The Dentist Magazine.

Study finds increased risk of dental decay in children breastfed beyond two years of age

Published: 12/07/2017

A new study carried out to understand the effect of breastfeeding on children’s teeth has found there is a higher risk of dental caries if breastfeeding continues for two years or more.

The research findings have been published in Pediatrics, the journal of the American Academy of Pediatrics.

Because of the known benefits of breastfeeding to children’s health, the authors, led by Professor Karen Glazer Peres of the University of Adelaide, say that breastfeeding should not be discouraged but instead, that parents should adopt measures to prevent dental caries as early as possible.

Professor Emeritus Andrew Rugg-Gunn, an advisor to the British Society of Paediatric Dentistry (BSPD), and an international authority on children’s oral health, said the results of this study are significant. The authors analysed the impact of sugar in the diet and the role of Streptococcus mutans (S. mutans), the most common bacterium associated with dental caries. 

They found that breastfeeding after the age of two years remains associated with severe early childhood caries independent of sugar consumption and the presence of S. mutans. This is important as previous studies have not examined each potential risk factor in isolation, making it sometimes difficult to establish which factor is causing the decay.

The research involved more than 1,000 children from an area of Southern Brazil where the water is fluoridated. They were seen several times from the age of three months to five years. Breastfeeding information was collected until the children were aged two and sugar consumption data were collected at ages two, four and five years.

Children who were breastfed for more than two years had a higher number of decayed, missing or filled teeth (dmft) and were at a higher risk of severe early childhood caries (S-ECC) than those breastfed up until the age of one. Further analyses which took into account sugar consumption showed that breastfeeding at two years of age was an independent risk for severe caries.

Claire Stevens, BSPD’s vice president and media spokeswoman, said, “BSPD supports breastfeeding but at the same time must keep up-to-date with the emerging evidence base in infant feeding so that we can give sound advice.

“Parents striving to do their best for their child should be allowed to feed their babies and toddlers as they wish but our advice is that where possible, from the age of one, mothers who choose to breastfeed their child should aim to do so at mealtimes, rather than on demand, and avoid feeding through the night.

“It is also vital that preventive measures are in place, such as ensuring that the child’s teeth are brushed twice daily as soon as they come through with a flat smear of fluoride toothpaste and that a first dental check up takes place before the child’s first birthday.“

Professor Karen Glazer Peres of the University of Adelaide, who led the research in Brazil, told the news agency, Reuters, “Breastfeeding is the unquestioned optimal source of infant nutrition. Dental care providers should encourage mothers to breastfeed and, likewise, advise them on the risk.”