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Tooth Decay in Babies & Toddlers

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16 month old has severe tooth decay

August 2009

We need referrals for toddler dentists and homeopathic/herbal appreciating pediatricians. Our story : we asked our pediatrician about discolored front teeth when we went in for his one year check up. She said not to worry about it, it didn't look like anything. She knew I was still avidly nursing him, and we discussed night nursing etc. I asked if it could be iron or not enough calcium..? He has never been on antibiotics, went straight to a cup (no pacifier, no bottle, no sippy cup, no juice, etc....plus we wiped his little teeth with cotton towels all the time, and used a toothbrush here and there, although not religiously). The pediatrician dismissed all concerns. We decided to take him into a dentist anyway just as he turned 16 months (couple months later), and were horrified to learn that our child has severe decay, would need his four front teeth extracted asap(no chance even for a crown or filling it was already so bad !). The dentist blamed the night nursing - and we are still shocked this has progressed to this point ! I had to stop night nursing immediately. Weaning the day nursings and brushing scrupulously now. We need referrals for more alternative medicine type dentists and pediatricians - in order to save the rest of his teeth. Also, anyone have opinions about general anesthesia for tooth extraction for a 16 month old ? The dentist wanted to also put in space maintainers (like little false teeth on a wire arch cemented to his little molars !) I'm terrified. please offer any solution-focused advise/ encouragement ! Thank you.


My heart goes out to you-- I had a similar experience when my son's front teeth went soft and crumbly at age one and I know how horrifying it is to think that your baby may lose his teeth. The first dentist I consulted told me that breastfeeding was responsible and to wean him right away. I did lots of research and got a second opinion-- in which case the dentist said it is the acid pH of the mouth that determines decay, and that is a hereditary and diet issue-- find out which foods are most alkaline and avoid those that form acids in the mouth. He also said that lack of sufficient vitamins when the baby teeth were forming in early weeks of pregnancy (I was thin & vegetarian and didn't take vitamins until I knew I was preggo) could be a factor. He advised me to get caps put on but after my son underwent the general anesthesia the white caps proved to be too large for his teeth, and instead he got silver caps. This was a terrible trauma for me, as my adorable little boy had monstrous metal teeth and people assumed I'd given him candy and junk that harmed him. I continued to breastfeed him, I just think its too crucial and that Big Denta is too quick to blame/dismiss breastfeeding, but I did brush and monitor to get higher alkalinity in the foods we both ate after that. La Leche probably has some good info on this. At age 3 he got white crowns (also under general anesthesia, yes it is stressful but way better than anything else).

Your dentist's proposal sounds very invasive and scary, and the fact that s/he blames breastfeeding without parsing the other factors suggests you should explore other perspectives and options. Good luck, and remember, they're only baby teeth, it's not a life sentence-- my son is now a 12-year-old with a set of strong, healthy adult teeth that have never had a cavity! db


First get a second opinion. It just seems weird that the pediatrician has such a different opinion than the dentist. The dentist is asking you to do something so extreme, even a third opinion might be a good idea. sanon
Wait!!! Don't let them pull the teeth. I went through the same thing with my son at the same age a few months ago and I also posted frantic to the BPN. I saw a great dentist on Broadway in Oakland, Dr Denise Bass Allen and she has been a life saver! She applies a flouride temporary filler that has been able to keep his teeth from getting any worse while we wait for him to get old enough to sit through fillings and caps. The filler is orange unfortunately but in the big scheme of things who cares. It can stay in for days to months and when it comes out she's great about seeing us right away to refill them. It's very inexpensive and we don't have dental insurance. Our last dentist told us he had to have his teeth pulled also but he is just fine now and Dr Bass Allen is confident he can keep all of his teeth and she is supportive of my continuing to nurse. Good Luck and Keep Nursing! Dr Allens # 510 763-2022
This happened to us too. Our very good pediatrician really couldn't tell us anything about our son's front teeth, which were also discolored and looked worn down. I also night nursed, and when I took him to Denise Bass-Allen, a pediatric dentist on Broadway, she had just come back from a ped. dentistry conference where she learned that there is a particular type of bacteria that can be passed from mother to child via utensil sharing, etc, and some people are more susceptible to it and it doesn't bother others. But she told me I should not feel guilty, and that people have been nursing their children forever and this does not always happen. She was basically saying they are not 100% sure why it happens to some and not others but seemed pro-nursing with practical solutions like the rinsing and wiping, and getting the child to drink water, not juice, etc. Well, my son had 5 root canals with caps and crowns, and it was the worst day of my life, not because they didn't do a good job- they cared for him really well and she did a really beautiful job. It was just hard to see my 2 year old having to go through this so early. But his teeth are perfectly healthy now and we get compliments about our brushing on checkups. Please email me if you want to talk and I'll tell you all I can. There really does seem to be a shocking disconnect between pediatricians and pediatric dentistry.
''Nursing does not cause tooth decay,'' one BPN contributor opined last week. Unfortunately, she is wrong--nursing can definitely cause tooth decay, especially at night. Just ask my friend with twins, one of whom breastfed all night long even as a toddler, and one of whom always refused the breast (he drank a bottle at bedtime and then slept through the night). The nurse-all-night toddler ended up with four rotten teeth, and had to have four crowns put on (under general anesthetic). His twin brother has never had a cavity. If you're concerned about tooth decay, don't let your toddler nurse all night long. (I'm not talking about babies, of course.) My kids have no cavities
i didn't see your original post but nursing throughout the night DOES cause tooth decay. at least it did with my daughter. she nursed several times a night, i gave her the breast whenever she wanted it. she would fall asleep with a pool of breast milk dripping from her mouth. by the age of two she had four cavities. shortly after, i stopped nursing. it's been years and she has not had a cavity since. my son, who nursed before going down for the night and once or twice a night never had a cavity. nancy

13 month baby with cavity

March 2009

I have a 13 month baby that was dignosed with cavity.one of his teeth is in a realy bed shape.he is mainly nursing but i got him on solids too.i can tell that he has got another teeth infected,now my question is does anyone know a dentist with an holistic approach? I took him to two already but was blamed for not brushing his teeth,which i started to three times a day,and i have been told to win him from night nursing. My hurt is tataly broken to see his beautiful smile and knowing that i damage him with my milk Is there something i should add to his diet?pherheps calcium is missin? i am dessperetly seeking for advice thanks


Hello, In response to your child with tooth decay. My heart goes out to you. I would suggest you read Ramil Nagel's work, at curetoothdecay.com. He's a local bay area dad, who also watched his daughter's teeth decay and found solutions through diet and specifically from Weston A Price's work. I believe dentists at 1313 Gilman treat teeth from a holistic viewpoint. Best of luck. Runa
You should try Marin Dental Wellness. They are all the way in Corte Madera, but Dr. Brian Smith takes a holistic approach and is great! They treat cavities with a natural oxygen treatment that really helps in the healing. His # is 415-924-6551 I would also wean the night nursings if tooth decay is a problem! Try to wipe the teeth with a toothbrush or gauze of some sort a few times a day...after meals/snacks and before naps/bedtime. courtney

2-year-old with 8 cavities

March 2008

My 2yr. old son has 8 cavities the pedi dentist say may be due to nursing at night. The only way to fix the cavities would be to use general anesthesia for the procedure. I've been to two experienced pediatric dentists and they can offer no other alternatives. And they advise I stop Breast feeding. Does anyone know of any other holistic approaches to this situation??? I am heartbroken, and could really use some advice. Thanks. Jennifer S.


