Dental caries

What should I know about caring for my baby’s teeth?

Breastfeeding protects against caries in babies up to 12 months of age and does not appear to increase the risk of caries when breastfeeding continues beyond. The risk of caries increases if babies’ mouths contain certain bacteria or if their diets include sugars such as those found in juice, candy, or junk food. Once teeth are present, they need to be brushed. Breastfeeding, compared with bottle feeding, appears to protect babies from misaligned teeth. Bottle-feeding is discouraged after one year of age.

A) The baby’s firth teeth

The baby’s first teeth come in around eight months. Teeth are very hard and easily felt. To check for new teeth, run your finger along the ridge of the baby’s gums. You can often feel them before you can see them.

White bumps may be present on the gums soon after birth. These are not teeth; they are normal cysts.

Many parents worry about teething. Some babies are bothered by teeth coming in but many others aren’t.

B) Caring for your baby’s teeth

Once the baby’s teeth come in, you need to take care of them with regular brushing. It is not necessary to clean a baby’s mouth or gums before the teeth have come in.

C) Dental caries

Dental caries (cavities) became more common after the 1850ies when people started eating industrially-processed flour and sugar (Adler 2013). At the same time, the bacteria in our mouths changed. Modern mouth bacteria are fewer in type and caries-causing bacteria, such as Streptococcus mutans dominate (Adler 2013).

The evidence shows that breastfeeding protects against caries in babies up to 12 months of age (Avila 2015; Du 2018; Erickson 1999; Kramer 2007; Peres 2018; Richards 2016; Tham 2015).

Breast milk appears to encourage the growth of healthy bacteria in the mouth (Holgerson 2013) and contains large amounts of antibodies directed at the bacteria that cause caries (Eggert 1984). One study showed that breast milk made teeth stronger (Aly 2019).

The best available evidence shows that breastfeeding up to two years of age does not increase the risk of caries (Chiao 2021; Devenish 2020; Moynihan 2019; Peng 2020). Rather children may have other reasons for developing caries such as (Branger 2019; BSPD 2018):

  • Having certain bacteria (such as Streptococcus mutans) present in their mouth.
  • Having a diet that includes free sugars such as those found in:
    • Juice.
    • Sweetened or carbonated (soda pop) drinks.
    • Candy.
    • Junk food.
    • Other foods high in sugar.
    • Prescription and over-the-counter medication.
  • Using toothpaste or drinking water that does not contain fluoride.
  • Having teeth with weak enamel.
  • Having certain genetic factors (Udina 2018).
  • Having a bottle in their mouth while sleeping.

D) Dental alignment

Breastfeeding, compared with bottle feeding, may protect babies from misaligned teeth. Bottle-feeding should be discouraged after one year of age (BSPD 2018).


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