Keeping caries at bay in breastfeeding babies
As an infant grows, human milk may become the substrate for cariogenic bacteria. Here’s what to watch for and how to counsel parents.
PRACTICE RECOMMENDATIONS
› Promote breastfeeding as the preferred method of feeding infants. A
› Optimize pediatric oral health by reducing risk factors for dental disease and by providing parents with anticipatory guidance to prevent early childhood caries. B
Strength of recommendation (SOR)
A Good-quality patient-oriented evidence
B Inconsistent or limited-quality patient-oriented evidence
C Consensus, usual practice, opinion, disease-oriented evidence, case series
Talk to parents about how to provide optimal exposure to fluoride, which is known to be safe and effective for the prevention of ECCs.1 Use of fluoridated toothpaste in small amounts provides the benefits of fluoride without increasing the risk of fluorosis, especially for children at risk for caries (see TABLE 221).
The US Preventive Services Task Force recommends that primary care practitioners apply fluoride varnish biannually for at least 2 years to the primary teeth of all children up to 5 years of age (Grade B evidence).22 This is particularly important for high-risk children, such as those with low-income or minority status. However, practitioners should also take into account that high cumulative fluoride intake can lead to dental fluorosis.1 Finally, tell parents to avoid giving their children sugar-containing snacks and drinks to reduce ECC risk.
CORRESPONDENCE
Peter D. Wong, MD, 303-89 Humber College Boulevard, Toronto, Ontario, Canada M9V 4B8; peter.wong@sickkids.ca.