I'm sorry I can't offer any advice on holistic approaches. However, I just want to empathize. I know you are facing a difficult and very worrisome situation. My 2- year-old needed a partial root canal (and crown) and 4 other small cavities filled. I struggled with the idea of general anesthesia, but ultimately was SO glad we went ahead with it. My son was so wary of the dentist as it was. I think he would have been totally terrorized and traumatized if he had had any idea what was going on during his procedure. Instead, he was blissfully unaware. That night he even said ''That was a fun trip to the dentist'' because all he could remember was playing with the trains in the waiting area. There were, of course, risks involved with the anesthesia and he had a really hard time coming out of it, but overall the benefits greatly outweighed the costs for us. Liz O.
I cannot address the issue of nursing or how your child came to have so many cavities at such a young age. I did want to let you know that I had general anesthesia on my child to fill 6 teeth and it actually went pretty well. They squirted something up his nose to make him drowsy and then set up an IV for the general anesthesia. All he remembers is ''yucky medicine up my nose'' and then nothing. It was expensive but much less traumatic than more recently when he needed one filling and the dentist did it with him awake and scared. laura
General anesthesia is scary to most people, and nobody wants it for themselves or their children unless absolutely necessary. First and foremost I would like to say: Stop breastfeeding! The child is 2 years old, the benefits go way down after 13 months of age in terms of the health of their teeth - it actually becomes detrimental to the child's oral health. If you are not going to stop at least brush the child's teeth every time after breastfeeding --- and ESPECIALLY at night. Also floss their teeth once a day using little kid flossers.

In terms of the issue at hand you may have 2 choices:

1. You can get the treatment done with general anesthesia. it's scary, but most likely your child will be just fine, and will have no memory of the experience. It's a one time deal and you are done.

2. You can find a pediatric dentist who will use oral sedation (where the child is awake, but sedated) in combination with a papoose board. A papoose board is a restraining device, much like a straight jacket that holds the child in place while the dental work is done. 2 or 3 appointments may be needed to finish the dental treatment. This may be medicaly less scary, but may lead to long term major dental phobia for your child. Or you may be lucky and your child may remember nothing anyway. general dentist and mother


Nursing baby to sleep - bad for teeth?

Dec 2007

I've heard that letting a baby nurse itself to sleep can lead to a terrible kind of tooth decay... does anyone know if this happens? My daughter is 6 months old and has her 2 front bottom teeth. I nurse her to sleep every night and throughout the night if she wakes, is this safe? Also, should I be brushing her little teeth yet? Kate


Yes, you should be brushing her little teeth. Your dentist can recommend a gentle little children's toothbrush. Cavity-free kids
Hi, I nursed (and am still nursing) our almost 3 year old to sleep for most naps, bedtime and during the night. He was seen by a dentist at 18 months and just recently and has good teeth, no cavities. We are very careful to brush his teeth well at bedtime and don't eat a lot of sugary snacks. We are starting to brush in the morning as well which I should have started a while ago. I think a lot of tooth problems are genetic. Also, if you do some research, you will find that there are groups that support night nursing. Nursing is quite different from giving a bottle through the night. I believe we started with just wiping the new teeth with a clean cloth and after a while gave him a toothbrush to play with and chew on before we really got going on the toothbrushing. Take Care. Supporter of night nursing
This totally happened to my daughter. By age 3 she had two severe cavities in her front teeth that were attributed to night nursing -- I nursed her A LOT at night until she was 2 1/2 years old. Because of her age and her fear of the dentist we had to have her cavities filled using general anesthesia. It was less traumatic for her, I think, since she was asleep the whole time, but very expensive and stressful for us. That said...I am now nursing my 2nd child at night as well. For our family, the benefits of nursing and co-sleeping outweigh the desire for a cavity-free child. With our 2nd baby, though, we are definitely more conscious about brushing his 4 little teeth every morning. So my advice -- keeping nursing and start brushing! Survivor of child cavities I nursed both my girls to sleep and through the night until they were both around 2 years old. Their teeth are fine. Mother's milk has anti-bacterial qualities so I wonder if that helps. After they started drinking cow's milk (with a little chocolate), their pediatrician did tell me to have them drink a little water after a bottle at night. We didn't really start brushing until about 2 years old. anon
I nursed my baby to sleep and through out the night all the time and she never developed decay. When her first baby teeth finally arrived I did buy one of those baby ''tooth brushes'' that you stick on your finger so you can brush their gums and baby teeth. I don't remember how often i did it. I think it may have been once a day at the most. I would just use a very very tiny amount of flouride-FREE tooth gel for babies and toddlers and rub it around. It was more to just get her use to the feel of it. I did not try to brush right after nursing, because she was always alseep. And I don't think i brushed every day either. However, once I started introducing solids into her diet, that's when I was much more careful and made sure her teeth and gums got brushed every day before going to bed. I think the starches in things like rice cereal, and the sugars in fruit and juices, are more to blame for early tooth decay. I think an early brushing regimin is always important, especially as soon as starchy solids, fruit or juice is introduced into their diet. My duaghter continued to nurse all the way up until she was 3 1/2. And during that time she always woke up once in the night to nurse. She never got a single cavity. Since she was about 2 or 3 years old she has been seeing the dentist regularly (every six months). Today she is 7 years old, brushes her teeth twice a day and is still cavity-free!. Start those good brushing habits early and get one of those baby ''tooth brushes'' that you put on your finger. And enjoy all the nursing while you can, day or night. What a wonderful experience and so healthy for your baby. Anon
There are a lot of factors and I am sure you will hear a lot of different opinions and experiences. Here is some simple advice. Yes, keep nursing her to sleep as long as you want to, it is tough enough having a 6 month old and nursing makes life easier! But it is good practice to start brushing now. When she wakes up from a nurse induced slumber, give her a quick brushing with a soft toothbrush and water. If she has a starchy snack or juice, brush and/or give her water after to rinse. And keep an eye on her teeth and get her to the dentist if you see anything worrying. Brushing twice a day should keep the cavities away. Now is a great time to start good habits. Nurser and brusher
I'm sure you'll get lots of responses about this. I thought the same thing, especially when I brought my son to the dentist and he had three cavities at four years old!! My son's dentist said, and I've heard this from other sources, that night nursing does NOT cause tooth decay. True, there is lots of 'sugar' in breast milk, however, it comes down to bacteria in the mouth! In other words, a predisposition, which would be the type of bacteria that is in a person's mouth causes the weakening of the enamel which then allows an environment to support decay. Perhaps, this is where genetics comes in b/c typically, families share the same bacteria by sharing foods, etc. If you are concerned, you can always sweep through her mouth with a gauze pad after she nurses.... As far as brushing goes, they have those soft brushes you can put on your finger and brush your baby's teeth. Also, you can use gauze (as suggested above) on your finger to brush them. You absolutely should start brushing them as they sprout out. You don't need toothpaste yet, just water and the brush or gauze. anon
My opinion on this is purely anecdotally- and not scientifically-based. Here are the anecdotes: A) I have 3 kids all of whom were nursed to sleep for some length of time and none of whom had their teeth brushed following nursing EVER. The oldest two started having their teeth brushed at about 2 yrs of age and began regular visits to the dentist at 4 yrs. They are now 8 and almost 6 and have had one tiny cavity each. My youngest is 2.5 and has been having his teeth brushed for about a year now. He nurses at night but not to fall asleep, but he doesn't have his teeth brushed after nursing. He will go to the dentist for the first time next spring. His teeth seem pretty okay. None of my kids are big-time sugar eaters and do not consume soda but once in a GREAT while. B) My best friend has 2 kids. Nursed them both to sleep. Started tooth-brushing when teeth first started appearing. Visits to the dentist began shortly after the 2nd birthdays. Both kids enjoy candy (not to great excess, but on a frequent basis). Both kids have had multiple fillings/cavities at more than one dental visit. They are 8 and 4. In situation A, the parents have fairly good teeth histories (the mom has never had a cavity ever). In situation B, both parents have difficult dental histories. My opinion is that the teeth deal is genetic. Yes, a program of good dental hygiene can really help and is very, very important. But some people are born with good teeth and some aren't. Not sure if that helps at all. In your situation, what both my friend and I did was nurse the baby and sleep. Brush later. anon
Many babies are nursed to sleep and nurse during the night. There are many misconceptions around tooth decay and nursing. What I have heard is that babies swallow the milk and it doesn't usually pool around their teeth. Also I have heard that mother's milk has properties not present in formula, which prevent the decay. My children nursed themselves to sleep for years, and have beautiful strong teeth. You can contact La Leche to see what their latest advice is. I support you in taking such great care of your young baby. Nursed my babies too

