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Early Childhood Cavities?

Oh, no -- could it be?  Cavities at such a young age?  Nursing caries, perhaps?  Any experience to share with Maria?

Few weeks ago I noticed some tiny black dots on my 13 month old baby's front tooth. When I asked the pediatritan about it she was very quick to "diagnose"" early childhood cavities. What??? the one and only pice of sweet food that my boy has ever had was this all organic-homemade-blueberry cake for his birthday. He is still breastfeeding and I cook all meals for him from scratch. I chose not to give him the fluoride and hope not to have to do it. I don't understand... no candy, no ice cream, no juice...what went wrong then? The cavity seems pretty small and I am meeting with the pediatric dentist very soon but what do you mamas know about this?

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I may be wrong, but I think ALL foods, including breast milk, can leave nutrients on the teeth that can grow into plaque. uM, wasn't there a post about this before, and with some good advice about dentists for children?

There was a previous post on this:

http://urbanmamas.typepad.com/urbanmamas/2006/05/seeking_advice_.html

And here is a link to a related article in Mothering:

http://www.mothering.com/articles/growing_child/child_health/cavities.html

We had this situation with Mila but not with Gael.

It turns out that having a fever during pregnancy and/or taking antibiotics can affect tooth integrity in an infant - Jen had both of these issues while carrying Mila.

Also developing teeth before 5 months of age increases the risk of cavities (true for both kids). Basically, this is a situation that sometimes there is really NOTHING you can do to avoid it.

As for addressing it, as always our recommendation is Dr. Pike.

Before panicking too much, I'd wait to see what the dentist says. My three year old has had several discolorations/dark spots on her teeth over her years, and each time the pediatrician has thought they were cavities, but the dentist decided otherwise. Maybe your situation will be the same?

Yes, breastmilk can unfortunately cause cavities, especially if nursing them to sleep ... anything pooling against the teeth can do it ... we've been instructed to really wipe down our daughter's teeth with a cloth at least twice a day and not give her anything to eat/drink besides water before bed .... this is one of my greatest fears, and it's great it was caught early if it is indeed cavities! Good luck and let us know what happens!

Milagros is right on it. I've certainly done my own share of worrying about my son's teeth. I had a high fever in the seventh month of my first pregnancy, and then my son got his first tooth at three and a half months. Poor kid has had to deal with caps, fillings, even a pulled molar, and he's only seven years old. We found the first cavity when he was two, and we've gone to the dentist every six months since then. And he gets flouride! Now that he's had sealant on his teeth, we are all hoping for the best in his permanent teeth. My second son also got teeth early, at four months, but so far(knock on wood) he hasn't had any problems.
I've found that it doesn't hurt to get a second opinion from another dentist.

Imagine my suprise when our dentist told us on our second visit that our 4 year old son had FOUR cavities! My dad is a dentist and I'm almost obsessed with brushing my kids teeth. I (and my dentist dad) just about died. Our dentist (who did the most amazing job filling the cavities without inducing any anxiety or fear in our son) said that kids who eat lots of fruit for snacks are more prone to cavities because the natural sugars just sit on the teeth. He suggests protein snacks instead, leaving fruit to be eaten as part of a meal. Kind of goes against the traditional nutrition recommendations huh? I don't know how much this would hold true for a 13 month old, but thought I'd pass this on for other moms too.

Sorry to hear of your child's teeth problems.

Having read uM now for some time, I know that both this issue/fluoridation has been discussed more than once AND I know that some issues can get a bit heater...however, I do believe that we do have the opportunity here to gather some data (however rough) on this subject. So, if people do not mind me asking....

1) Did you give your child fluoride?

2) Did they or did they not get cavities before the age of 18 months?

Maybe the results will only be clear as mud. But, on the other hand, they might reveal something that may help mothers down the road with their choices.

Yes, we do fluoride. (In the vitamin which gets taken about 4 days/week). No cavities, no signs of decay at 3+ years.

Although I appreciate the idea of asking the question of did you/didn't you use fluoride, any response here will be totally unreliable and totally unscientific. All you will get is something that is as clear as mud.

