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Children breastfed after age 2 at higher risk of tooth decay

21 July 2017

Children breastfed after age 2 at higher risk of tooth decay

A recent investigation undertaken to identify the effect breastfeeding has on children’s teeth has found that children are at an increased risk of dental caries if breastfeeding continues for two or more years.  The research findings have been published in Paediatrics, the journal of the American Academy of Paediatrics.


Due to the known advantages of breastfeeding to a child’s health, the authors of the study (led by Professor Karen Glazer Peres of the University of Adelaide) suggest that breastfeeding shouldn’t be discouraged but that parents should implement measures to prevent dental caries as early as possible.


An advisor to the British Society of Paediatric Dentistry (BSPD) and an international authority on children’s oral health, Professor Emeritus Andrew Rugg-Gunn, claimed the findings of this research are significant. The authors examined the effect of sugar in the diet as well as the role of Streptococcus mutans (S. mutans), the most common bacterium linked with dental caries.


The authors uncovered that breastfeeding after the age of 2 continues to be associated with serious early childhood caries independent of the consumption of sugar and the presence of S. mutans.  This is significant as studies in the past have not looked at each potential risk factor in isolation, making it sometimes difficult to determine which factor is the cause of the decay.


The study included over 1000 children from an area of Southern Brazil where the water is fluoridated. They were observed several times between the ages of 3 months and five years. Breastfeeding information was gathered until the children were aged two and sugar consumption data was collected at ages 2, 4 and 5 years.


Children who were breastfed for over two years had an increased number of decayed, missing or filled teeth (dmft) and were at a higher risk of severe Early Childhood Caries (S-ECC) compared with those who breastfed up until the age of one.  Further examinations which considered sugar consumption revealed that breastfeeding at two years of age was an independent risk for severe caries.


BSPD’s vice president and media spokeswoman, Claire Stevens, 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 study in Brazil, also said: “Breastfeeding is the unquestioned optimal source of infant nutrition. Dental care providers should encourage mothers to breastfeed and, likewise, advise them on the risk.”



Reference: Peres KG, Nascimento GG, Peres MA, et al. Impact of Prolonged Breastfeeding on Dental Caries: A Population-Based Birth Cohort Study. Pediatrics. 2017; 140(1):e20162943



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