21-m-o's tooth decay caused by night-time breastfeeding

Sept 2007

I've just taken my 21 month old daughter to the dentist for her first check-up. The dentist was very kind and applauded me for bringing her in, but also had to tell me that she has the first and tell-tale signs of tooth decay, probably due to the fact that not only are we still breastfeeding, but she drinks a lot of milk and she nurses at night. I have done so many other things hoping to not add to the potential for early decay. She does not drink juice and she doesn't drink from a bottle. But, she is not a good sleeper and I take full responsiblity for our continued night nursing for all these months. Any advice about this issue would be so appreciated. Anything from suggestions on how to stop the night nursing (she pitches the most unbelievable fit) to what the actual consequences are? I need to do more research and will continue to talk to my not-quite- two year old about why the milk at night is going bye-bye. Thanks! Lynne


I nursed my son all through the night until he was three, and at age 4 1/2 he has 7 cavities. I was quick to blame the nursing, too, because he doesn't eat much candy and his oral hygiene is good. I saw two dentists and they both told me that it was probably genetic. Some kids just get cavities - I know I did as a kid, and my adult teeth are cavity-free. So if you want to continue nursing, I think you should do so without worry.

If you want to night-wean for other reasons, here's what I did: I intended to have an honest, kind-but-firm conversation with my son about why the night nursing had to stop, and follow through consistently. It turns out that I am way too much of a softie for all the crying, begging, negotiating that ensued. I ended up taking the advice of my kid's dad and a lot of friends. I put some crushed garlic on my nipples (anything stinky will do) and told him the milk went bad. It sounds ridiculous, but it worked like a charm. He moped around some and I felt horribly guilty for being deceptive, but there were no tears AT ALL and that very same night he slept through the night without waking for the first time since birth. We also had a weaning mini-party a few days later which he liked a lot. anon


I know how you feel. My son developed tooth decay at that age. It killed me to see it. But I finally asked myself, what is more important? One baby tooth or my child's healthy emotional development? If your child needs that night nursing, you don't have to let this stop you from giving her the comfort she needs during the night. You will have people tell you to wipe or brush his teeth at 3:00 am after a nursing, not practical if you have a light sleeper. You will have people imply that your toddler shouldn't be nursing at night or at all at this age. But I hope you'll consider continuing to nurse your child during the night. Just see your dentist regularly so he or she can monitor that tooth. I nursed my sensitive guy until he was almost three, including night nursings until the very end. He has one filling and, at four, he is sleeping through the night in his own bed almost half the time. He has a beautiful smile. Good luck. Kept Going
Hi, I'm sorry to hear about your daughter's signs of tooth decay. I night-nursed my daughter until she was 22 mo; I think that the reason she didn't ever experience dental caries was because of her (and my) diet. When she was about 18 months old I found out about Weston A. Price, DDS, a dentist from the 30's who wrote ''Nutrition and Physical Degeneration''. As a private-practice dentist, he wondered why in the 20 preceding years he had seen such a jump in tooth decay, especially in children, and wondered if traditional societies had the same problems. He went out and studied them all over the world, and the result was the aforementioned book. Essentially, Western processed foods (including refined flour and sugar, and pasteurized milk) are responsible for many of the health problems we take for granted, including tooth decay. The most isolated traditional peoples had virtually no tooth decay, even though they didn't brush their teeth, and similarly low levels of orthodontic problems or degenerative diseases such as diabetes, arthritis, or other immune system problems. Their diet of course had no processed foods in it, but also had lots of things that we have forgotten or have been told are bad for us, such as fermented foods and animal fats (the key being that these animals were not raised in factory conditions like the bulk of ours are).

Anyway, it's a bit much for someone just starting out; I recommend the www.nourishingourchildren.org website for a good overview of what dietary changes would be most beneficial for kids and why. We have been eating much better since we started reading about this stuff and putting it into practice, and my daughter (who was somewhat thin at age 15mo) is now strong as an ox at age 3.5. I'm currently 38 weeks pregnant as well, and I'm interested to see the difference in a baby that's received superior prenatal nutrition. Good luck to you and your family. --WAP mama


This same thing happened with my third child. I breastfed all 3 the same, including on-demand breasfeeding at night, but only the last one had any dental problems. I just had to quit cold turkey (it is actually one year ago today as I write this). She protested for about 2 days, but then forgot about it and hasn't looked back since. I had to go this route because I brushed her teeth 2 times a day and had them fixed my the dentist but it still wasn't enough. I even had to put flouride directly on her teeth so I decided her dental health was more important. ARA
here's what we do: i've noticed that when i brush my kids' teeth, if afterwards i use my finger to scrape near the gumline of the inside front teeth and the molars, i almost always can scrape off more plaque. so i wipe with a baby washcloth as the first step in cleaning (making sure to get down near the gumline), then floss, then brush, then swish and spit a couple times. my kids have learned to tolerate it. we do this at bedtime, and just brush/swish after breakfast.

also the probiotic L. Reuteri has been shown clinically to stop the growth of S. Mutans, the cavity bacteria: ''Lactobacillus reuteri in bovine milk fermented decreases the oral carriage of mutans streptococci.''http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=15282133&query_hl=2&itool=pubmed_docsum

if you search in the LLL website, they have a couple of articles that you can view online.