With regard to choices for parents, I think that the starting point could be the guidelines from the American Dental Association (ADA) which include the following:

"Unless advised to do so by a dentist or other health professional, parents should not use fluoride toothpaste for children less than two years of age."

Further,

"Children should only receive dietary supplemental fluoride tablets or drops as prescribed by their physician or dentist based on the dietary fluoride supplement schedule approved by the ADA, the American Academy of Pediatrics and the American Academy of Pediatric Dentistry. Supplements are not recommended for children under six months of age."

These statements are included in the ADA's interim guidance issued late last year on fluoride intake for infants and young children:

http://www.ada.org/prof/resources/positions/statements/fluoride_infants.asp

Our little guy is almost six. He's never had a cavity. Yes, we use flouride. He has also been to the dentist for teeth cleanings every six months. I'm kind of absessive about teeth.

To me, the flouride debate is beside the point. Teeth problems can be in large part genetic. Your child may have teeth that are simply more prone to cavities.

My almost 8yo has never had a cavity. His almost 5yo brother, on the other hand, has had 3 fillings already. His teeth (says the pediatric dentist) have little pits in them where decay gets an easy foothold. Not because of anything we've done or not, just because. Both kids have the same healthy diet, brush twice a day under supervision with flouride toothpaste and have regular checkups.

You do the best you can, but I think sometimes teeth are just going to be the way they are.


PRESS RELEASE: Breastfeeding and Infant Tooth Decay
(April, 1999)

Infants who are strictly breast fed are more resistant to tooth decay than those who are fed sugar-rich foods together with infant formulas and cow’s milk. But when sugary substances are alternated with breastfeeding, breast milk becomes a dangerous catalyst that can lead to rampant dental caries.

Pamela Erickson, DDS, PhD and researchers at the University of Minnesota investigated the decay potential of human breast milk. In laboratory studies, breast milk alone did not damage tooth enamel. But when combined with another sugar source, the breast milk/carbohydrate combination is highly cariogenic. Results of the study were published in the April issue of Pediatric Dentistry, the Journal of the American Academy of Pediatric Dentistry.

Researchers concluded that breast milk prohibits acid and bacterial growth in the mouth. However, breast milk has a "low buffering capacity" and does not buffer the addition of acid. When breast milk is alternated with sugar, the rate of caries development is faster than that of sugar alone.

From an oral health perspective, pediatric dentists believe that breast milk alone is indeed the healthiest option for infants. But introducing sugar from food and beverages into the infant’s diet while breastfeeding is hazardous. Gaining proper nutrition from breast milk or food is the primary goal of infant health, and early dental intervention and monitoring may be the best way to prevent early childhood caries in the breast- and bottle-fed infant.

Pediatric dentists recommend that parents schedule their child’s first dental examination when the first tooth erupts or no later than the first birthday. Infants who are evaluated by a pediatric dentist at an early age are less likely to develop dental caries and oral diseases that can interfere with nutrition, learning to speak, or oral-facial development.

Pediatric Dentistry is the bimonthly didactic publication of the American Academy of Pediatric Dentistry. Pediatric dentists are primary care providers who also provide comprehensive treatment for infants, children, adolescents, and patients with special health care needs. aapd.org


I don't remember where I read this but it was an article about dental health saying that a big cause of cavities in kids sharing silverware, cups with adults. Something about the bacteria in adults' mouths causing kids' cavities. Anyone heard of this?

Hi there, I haven't heard of that, Shayne. Our 2 year old eats fruit and lots of various sugary snacks in addition to his healthy meals. He does get fluoride vitamins, as prescribed by the doctor, and only water after brushing his teeth at night. He has no cavities.

As someone mentioned, I think this is at least in some part (if not large part) genetic, and I'm not sure how much the fluoride does/does not contribute. But we do give it to him every day. So far so good.

Yes, there is data to suggest that the bacterium responsible for caries, Streptococcus mutans, can be transferred from mother to child.

http://www.ingentaconnect.com/content/bsc/ijpd/2002/00000012/00000001/art00002

Well, from anyone to child, but it's usually the primary caregiver who passes the bacteria along. I believe that's what happened to our son, who did use the fluoride drops starting at 6 months, and did in fact develop cavities at 12 months. I won't do the drops in the future.

