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).

References

Adler CJ, Dobney K, Weyrich LS, et al. Sequencing ancient calcified dental plaque shows changes in oral microbiota with dietary shifts of the Neolithic and Industrial revolutions. Nat Genet. 2013 Apr;45(4):450-5, 455e1
 
Aly AAM, Erfan D, Abou El Fadl RK. Comparative evaluation of the effects of human breast milk and plain and probiotic-containing infant formulas on enamel mineral content in primary teeth: an in vitro study. Eur Arch Paediatr Dent. 2019 May 23
 
Avila WM, Pordeus IA, Paiva SM, et al. Breast and Bottle Feeding as Risk Factors for Dental Caries: A Systematic Review and Meta-Analysis. PLoS One. 2015 Nov 18;10(11):e0142922
 
Branger B, Camelot F, Droz D, et al. Breastfeeding and early childhood caries. Review of the literature, recommendations, and prevention. Arch Pediatr. 2019 Nov;26(8):497-503
 
British Society of Paediatric Dentistry (BSPD) [Internet]. London: British Society of Paediatric Dentistry; [date unknown]. Position Statement on Infant Feeding. 2018 Jan [cited 2018 Mar 29]

Chiao C, Kaye E, Scott T, et al. Breastfeeding and Early Childhood Caries: Findings from the National Health and Nutrition Examination Survey, 2011 to 2018. Pediatr Dent. 2021 Jul 15;43(4):276-281

Devenish G, Mukhtar A, Begley A,et al. Early childhood feeding practices and dental caries among Australian preschoolers. Am J Clin Nutr. 2020 Apr 1;111(4):821-828

Du MQ, Li Z, Jiang H, Wang X, et al. Dental Caries Status and its Associated Factors among 3- to 5-year-old Children in China: A National Survey. Chin J Dent Res. 2018;21(3):167-179
 
Eggert FM, Gurner BW. Reaction of human colostral and early milk antibodies with oral streptococci. Infect Immun. 1984 Jun;44(3):660-4
 
Erickson PR, Mazhari E. Investigation of the role of human breast milk in caries development. Pediatr Dent. 1999 Mar-Apr;21(2):86-90
  
Holgerson PL, Vestman NR, Claesson R, et al. Oral microbial profile discriminates breast-fed from formula-fed infants. J Pediatr Gastroenterol Nutr. 2013 Feb;56(2):127-36
 
Kramer MS, Vanilovich I, Matush L, et al. The effect of prolonged and exclusive breast-feeding on dental caries in early school-age children. New evidence from a large randomized trial. Caries Res. 2007;41(6):484-8. Epub 2007 Sep 18
 
Moynihan P, Tanner LM, Holmes R, et al. Systematic Review of Evidence Pertaining to Factors That Modify Risk of Early Childhood Caries. JDR Clin Trans Res. 2019 Jul;4(3):202-216

Peng SM, McGrath C. What can we do to prevent small children from suffering from tooth decay? Evid Based Dent. 2020 Sep;21(3):90-91

Peres KG, Chaffee BW, Feldens CA, et al. Breastfeeding and Oral Health: Evidence and Methodological Challenges. J Dent Res. 2018 Mar;97(3):251-258
 
Richards D. Breastfeeding up to 12 months of age not associated with increased risk of caries. Evid Based Dent. 2016 Sep;17(3):75-76
 
Tham R, Bowatte G, Dharmage SC, et al. Breastfeeding and the risk of dental caries: a systematic review and meta-analysis. 2015 Dec;104(467):62-84
 
Udina IG, Gulenko OV. Molecular-Genetic Mechanisms of Caries Development. Russ J Genet 2018;54(4):415-22