26-month-old has 5 cavities - dentist says stop breastfeeding

Jan 2006

My daughter has 5 cavities (2 behind her front 2 teeth, 1 on the front, and 2 on 2 separate top molars). She's 26 months old and we are looking for a gentle dentist who would help us to fill her cavities without using anesthesia. We've been to a pediatric dentist and the first thing they told us is that they want to sedate her for the procedure, that I can't be with her in or during the process, and to stop breastfeeding her. WE're looking for a dentist who will look after her emotional needs as well as physical. She's very afraid of the dentist and I think that if we found someone who paid a little attention to her and spoke her language (and let us take the time we needed for her to be comfortable there) that she might be a little bit more cooperative. Does anyone know of a dentist who has who could help us with our situation? What have others done who've had a little one with dental caries? Any help would trully be appreciated. kathleen


Look into laser dentistry. It is a quick and anesthesia-free way of repairing cavities. Drs. William Gianni and William Tenant in Berkeley do both laser and conventional dentistry. I went to Dr. Gianni for the first time this summer and it was great. No drills, no anesthesia, no pain. Removing the cavity with the laser pulse took less than a minute. It didn't hurt at all. It just felt like a little tap-tap-tap. The longest part was filling the cavity, which was only about 5 minutes. I don't know if they work with children so you should give them a call to find out. Dr. Gianni was very nice and I can imagine he would be good with children. (510) 848 3143. Alexis
Vivian Lopez, D.D.S. and an assistant name Tanya, are amazing! They really connect with my son and take their time and talk to him in a child appropriate way. We just go for regular check ups with them, but at 18 mos, he had about the same amount of decay as your daughter. Email me for more info. Vivian Lopez is on Telegraph near Ashby in Berkeley. andalove
I was saddened to read how your daughter already has cavities. I highly encourage you to read about Dr. Weston A. Price's work as he proved how the teeth reflect overall nutritional status. He was able to remediate shallow cavities in children with the use of vitamin A rich foods and raw milk. For information on both, go to www.westonaprice.org and www.realmilk.com. As for dentists who can help, I suggest the team at 1313 Gilman (Rusta, et alia). They are biological dentists and have expertise compatible to the principles of WA Price. They are especially good with kids. Nori Hudson, NC
We experienced the full range of dental traumas when my daughter was that age (an extraction, restraints, verbally abusive dentists, sedation, etc.) Sedation with a low dose of valium paired with nitrous, administered by a reputable pediatric dentist, turned out to be the best approach for us. Mostly because my daughter did not have to be restrained and had only fuzzy memories of the experience after the fact. Once she was afraid of the dentist, nothing else really worked. After we got the initial work done, we went back to working with the dentist on helping her feel better, and after a few years she was no longer afraid. As for the dentist's advice to stop breastfeeding, I listened to what they had to say, did a little reading, and quietly ignored it. I hope someone else will know the dentist who can calm her without meds, but this was my experience. been there
I'm sure I won't be the only one who suggests you find a NEW DENTIST! There are many pediatric dentists out there who do not blame breastfeeding for everything, and will welcome you to stay with your child during any procedure. Check the archives and ask around. R.K.
When my then 28-month old son was found to have 8 (!) cavities, we were referred to Dr Edward Matsuishi in El Cerrito. Dr. Ed was very understanding and kind to me and my son, and did NOT recommend eliminating breast-feeding (which I did then and continue to do now -- though I HAVE given up night nursing!). I appreciated his advice, which was mainly to cut out sugars from the child's diet, esp juice, but keep breastfeeding as long as the milk doesn't ''pool'' in the mouth -- don't let the child fall asleep while nursing! As for anasthesia, I invite you to re-think your position on it. Though we were scared at the prospect, the thought of putting my son through multiple visits to have fillings was unthinkable. The anesthesia was actually BETTER in that the work gets done all at once, and the child has no memory of it (and thus does not compound the fear of dentists).

Dr. Ed hires an outside pediatric anasthesiologist from Children's Hospital to administer the anesthesia. They are well-trained in anasthesia and ER procedures, and do this all day every day. We were there with the anasthesiologist and our child in the waiting room, while he administered a sort of Valium-like drug in my son's nose (he did this cleverly and non-traumatically -- the idea is it relaxes the child before the actual anasthesia is administered). We did sit with our son during the first part of the anasthesia, until he fell asleep. Then we left the room. Afterwards, he was given to us to hold as he gradually woke up. We were very happy with the results, and are so glad we did it this way (and believe me, we were VERY concerned). Good luck to you. Christine


I highly recommend the pediatric dentist office of Dr. Katsura & Miahara. I don't know what their policy is for anesthesia for younger kids, but my 4 year-old has had her cavities filled (using just local anesthesia) in their office, and they are excellent, very family-oriented. Parents can go in with the kids, and sometimes they can actually lay down on the chair and hold the kid on top of them. Their office is full of toys, pictures, books and nice stuff that really attracts the kids and makes them feel more comfortable.

On the other hand, my daughter also had dental work done when she was 20 months-old (at a different office) and they gave her a mild sedative, which really didn't do much. She was wide awake and fully aware for the whole time, and, needless to say, it was very traumatic both for her and for us hearing her cry so hard. I really wish they had given her full anesthesia.