Just a posting clarification - although my name is Tony Fuentes - Jen and I post here as Milagros.

On occasion I will post as Tony at Milagros. These are the only names that we post under. I do not post at T Fuentes and I did not post the the press release included here.

Either there is another Fuentes in the mix or someone has assumed a pseudonym that is close to my name.

If you ever see a post that I have made or any post that you THINK I have made and have questions about it or want to confirm that Jen or I authored the post/comment. Do not hesitate to contact us directly:

milagros (at) milagrosboutique.com

Peace.

1st we found an amazing children's dentist on NE Halsey: Krista Badger. She takes special care with each child and my son sailed through 4 visits without visible anxiety--in fact he was eager to brush his teeth afterwards!

2nd: I was horrified also as a parent to learn my son had several "surface" cavities at his first visit. He was a late (11 mo) teether but I did have a high fever in mid pregnancy. He also loves fruit--fresh and dried.

The challenging news is that no matter how careful you are, I believe it come down to a bit of genetics + nurture what you have. He loves fruit, so we try to steer clear of the dried fruits and avoid all the typical candies, etc. But still, hoping his adult teeth are not as vulnerable.

You are not alone!

Genetics plays a minor factor in dental caries. The components that cause dental decay are sugars/ carbohydrates in our diet + bacterial flora(strep mutans) in our mouth. This combination lowers the ph in our oral environment, causing a break in the enamel matrix. The enamel matrix is made up of ions consisting of hydrogen and calcium. Once this is broken down, Fl is the only component that can replace this loss in calcium.
My advice is to limit the amounts of sugars (breast milk included) and brush your childs teeth 2x a day with a nonflouridated toothpaste AND give them supplemental flouride until they have most of their adult teeth in. Dosage depends upon age. It is VERY important to have this supplemental flouride since Portland does not have flouride in its water system.

I stress this to my patients and always tell them that prevention is key. Come to the office every 6 months, use flouride, brush and floss.

Lenore Supnet DMD

Yeah, Dr. Badger got my 4yo through his three fillings with an ease that astonished me. She and her staff talk to kids in that annoying, sing-song "I'm talking to a little kid" voice that grates on my last nerve...but it doesn't bother my son and there was no fuss, no crying, no nothing. The strawberry-scented laughing gas helps too, I imagine...

I am prone to bad teeth and my 6 yr old is now having a time with her's.I wonder if it is a lack of something she's not getting? We brush 2x a day floss and we dont let them have suger.With 5 kids under nine a set of twins 6 mt suger is not allowed. Im scared she is starting to get her adult teeth and im wondering if im missing something?

I think breast milk can also cause cavities even though the baby is too young,thank you for this entry it could be a good subject to explore. keep posting!

by: florence

AnEmily is right; you should go for a second opinion. It's better to listen to the input of a few dentists so that you'll have a broader understanding of the problem. And don't panic! :)

You could always ask the dentist to send some samples to a dental lab to see if you child has any deficiencies, but cavities are increasingly more common amount infants. You may want to brush his teeth once a day to keep the bugs off :0)

Childhood cavities are not uncommon. They are very common among children because of their susceptibility to sweets and bacteria. So, as a mother, it is your responsibility to take good care of your children's dental physique.


Hi,
One has to be ever vigilant and well prepared for a Auto accident, and the untold trauma suffered during an incident. The best way in which a person involved in a car accident can recover the huge financial and emotional damages caused is to purchase St.Petersburg Florida Auto insurance coverage.

Dr. Pam Erickson was my professor back in pediatric residency years ago. We studied how nursing combined with other sugars can affect the baby teeth. Gathering more information about you and your particular child, we can help design a preventative and/or restorative plan to best suit your child.

It's definitely difficult to see your child develop cavities despite your best intentions.

Please contact The Kids' Dentist in West Linn if you have any questions.

Dr. Dana A Yip - The Kids' Dentist
grin@oregonkidsdentist.com
www.oregonkidsdentist.com

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