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Breastfeeding and Oral Health Issues

Margaret Bickmore
Longmont CO USA
Report on a session from the 2005 LLLI Conference
From: NEW BEGINNINGS, Vol. 22 No. 5, September-October 2005, p. 211-212

Anyone who has ever had the opportunity to hear Brian Palmer, DDS, speak about breastfeeding and dental issues or view his Web site ( would also be a fan of Dr. Glori Enzor. Enzor picks up where the now-retired Dr. Palmer left off, and has new information to add including alternative health care options. However, her best credential is that she is an experienced breastfeeding mother of three. She has a thorough understanding of the breastfeeding relationship, as well as a mother's perspective on taking care of children's teeth.

The appearance of cavities in breastfed babies is often a shock to families who are making healthy choices and using good hygiene. During her session, "Breastfeeding and Oral Health Issues: Diagnosis, Prognosis, and Treatment Modalities," she explained that a few strains of "bad" bacteria, Streptococcus mutans in particular, are responsible for most cavities. Cavities can actually be considered an infectious and transmissible disease. The levels of "bad" bacteria in a child's mouth are directly proportional to the number and severity of cavities. This makes it clear that controlling the S. mutans is a critical step in reducing cavities. The first aspect of prevention, according to Enzor, is for all family members (particularly the mother) to practice good oral hygiene. A mother's oral condition is indicative of a baby's future cavity experience.

What else can families do to reduce or prevent cavities in their breastfed children? A healthy diet, which includes only small amounts of simple sugars and limited carbohydrates, is helpful. High carbohydrate intake is correlated with high levels of another cavity-causing bacteria, lactobacillus. Eating patterns are important, too. Children should be encouraged to eat larger portions a few hours apart instead of nibbling all day. Also, carbohydrate-containing drinks such as juice or milk should be consumed in one sitting instead of being carried around in a sippy cup for hours.

Many families may be interested in the use of xylitol, also known as birch sugar, for cavity prevention. The S. mutans bacteria cannot use xylitol in their metabolism, so they cannot reproduce or make tooth-etching acid. When xylitol is eaten, less plaque is formed, and it is less sticky. It beats fluoride as a preventive, reducing cavities by up to 80 percent. When mothers used xylitol during the first two years of a child's life, there was a 77 percent reduction in children's cavities at five years of age even though the children themselves were not treated.

Cleaning children's teeth is not usually a favorite activity for either parents or children, but Enzor emphasized that it must be non-negotiable. Just as diapers must be changed and hands washed, teeth must be wiped or brushed. She recommended beginning at birth with a wet washcloth to accustom the child to the idea of something in his mouth. When the first tooth comes in, a soft toothbrush should be introduced. Dr. Enzor acknowledged that some children will resist and gave examples of using humor and novelty to encourage cooperation. She pointed out that insisting on cleaning a child's teeth is still much less invasive and forceful than the alternative: dental work to repair cavities.

Sealants protect teeth by covering the microscopic pits and fissures that are a normal feature of the chewing surfaces of teeth. Enzor shared that 85 percent of all decay begins in the pits and fissures, and they are almost impossible to clean. She recommended applying sealants, which also have the welcome effect of reducing S. mutans levels.

Alternative health care options for dental issues are rarely discussed. Dr. Enzor discussed the use of essential oils, homeopathy, probiotics, and certain foods that she has seen good results with in her practice. Some essential oils with antibacterial properties, such as tea tree, clove, red thyme, cinnamon, and eucalyptus, may be especially useful as nighttime nursing aids. Parents should mix a few drops of the oil with a few ounces of water, and wipe the solution on the child's teeth and gums.

Participants in this session left feeling that breastfeeding is clearly best for oral health, and there are many strategies available for preventing or reducing the occurrence of cavities in breastfed children.

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