In summary, I do advice that you take her to a pediatric dentistry office, it's worht paying the difference, and trust what they think is more recommendable for your kid (w/ or wo/ anesthesia). Toni


I recommend the practice of Wampler et al. Our daughter started there (with cavities) at about 18 months. They worked with us and particularly with her to help her get comfortable. Also they were open to our preference to do less permanent ''scoop and fill'' filings, which are less durable, but less invasive. They started out ''counting her teeth'' and ''painting'' them with flouride varnish, and only did the scoop and fill when she was comfortable enough to tolerate it. She also sat on mommy's lap, and at first we practiced at home with a mask and gloves the dentist gave us, then daddy ''helped'' at the dentist and she would open wide for me and let the dentist work. These last parts were more our inventions then something suggested by the dentists, but they were always willing to work with us. BTW, we paid out of pocket to go to Wampler et al., after trying the UCSF clinic and having a horrible experience with a pre-doc student with no pediatric training. There is considerable difference in what different pediatric dentists think is ''necessary'' as far as general anesthetic, strapping the kids to boards, etc. It's worth it to find someone to work with who is gentle and willing to work with you, so your kid forms a good feeling toward the dentist. Our daughter is now (at age 7) a model patient at a clinic which accepts our (Healthy Families) insurance and even gets excited about going to the dentist. Peter
Our pediatric dentist is WONDERFUL. Dr. Miyahara, 528-1526 or 848-6494. She is extremely sweet and gentle. I hear the other dentists in the practice are also great. However, I can't imagine she or any other dentist could possibly fill cavities in a toddler without general anesthesia. My children have not had fillings, but I've had many myself. Have you had fillings? The sound of the drill alone would make it impossible for my children to sit still and if they didn't I imagine they could get injured. Additionally, the pain involved in filling an unanesthetized too would be unbearable for a child. It is for me as an adult. I think the best to hope for is a local rather than a general anesthetic, but I believe even then the situation (noise, intrusion) would be intolerable for most small children and their consequent agitation would make it impossible to fill a tooth safely. Liz O.
My five year old just had to have a cavity filled and our dentist recommended that he go ahead and fill it without anaesthetic, because the pain of the injection and the pain of the procedure would be roughly equivalent (the cavity was shallow), and our son might not be willing to let the doctor proceed after he put the Novacaine in. I let him proceed, and my son, who is very sensitive, came through with flying colors. I would highly recommend our dentist (mine and my sons') for gentleness and caring. His name is Eric Citron. (510)849-1660. heather
It sounds like what you are dealing with is as much a values conflct as one over appropriate medical care. It would probably be worthwhile for you to talk to several dentists to find one with whom you feel you can communicate better than your daughter's current dentist. Our daughter sees San Francisco pediatric dentist David Rothman, and has since she was a toddler. I think she gets excellent care, and she loves going to the dentist. Our situation is somewhat different from yours in that she has never had a cavity so we've never had to face the issues you are facing, but I've found that Dr. Rothman shares my family's values which makes everything much easier. He has two offices, one on Union St. and one on Ocean Ave. Good luck! Lisa
I take my 12 year old and my 26 month old to Dr. Leticia Mendoza-Sobel on Grand ave. at the Oakland/Piedmont border. She is the best! When my 12 year old was about 3 we had a horrible experience with a doctor that reluctantly let me in the room during the procedures (8 cavities.) When I took her to Dr. Mendoza she first did a series of ''behavior modification'' appointments where she had us come in when no body else was in the office just to talk to her about the office and the equipment and the procedures and encouraged her to ask questions and just got her to feel very confortable. They always asked my daughter if she wanted me to come in with her. Dr. Mendoza invited us to ''behavior modification'' as soon as the second child was 6 months old and now both my kids look forward to going to the dentist. I know she is there only part time now but I understand that her practice partner Dr. Negron is pretty good too. veronica

Decayed teeth in toddler nurslings

May 2003

I have a 27 month old boy who still nurses to go to sleep at naptime and at nighttime 2-3 times. My question is for those mother's who nursed this late and later and if their child got decayed teeth because of it. A dental professional freaked me out today telling me that it causes decay and she sees it often. She says it causes decay as much as milk bottles at night do (bottle mouth) She is a teacher at the Dental School of the Pacific. Also, when to send your child to first dental visit. worried my baby will get decayed teeth and then that'll really be fuel for those, like my mother, who think I'm nursing to late. worried mama


We have 2 little ones who nursed until age 4 years (night, morning, during the night), and both have gorgeous teeth, no cavities, and even after injury ( smashing the front teeth due to bad falls, to the point of almost losing them) no problems. we recommend also our very responsive and supportive dentist, dr. vivian lopez (on telegraph). our weanlings are now 4 and 6 years, and doing great. good luck! frieda
Hi, Your child nurses more than either of my did (do). My son nursed until 3+ and his teeth are fine. My daughter now 2+ still nurses and her teeth are rotten. She has had one tooth pulled, two root canals with caps, and cavities. My advice is to keep nursing when your child is awake but stop at night just in case that is how the rot happens (dentist advice). La Leche Leauge says that kids will get cavities despite nursing not because of it. Let a dentist have a look and go from there.... anon
My older daughter nursed until 27 months, and had 4 cavities before she turned 3. Some of my friends have kids who nursed in a similar pattern and have absolutely no problems with their teeth. So yes, it can happen. For us, I'm pretty sure that halfhearted brushing and middle-of-the-night doses of Advil when she was teething were both contributing factors. Your post doesn't say whether you're religious about brushing, but I'd highly recommend that. 27 months isn't too early for a dentist visit. My daughter's first visit to our family dentist, Dr. Meeta Doshi, was completely non-traumatic. She gave my daughter a ride up and down in the chair, set her up with sunglasses for the bright light and a toy for each hand, and ''counted'' her teeth while checking each one. The whole thing took less than 10 minutes, and my daughter (2 1/2 at the time) thought it was fun. With my second child, I'm still doing some night nursing, and brushing teeth. So far so good. Jennifer
Maybe you need to find a new dentist? My daughter still nurses herself to sleep after five years (plus a lot of night-time nursing until age 4 or so). Although she did have one small cavity at 2 and another at 4 her dentist specifically said that her night nursing is probably not the cause--- he thought it was most likely genetic. Apparently, bottle-caused tooth decay has a specific form (I think it occurs behind the front teeth); he said he'd never (or rarely?) seen it in nursing kids. After the second cavity, he did seal her back teeth with some kind of sealant; no cavities for the last 3 checkups. We moved here only recently, but I imagine there must be some nursing-friendly dentists around the Bay area! I'll be reading the posts to find out myself! Karen
I nursed my first for 2.5 years- day and a lot at night, and he has perfect teeth now at 5- no cavitities. I was pretty lax about brushing his teeth until after I stopped nursing, but now I am pretty strict. However, I have a friend who also nursed a long time, and her kids teeth did decay. I think part of it is genetic. So, try to brush once a day, and don't worry to much. It seems like all health care professionals are against long nursing, and I think mostly because they do not have a lot of data, and they guess. Dentists- FIND A PEDIATRIC DENTIST. I like Wampers/Katsura. They start at 3 years old- but will see a 2.5 year old if you are really worried. Trust your instincts. Lisa
I nursed my twins until they were 27 mos. too; day and at night. One of my boys did have two cavities in his molars while the other one didn't. I personally feel that this was caused by incompletely closed molars which I had as well as my mother. Especially since only one child had them and not both. There was an article in Mothering Magazine that came out around Sept/Oct 2002 that aruged against the notion of nursing causing cavities. It made me feel a lot better. Don't other mammals nurse their young when they have teeth? Why should it be different for us? Read the article if you can get ahold of it. That's the magazine I go to for support on many of the less common child rearring practices such as co-sleepnig and nursing a toddler etc... cb
Dentists often blame nursing when a child has dental caries. This is simply not true. Go to lalecheleague.org and find good support and additonal information on the subject of nursing and dental caries. Usually genetics plays a stonger role in dental caries than anything else. I am a LLL Leader and Lactation specialist. and know this to be true in most cases. Teresa
It's genetic so nursing is not to blame; decay would happen anyway. My older son had cavities and my younger did not, and the younger actually nursed longer (stoppped at age 4). So find a nursing-friendly dentist (wasn't there a discussion on this a little while ago?) to fill the cavities, and brush a lot. Oh, and no sugary or starchy snacks (in our case, I think jellybeans played a role). By the way my dentist is not a nursing advocate so I would just smile and nod a lot when he was telling me no night nursing, then just continue. good luck
From what I have learned and studied, the nursing at night equals cavities position is actually a myth, and unfortunately one that many dentists and even pediatricians tout.

