Prolonged Breastfeeding and Dental Caries In Children In the Third Year of Life

[Knowledge, attitudes and practices in oral health of breastfeeding women]

The benefits of breastfeeding on the health of infants and mothers are no longer in doubt. On the other hand, the advantages in terms of maxillofacial development and the risks of prolonged breastfeeding on oral health are much less discussed. An exploratory qualitative study, carried out within the pediatric dentistry functional unit of the dental care service of the Lille University Hospital Center in 2022, aimed to analyze the knowledge, attitudes and practices in oral health of breastfeeding women. This article will discuss the gaps in prevention as well as the obstacles and levers to improving care.

Integration of Breastfeeding Consultation and Practices in the Scope of Pediatric Dentistry: Collaboration with Lactation Specialists

Background

In recent years, breastfeeding has been largely promoted due to health benefits for the children and the mothers and social, economic, and environmental advantages. World Health Organization (WHO) recommends breastfeeding for at least 2 years and to be continued for as long as this is desired by the mother-child dyad.Despite its advantages, including protection against caries in the 1st year of life, prevention of malocclusions, and development of more normal breathing patterns, there is a great controversy in the literature regarding breastfeeding involvement in elevated risk for early childhood caries (ECC).Breastfeeding and oral health are strongly related. Breastfeeding can influence oral health and development, but oral findings, such as tethered tissues and natal/neonatal teeth, may negatively affect lactation.

Conclusion

A healthy collaboration between the oral health care provider and the lactation specialist is important in order to identify those oral findings and prevent breastfeeding implications, but also in order to facilitate uneventful breastfeeding by emphasizing oral health care prevention strategies.

Clinical significance

Information on the advantages of certain lactation aspects and the potential risks for ECC is important for the pediatric dentist to be able to form an individualized treatment/prevention plan that will benefit and promote the oral and general health of young patients.

How to cite this article

Papadopoulou P, Boka V, Arapostathis K. Integration of Breastfeeding Consultation and Practices in the Scope of Pediatric Dentistry: Collaboration with Lactation Specialists. Int J Clin Pediatr Dent 2023;16(S-3):S306-S310.

Prolonged breastfeeding and dental caries in preschool children

PURPOSE

To explore breastfeeding from 6 to 18 months of age and to study the association between breastfeeding and caries prevalence at 5 years of age.

METHODS

The study included 1088 children from one Norwegian county and was based on the Norwegian Mother, Father and Child Cohort Study (MoBa). The children had clinical dental examination at 5 years of age, and parents answered a questionnaire, which included information on breastfeeding, oral health behaviour and child characteristic. Multivariate logistic regressions were performed. The study was ethically approved.

RESULTS

Of the studied children, 77% were breastfed at 6 months of age and 16% were still breastfed at 18 months of age. Few children (6%) were breastfed during night at 18 months of age, while 11% received sugary drink during night. No association was found between breastfeeding up to 18 months of age and caries prevalence at 5 years of age (p > .05). Children who at 18 months of age had their teeth brushed less than twice daily (OR 2.4, CI 1.5-3.9), consumed sugary drink once a week or more often (OR 1.7, CI 1.1-2.7) and had non-Western parents (OR 3.4, CI 1.5-8.1) were more likely to have caries experience at 5 years of age than other children.

CONCLUSION

Breastfeeding up to 18 months of age was not associated with caries development during preschool age.

Risk Factors of Early Childhood Caries Among Preschool Children in Eastern Saudi Arabia

This study aimed to determine the risk factors of early childhood caries (ECC) among preschool children from eastern Saudi Arabia. In this cross-sectional study, 241 carers and their children from 10 daycares were recruited and asked to complete a questionnaire aimed at assessing their sociodemographic profile and oral health-related behaviors. This was followed by a dental examination of the children by two calibrated dentists. Caries status was recorded using the dmft index. Chi-square and logistic regression tests were used to analyze the data (p < 0.05). The mean dmft of the children was 4.39 (SD ± 4.25). According to logistic regression analysis, children who were bottle-fed between 7 and 12 months (Adjusted Odds Ratio (AOR): 0.110) or breastfed between 13 and 18 months (AOR: 0.028) were less likely to have ECC than those with a prolonged feeding duration (>18 months). Also, those with smoking carers (AOR: 0.176) were less likely to have ECC than those with nonsmoking carers. On the other hand, children who had working carers, mainly mothers, in the education sector (AOR: 11.105), were more likely to have ECC (p < 0.05). The risk factors associated with the presence of ECC among preschool children in eastern Saudi Arabia include the mother's occupation and the carer's smoking status, as well as feeding practices (particularly bottle feeding). These factors can be modified by encouraging carers to completely wean their children (particularly from the bottle) by 18 months of age and advising working mothers to perform tooth brushing for their children in the morning before they go to work and in the evening before the children go to bed.

Influence of breastfeeding duration on the incidence of dental caries in preschoolers: a cohort study

Abstract Objectives: investigate the association between breastfeeding duration and the incidence of severe caries in preschoolers. Methods: a cohort study was conducted with 132 pairs of mothers and children in the city of Diamantina, Brazil. Data collection was performed in 2 moments: when the children were between two and three years of age (baseline- 2013/2014) and after three years (T1-2016/2017). In both moments, children were evaluated for dental caries (International Caries Detection and Assessment System - ICDAS) and a questionnaire was administered to the mothers addressing socioeconomic aspects and thee habits of children. The outcome evaluated was the incidence of severe caries (Dentin caries - ICDAS Codes 5 and 6). Data analysis involved descriptive statistics, chi-squared test and Poisson hierarchical regression with robust variance. Results: children who breastfed for more than 24 months (RR = 2.24 CI95%= 1.23-4.08), those whose parents were separated (RR = 1.73 CI95%= 1.11-2.69), and those with estab-lished/severe caries (RR = 2.74 CI95%= 1.37-5.49) at baseline were at greater risk of incidence of severe caries after three years. Conclusion: breastfeeding for more than 24 months is a risk factor for incidence of severe caries. In addition, family structure and established or severe baseline caries were associated.