6 months, most babies should be able to sleep through the night.
  • Avoid long periods of breastfeeding, particularly when your child is very sleepy or falling asleep at the breast.
  • Do not allow your child to walk around with a bottle or sippy cup to continually drink from or use as a pacifier.
  • As your child begins to have other liquids and solids, limit foods that contain sugar. Discourage frequent snacking. This is one of the most important things you can do to reduce your child’s risk of cavities.
  • Teach your baby to drink from a cup by his or her first birthday. Provide milk or water, rather than juice or sugary drinks.

Are pacifiers a problem?

Sucking is a natural reflex for babies. It often brings comfort even after a child no longer needs the breast or bottle for food. Many children suck on hands, fingers or pacifiers. Parents often wonder if these sucking habits can create a problem for a child’s teeth or mouth.

During a child’s first few years, sucking habits probably won’t do any damage. But frequent and long-term sucking can cause problems. This is especially true if the habit continues after baby teeth start to fall out. Long-term sucking can cause:

  • The top front teeth to slant out
  • The bottom front teeth to tilt in
  • The upper and lower jaws to be misaligned
  • The roof of the mouth to be narrower side to side

Here are a few things to consider if your child uses a pacifier:

  • Buy products that are constructed as one piece. There shouldn’t be any parts that can break off. Loose parts could be swallowed or breathed into the lungs.
  • Never fasten a pacifier on a string or necklace around your child’s neck. Your baby could accidentally be strangled.
  • Don’t try to calm a fussy baby by dipping a pacifier in honey or sugar water. This will increase your child’s risk of tooth decay.
  • Use praise and rewards to encourage older children to give up the pacifier.

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