If you were to see a picture of the nipple while breastfeeding, you would see that your nipple goes way back past the teeth area of your toddler's mouth. I know it's hard to believe that it stretches back that far, but it does. The milk doesn't ''stand'' in the mouth as your dentist may have told you. This is La Leche League's stand on the issue. As they state in ''The Womanly art of Breastfeeding,'' ''Studies have shown that breastfeeding itself doesn not cause tooth decay.'' In fact according to one study they cite, breastfed children ''had lower levels of decay.'' Good brushing is strongly recommended. I would suggest that if you are concerned enough to stop nursing, than I would contact La Leche League for yourself and ask a specialist.

My son is two and a half and we have had absolutely no problems, even though my pediatrician recommended I not nurse at night, which sent me on my research. Luckily Aidan loves to brush his teeth, which is great whether nursing or not. My dentist recommends ''brushing'' with a baby's wash cloth which is a great supplement to Aidan's ''brushing.''

Good Luck, hope this helps... decisions decisions decisions.... Jaclyn


I nursed my son until he was about two-and-a-half years old. From what I remember reading and hearing at the time (this was 2 years ago) nursing to sleep did not pose a significant risk for tooth decay as bottle feeding does. First of all, your breastmilk does not tend to pool in his mouth because he has to use suction to get the milk. Second, I also seem to recall hearing something about the nature of the sugars and enzymes in formula that may be different than/more harmful than breastmilk. Try looking for information from La Leche League.

With that said, my son did develop several cavities at an early age. All of them are in his molars and every dentist that we have seen over the last 5 years have explained that for some reason his molars are not completely covered with enamel. This would have happened during pregnancy. Even the dentist we saw when I noticed his first cavity at age two assured me that breastfeeding-to-sleep was not the culprit.

If you are still somewhat concerned about your sons teeth, maybe you could try to be sure he swallows, to get rid of any breastmilk in his mouth, before you put him down or leave the room. Congratulations on your dedication to breastfeeding! Jennifer


Severe tooth decay in night-nursing 15 Month Old

Sept 2004

Help! My 15 mos. son has multiple chipped teeth (due to weak, decaying teeth) and dental caries. I feel like a terrible parent. Well, I guess I really am. I haven't stopped or cut down on the night nursing, not even wiping his teeth after each nursing (he hates anything near his mouth and cries like Billy-o whenever we brush his teeth). After our visit today to the dentist, the dentist finally said that the one thing in common with all babies with such decay problems is night nursing.

We also haven't been regular about his brushing. We've been making a big deal about tooth brushing - and hang out as a family brushing our teeth. My son has a sign for tooth brushing and will happily puts the brush in his mouth now and move it around. The problem is that we need to brush his teeth and he hates it. It takes two of us - which limits the opportunities - and we have to literally hold his arms down to stop him grabbing the brush out of his mouth. He cries and tries to keep his mouth closed. Everybody says kids cry when having their teeth brushed, but this seems extreme. We hate doing it and I'm sure my son has picked up on all our mixed feelings. My husband and I also get quite tense with each other during these brushing sessions which only makes things worse. I really wonder if I should see if I can hire a dental hygenist or childcare expert to help for a few weeks until we get this figured out (it would probably be cheaper than having even more major dental work to do in the future). I just ordered a video on tooth brushing techniques from a dental school so maybe that will help.I don't know. The dentist says its a matter of will power and I guess I'm failing. I am so depressed right now. I know they're baby teeth, but teeth are so important for chewing correctly, speech development, and general self-confidence about smiling and appearance. Any suggestions welcomed about who I might get to help with tooth brushing, tooth brushing techniques, and night weaning welcomed. Worried Mom


I'm sorry to hear about your child's teeth. Don't beat yourself up about it too much. There's nothing you can do to change the past, and you are obviously committed to preventing further problems.

Have you tried a battery-powered brush? They make some for kids that have small, circular rotating heads. I find them to be the easiest shape for brushing. Also, if I start out with the brush off, when I meet resistance, I turn the brush on and then sometimes baby opens his mouth (I think it tickles) and I can reach some interior teeth too.

Does your child have any interest in holding the brush himself? I give him a different brush that he likes to kind of chew on and I try to manipulate it to do some brushing when he's chewing.

I would try to keep this as ''fun'' as possible. I know it's a horrible struggle for you, but I'm not sure if holding the kid down is going to work in the long run. Kids can be really stubborn and I'd be wary that you are going to create additional problems down the line if brushing is always a trauma for your child.

And finally, are you working with a good pediatric dentist? I would highly recommend Dr. Katsura (just off Solano Avenue in Berkeley) if you are looking for one. He is really gentle with kids and relates very well to them. Good luck. Anon


That sounds like unusually high levels of tooth decay in a child who lives in a house with ''aware'' parents! I night-nursed my daughter for much longer than 15 months and she has no sign of tooth decay and gets high marks from her dentist (she is almost 4 years now). Perhaps much of it is genetics? Perhaps there are other factors contributing to the decay? Have you examined the snacks that your child gets? Our daughter's dentist gave us a list that essentially wipes out crackers from the snack options as well as juice and the more obvious items like sugary fruits/candies/etc. If he is sucking on goldfish crackers all day, that could be a major source of decay.... As far as brushing is concerned, we started our daughter around that age with brushing and started flossing at 2 years. She rarely fought it and generally puts up with the whole routine. A lot could be temperment, but also making it ''enjoyable''. Have you tried finding a comfy place for him to lie down while you do it? What about picking out some special kids music to listen to? Have dad lie next to him and read a book that he can see? Let him play with a flashlight on the wall? Maybe he could brush a teddy bear's teeth first, or pick a flavor of toothpaste. I can certainly recommend our dentist - Dr. Matsuishi in EC. He's a peds dentist and his office is very friendly for kids. Good luck!!! Freyja
You're not a terrible parent! Banish that thought from your mind!! As far as I'm concerned, night nursing is good parenting. The tooth decay at age 15 months seems more a factor of genetics and bad luck than anything else. It's rare for a child that young to have tooth decay, even if they are night nursing. So please don't blame yourself.

