Dental caries

Press, 16 September 1987, Page 18

Dental caries

Sir,—l dispute the inference in the recent “Word of Mouth” article, “Dental care needed for toddlers,” that “inappropriate” breastfeeding is a cause of dental caries in older infants. When an infant is breast-fed, the nipple is drawn deep inside his mouth, coming to rest at about the junction of the hard and soft palate. The suckling action deposits milk on the posterior soft palate, posterior tongue and posterior wall of the oropharynx. As milk is spilled over the epiglottis after suckling, a swallow reflex follows, ensuring that the mouth is cleared of milk. When the breast-fed infant stops suckling, milk does not continue to drip out, as it would from a tilted bottle. I would suggest that it is not the breast-feeding of an older infant that is "inappropriate” but, rather, the diet both of the mother when she is pregnant and of the toddler, who is no longer getting all of his nourishment from the breast.—Yours, etc.. JUDY CROWE, Registered Dietitian September 8, 1987. [Desmond Smith replies: “Judy Crowe is right on target when she suggests that dental caries in an older infant is so often due to the supplementary diet being received apart from the breast. No truer word could be said on the subject and young mothers need to be well aware of the importance of keeping the snack foods sugar-free. Without being too one-eyed about it though, I would like to point out that unless the mother’s diet during pregnancy is woefully abnormal, its effect on dental caries in the child will be minimal. Decay in teeth relates to sugar, and that means any sugar, even the relatively harmless lactose present in breast milk. Only a foolish person would take issue with your correspondent’s obviously broad knowledge of the sucking and

swallowing mechanism in a baby. It is, nevertheless, true that the breast milk cannot be totally contained in the back of the throat. Some of it does tend to stay near the teeth, and therein lies the problem.”]