Do I need to night wean because of cavities?

Were you told by your dentist to night wean your breastfed baby for concerns of it causing cavities? Extensive research has proven that there is no link between breastfeeding (nighttime or otherwise) and cavities. Breastfed babies can get cavities, though, so good dental hygiene is still needed.

Over three dozen studies have proven that cavities found in toddlers and young children (also called caries) were not caused by nursing – breastmilk is not cariogenic – but by an infectious disease classified as Early Childhood Caries (ECC). Furthermore, according to the National Institute of Dental and Craniofacial Research (NIDCR), breastfed children are less likely to develop ECC than children who are bottle-fed, and population-based studies do not support a link between prolonged breast­feeding and ECC.

According to La Leche League International (LLLI), “Breast­feeding is typically assumed to be a cause of dental caries because no distinctions are made between the different compositions of human milk and infant formula or cow’s milk, and between the different mechanisms of nursing at the breast [with the nipple at the back of the mouth, not allowing for breastmilk to pool around the teeth] and sucking on a bottle with an artificial teat. We have only to consider the overwhelming majority of breastfed toddlers with healthy teeth to know that there must be other factors involved.”

The Centers for Disease Control (CDC) also stopped using the terms “bottle-mouth” and “nursing caries” in 1994, thereby acknowledging early childhood caries as an infectious disease not caused by breast- or bottle-feeding. Most current studies now focus on the true causes of cavities in children, contributing factors, and prevention or cures.

Early Childhood Caries (ECC) appears on teeth as white spots, plaque deposits, or brown decay and can lead to teeth chipping or breaking in children under five. They are formed by bacteria sitting on the teeth which feed off of the sugars found in formula, juice, milk, and food. These and other factors, such as the frequency of feedings, oral hygiene, medications, other medical and dental conditions, determine the risk of your child developing a cavity. Once the pattern of decay begins, though, it can be extensive.

The CDC and the dental and medical communities consider ECC to be the most prevalent infectious disease of American children (5-8 times more common than asthma). Approximately 8.4 percent of all children will develop at least one decayed tooth by age two, and 40.4 percent by age five. Of these cases, 47 percent of children between the ages of two and nine never receive treatment. According to the CDC, “Untreated decay in children can result in chronic pain and early tooth loss … failure to thrive, inability to concentrate at or absence from school, reduced self-esteem, and psychosocial problems.”

While researchers have recognized S. mutans as the primary bacteria responsible for ECC, there are other surprising risk factors which make children more susceptible to cavities than others. Significantly high correlations have been found between ECC and pregnancy complications, traumatic birth, and cesarean sections. Other risk factors on the maternal side which increase the risk of ECC include maternal diabetes, kidney disease, and viral or bacterial infection. Babies born prematurely, with Rh incompatibility, allergies, gastroenteritis, malnutrition, infectious diseases, and chronic diarrhea are also at increased risk of cavities. Diets high in sugar AND/OR salt (such as French fries and chips), iron deficiency, pacifier sucking, and prenatal exposure to lead are also ECC risk factors.

Along with these risk factors, what can cause cavities are nighttime bottles and not brushing teeth before bed once baby has teeth, and especially if they are also eating solid foods. Bottles allow liquids to pool in baby’s mouth and sit on baby’s teeth for long periods of time. Breastmilk doesn’t pool in the same way because milk only flows when baby is actively sucking. When baby is latched appropriately to actually express breastmilk, it enters the baby’s mouth behind the teeth. If the baby is actively sucking then he is also swallowing, so breast milk doesn’t sit in baby’s mouth like it can with bottles. Sugars from table foods can sit on the teeth and bacteria in saliva uses these sugars to produce acid, which in turn causes tooth decay. Actively brushing baby’s teeth twice a day helps reduce these sugars from sitting on the teeth.

So no need to night wean for cavities… but if you need the sleep I completely understand.

When can you take your child to the dentist for the first time? As soon as they have teeth! This is Peachy’s first cleaning at 19 months. We went a little later than when I took her sister for the first time, but #COVID. I highly recommend finding a pediatric dentist who have staff that are highly trained with working on tiny tots. It will make the experience so much better. Having movies on the ceiling didn’t hurt 😉