Brushing toddlers' teeth is incredibly, incredibly difficult. I have a 2 year old that acts exactly the same as yours - nothing seems to work to get him to let me brush his teeth, except pure perseverance, stubbornness, and a willingness to do something that he hates. I can completely understand that it is hard to make yourself do it. That said, it does need to be done. Making it absolute solid routine that teeth get brushed every morning when you wake up and every evening before bed, may make it easier for you rather than harder... he may realize it's inescapable. Once he knows for sure it will happen whether or not he struggles, he may give up the struggle.

For the techniques... some of these have worked briefly for us, and some have been suggested to me but haven't worked, but they may work for you. Distract with funny noises, songs, tickling, etc. Start a routine of singing the same song every time and only sing while he's letting you brush - make the song last a couple of minutes, and he will eventually get to know that when the song is over, brushing is over. Ask him to roar like a lion or bear, or to let you see if there are any monkeys in his mouth. Get him a couple of interesting-looking or electric spinning toothbrushes and some good flavors of toddler toothpaste, give them funny names, and let him choose which to use each time. Let him brush your teeth while you brush his. Give him a sticker if he lets you brush his teeth. Talk to him about ''cavity bugs'' and that you need to clean them up, and that not cleaning them up means that his teeth may hurt later. Pretend that the toothbrush is something that he likes - a train, a vacuum cleaner, a kitty. If he's teething, ask him to open his mouth so you can have a look at the new teeth he's getting. You could try taking something away if he doesn't let you brush, like a favorite toy... I haven't tried that one.

If you want to wean at night, it may be difficult if you are cosleeping. If he's in his own crib or bed, you can start a pattern that he doesn't come to your bed until it gets light out, or after a certain time in the morning. If our son wakes up in the night, my husband goes and sleeps in his room on the floor. Jen


You might try an electric toothbrush to help get your son to brush - our 15-mo son clamps his mouth shut when we try to use the manual toothbrush, but loves the electric one to the point of asking to have his teeth brushed even when he doesn't need it. I think the vibration feels good on his gums. If you don't want to shell out for a big electric toothbrush, you could try the Crest ''Spinbrush'' or something similar. JP
My daughter had oral surgery at 2 1/2 and my son had oral surgery at 18 months and age 2 and will probably need it again soon. It's horrible. You can't both be home every time you want to brush his teeth. To brush my 2 1/2 yr old's teeth, I sit on the bed with my legs stretched out in front of me, position him so that his head is toward me and my legs are holding down his arms. That way I have one hand for the toothbrush and one hand to open his mouth. Needless to say he hates it. So do I, but I've gotten used to it. I wonder if I was less brutal if he would be less resistant by now. But I have no choice; I have to do a good job each time I brush his teeth. The teeth, the night nursing, the dentist.. it is all the biggest stressor in our marriage. It's so discouraging.

The light at the end of the tunnel is that my daughter, now 5, can brush her own teeth, floss, and swish around flouride rinse. Her teeth are all coated, and we get regular flouride varnishes, and she's only had one cavity since the oral surgery at 2 1/2.

Try and get the January and February, 2003 editions of the Journal of the California Dental Association, which has excellent information on taking care of your teeth.

Feel free to email me. Sarah


My son didn't like me brushing his teeth at first. He loved chewing on the tooth brush and it seemed like at first, I held him down EVERYTIME and he screamed EVERYTIME. Then finally I said, 'If I can't brush your teeth then you can't have the toothbrush to chew on.' He tried me once, I took it away and ever since it has been pretty easy. Sometimes I tries to fight with me but I just say 'do you want it when we are done?' and then he cooperates. I try to do everyday morning and night, night is easy b/c it is with the whole bath thing. Hang in there. I use to let him chew on the toothbrush we were using, then I got smart and got him a different one. now I use a crest spin brush to brush his teeth and he chews on the regular one when we are done. he just turned 2. Good Luck! Laura

Dentist says caries are caused by nursing

March 2003

(See Dentists Favorable to Breastfeeding for the original question.)
Whoa, this is such a hot button for me. I have the same experience with my son. The brown stains on his front teeth were the beginnings of dental carries. I did have the offices of Wampler, Katsura, et al. paint on the flouride to help strengthen them. On my second visit I clearly said that if they gave me any grief about it I was going to find another dentist. Here is my somewhat educated opinion on tooth decay. Decay is caused by bacteria. Bacteria needs food (sugar) to to grow, thrive and do it's job of attacking the tooth. There is sugar in breastmilk as there is sugar in bread, crackers, cow's milk from a cup, etc, etc, etc. During the day our saliva helps to wash our teeth and help slow the bacteria growth but at night our saliva is reduced by 80% so that we don't drown. So any sugar from any source left on the surface of the teeth will lead to decay. When a child is actively removing milk from a breast the nipple is way back in the mouth and the milk runs down the throat. It does not pool in the mouth like it can with a bottle. If a child is just leaving their mouth over the nipple and not actively sucking some milk may be pooling. However, breastmilk has antibodies and anti-bacterial and anti-fungal properties. This is an added benefit in fighting decay among all it's other varied benefits. So the only true way to help prevent decay is to agitate the bacteria through brushing and flossing any teeth after eating/ drinking before sleeping. Many, many parents do NOT do this as much as they should whether they brestfeed or not. Tooth decay is also affected by genetics. I believe they discriminate against breastfeeding. The only question they should be asking is ''does your child have their teeth brushed after eating and before sleeping every night?'' What and when we are feeding our children is none of their business! Nurse your son as long as you both enjoy it!


My son has stains on his teeth too. He got them from iron drops (prescribed for anemia when he was 12 mo.) Some kids' teeth stain more easily. In January I took him to Dr. Denise Bass-Allen in Oakland when he was 28 months old -- we were still nursing. I got a bit of a lecture, but was NOT told I HAD to wean by any means. I really liked Dr. Denise and she had a good manner with my active toddler. Her assistant who lead us through our brushing lesson wasn't as good (even though she said her son was the same age!) Just getting him checked and told his teeth looked bad, but were good was worth it. Good luck, I hope your stains are as benign. You didn't mention your nursing pattterns, but night weaning might be helpful. My son nursed to sleep at night and naps until last month when we weaned (not because of teeth concerns!), but I night weaned him at about 15 months. Try toothbrush training every day! (We are still working on it . . .) sharon

Night nursing and tooth decay

October 1998

I was just informed by my nutritionist that I should cease nursing my 1 year old son at night when he wakes up because it could cause tooth decay. I'm rather confused by this because all along my lactation consultant told me it was no problem to nurse my son to sleep. I received quite a response when I wrote about my son waking during the night like 8 times a night and the majority of parents wrote about taking him to bed with us, which we have done and works great for all three of us, we sleep great now! But now I'm worried about tooth decay. Do any of the parents that responded to family beds and nursing at night have any experience with tooth decay because of nursing at night? I'm curious if this really does happen? It seems like such a natural thing to me to nurse to sleep and seems strange that it would cause damage to my son's teeth. Anyone have an older child that was nursed at night that can give me some input? Jena


I, too, was given the admonishments about nursing at night as soon as my son's teeth started appearing. For the most part, I chose to ignore them. The decay usually occurs from fluid resting against the teeth, like a bottle in the child's mouth after s/he has fallen asleep. In my experience, once he falls asleep, the nipple usually falls out of his mouth- and in any event, he's not getting milk unless he is actively sucking, unlike a bottle. Also, he tended to only nurse for a few minutes before falling back to sleep. Somewhere around 15 months of age, we started brushing his teeth (using just water and a child-size toothbrush) right before bed every night. He continued to nurse "on demand" until around 18 months, when I limited it to right before going to sleep (which is AFTER his teeth have been brushed) and right before getting up in the morning- no in-between nursing. He is still on this schedule at a little over 22 months of age, and so far I have seen no signs of tooth decay or other problems with his teeth or gums. I agree that the "naturalness" of nursing (especially given that in a "primitive" human population it often lasts for about 4 years) seems to make it an unlikely candidate for severe problems under normal conditions. Anyone have contradictory experience? Naomi
there are rare occurences of babies who nurse and develop "bottle mouth", but it is generally formula that can rot teeth if a child sleeps with their bottle in their mouth on a regular basis which they shouldn't do just because babies can choke if they are left with a bottle propped up. I nursed all 3 of mine during the night and they all have beautiful teeth. I heard from someone about children who nursed developing bad teeth so, for awhile I would wipe off the teeth after she fell asleep but, i admit I often fell asleep too and quit bothering after awhile. I nursed my first 2 children for approx. 14 months each and my youngest for over 3 years. I did start brushing their teeth (with Tom's natural toothpaste as they were so young and bound to swallow some) as soon as they got teeth.

there is more on this at: http://www.promom.org/ under Breastfeeding Myths and Realities

Myth #14: Night nursing causes dental problems. Reality: Generally, the worries about babies getting cavities through nighttime milk consumption arise from the practice of leaving babies to sleep with bottles of formula or juice. When this is done harmful bacteria have unlimited access to these sugary mediums and will thrive in the babies mouth. The acids excreted by the bacteria cause tooth decay. Such decay has been seen occasionally in breastfed babies if these children happen to fall into a small category of people with easily decayed teeth. For most children night nursing will not be a problem. One advantage that the human nipple provides over an artificial one is that it delivers the milk further toward the back of the mouth, past the teeth. Artificial nipples deliver the milk into the front and middle of the mouth where it can cause decay. Also, the human nipple does not continue to drip milk when it is not being sucked. In contrast, bottles will drip milk all night if left in the bed with the baby. Reminder: no baby should ever be left alone with a propped up bottle! If you notice anything strange looking happening to your child's teeth consult a breastfeeding supportive dentist for help. There are many articles on this subject available through La Leche League.

My now 5-year-old nursed for 2 years and for much of that time had at least one middle-of-the-night feeding. He has never had any cavities and his dentist is pleased with his teeth. Fran


My son has had 16 teeth since he was 11 months (he's now 16 months), so keeping his teeth healthy is something that we've been concerned about too. I nurse my son to sleep and we have a family bed, so he nurses throughout the night when he needs too. He has already been to his first dentist appointment and has no problems with his teeth. The dentist strongly emphasizes good teeth brushing habits, but seemed okay with the baby falling asleep nursing. I concluded, that as long as his teeth are being brushed well, it's okay for us to continue nursing as we have been. If you are really concerned, I would consult a dentist.
It is my understanding that what causes the really bad tooth decay is leaving a pool of milk in the baby's mouth. That's because bacteria love the milk as much as your baby does, and when they have a good food source they can multiply over the course of a few hours. It happens most often as a result of parents propping a bottle up *in* the baby's mouth and leaving it there for long periods of time *while the baby is sleeping*. (This is obviously dangerous not only from the standpoint of tooth decay.) I suppose the same could happen if you left your breast in your baby's mouth while you both went to sleep, allowing a slow trickle of milk to enter and pool there over the course of the evening. But if your baby simply nurses before sleeping, (s)he will swallow most of it and then continue to salivate, diluting out the rest. Sometimes you might dose off while nursing, but if you wake up a few minutes later and remove your nipple, you are fine. Please do not worry about nursing in bed. It is good for your baby. It is good for you. I did it and mine has healthy teeth. Sybil
There was an article in one of the more recent LLL Magazines by a woman whose child had caries from night nursing. She had a very understanding dentist and the article talks about how she managed to continue night nursing while at the same time being cautious about her son's teeth. If you go to their website and do a search I'm sure you'll find it.

In general though, nursing at night is not the same thing as "bottle-mouth" because when a child nurses they take the breast deep into the mouth preventing the milk from pooling at the teeth. So, even though breastmilk can cause tooth decay, it usually isn't a problem except in those kids that happen to be more prone to it. Also, many of the advantages of night-nursing and co-sleeping outweigh the dental risk IMHO. Sophie


I nursed my first two children for over 3 years each. They slept in the family bed and nursed many times during the night. They both have lovely teeth now--at ages 6 and 9. My third child is now 18 months old, and like with my other children, he nurses multiple times during the night. At a recent visit to the dentist we discovered that he has pre-cavity deposits (white deposit) all along the gum line of his two front teeth. These are areas that are hard to repair, according to our dentist. The dentist was very concerned and I felt very guilty. We had been brushing his teeth once a day. Now we are brushing them twice a day. The dentist also treated his teeth with fluoride. We'll see if we can arrest the development of the cavities.

When I was concerned about night nursing with my first child, I had heard that you need to have a nursing episode end with a suck (pull nipple out, child swallows). If the child falls asleep with the nipple in the mouth, before s/he swallows, then a small accumulation of decay-causing milk will stay in the mouth. It doesn't need to keep dripping in the mouth to cause damage--there just needs to be an accumulation. Even though I have known this, it is hard to implementthis practice when a child has free access to the breasts all night. While there are nights when he just nurses once and I am awake, there are other nights when he nurses many times and I am only quasi-awake. I guess my great survival trait of being able to mostly sleep through the many nursing interruptions has had its downside.

I don't regret nursing him and will continue. My nights are much less restful as I try to wake up and "finish" him off before I fall asleep again. This has been only partially successful as it seeems to have breeded a greater need--he sucks with renewed vigor whenever I try and withdraw the nipple. So now he seems to be nursing more than ever. Perhaps the most striking lesson is that it was fine for two kids and not for the third. This is consistent with all of the messages that stated that night nursing is fine for *most* kids. And we can't know our kids decay-proclivities until something like this happens.


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