Ben's Beautiful Smile

A year ago, I was worried sick over Ben's teeth. He had the tell-tale signs of decay: a light brown line across his front tooth that could not be scraped away. For three months, as I fretted, researched, called dentists etc., I saw that line spread like wildfire from one tooth to another until all four front teeth were affected. It was awful.

All the research I did, and each dentist I spoke to, suggested that breastmilk (specifically breastmilk consumed while sleeping) was the cause of this decay, and that prompt nightweaning was the only way to halt the decay. My gut instinct was that this could not be so. Humans were meant to nurse at night, into toddlerhood, and had been doing so for eons -- why would something so natural and wholesome be damaging?

And whatever the cause, how on earth could I nightwean my little boy? I can see it even clearer now: he was still such a baby, and was not ready to stop nursing at night. We would have, of course, survived (many people nightwean young toddlers gently and successfully), but it was simply not how I envisioned our nursing relationship progressing. It seemed to me that nursing to sleep was one of the seven wonders of the world, and it made me happy to give that to Ben. I remember one afternoon, walking and nursing Ben in the baby carrier, looking down at his warm, sleepy face, his soft flutter-sucks, his body drifting off into milky sleep. My heart ached. How could I let this end so abruptly, when neither of us were ready?

The research was sharply divided. Dentists across the board said breastmilk on the teeth at night caused decay, and recommend that "habit" stop as soon as a baby's first tooth appeared (how many babies would wean prematurely if sleeptime comfort nursing was taken away from them?). Breastfeeding advocates mostly said this was hogwash, and that breastmilk had little, if anything, to do with decay. This was supported by own experiences: all the breastfeeding toddlers I knew nursed at night and had no decay.

And yet, my instincts told me that even if breastmilk didn't cause Ben's decay, it must have played some role, as he consumed so much of it both day and night. I finally found an article (published by La Leche League) that made the most sense to me. Essentially, this article explains that breastmilk alone does not cause much more decay than water, but that breastmilk mixed with solid foods can be damaging to the teeth in certain vulnerable children. This made a lot of sense to me -- I knew we had been lax about cleaning Ben's teeth before bed, and that he had slept many nights with a mouth full of food particles mixing with breastmilk.

So I had a plan before me: keep Ben's teeth as clean as I could both day and night, and work on repairing the damage. My heart was still wracked with guilt, worry, and an enormous amount of uncertainty, but I decided to go with my instincts and not change our nursing patten unless this plan did not work.

The first dentist we took Ben to did not want to participate in my plan. "I know it will be hard," she said, with a sympathetic little pout in her face, "but I'm very strict about nighttime nursing." When I asked her if there was anything she could do to halt the decay, she said no, and that if I didn't nightwean, I would be giving my child cavities.

On the advice of a mom in my La Leche League group, we took Ben to a different dentist. Dr. Mercurio was not covered by our insurance, but she was gentle and soothing. She did believe that night-nursing had contributed to Ben's decay, but she also recommended dietary changes, increasing toothbrushing frequency, cleaning the mouth out after nursing to sleep, and a very conservative amount of fluoride to protect the teeth. She gave him a fluoride varnish as well.

We were very diligent with our plan. Ben protested, but soon became used to our routine of brushing his teeth three times a day. We were very strict about sugar in his diet. Xylitol had been recommended as a tool to decrease to the cavity-causing bacteria in the mouth, and we developed a routine of putting Spry, an indigestible xylitol gel, into his mouth several times a day. We reluctantly did the fluoride too, but were happy that the dentist recommend cutting out all fluoridated water, and using half a pea-size amount of fluoride. We also gave him a swig of water in a medicine dropper after he'd fallen asleep to clean out his mouth.

And (gasp!), things began to improve. Each time we came back to Dr. Mercurio, she said that the decay was stablilizing. After a few months, we started doing fluoride every other day instead of every day. We let him try ice cream and juice (both of which he fell in love with), and became somewhat more relaxed about occasionally missing a brushing. Eventually, I stopped giving him those nighttime swigs of water.

Now, one year later, Dr. Mercurio has declared the decay completely arrested. We're going to decrease the fluoride to once every two days, and the goal is to stop it altogether if things still look good in two months. I can't tell you how happy I am. I feel accomplished (and lucky -- this amount of tooth care doesn't always work to halt decay in young children) because I worked my butt off to take care of Ben's teeth, and my work paid off. But I am also proud that I was able to let my instincts guide me on this one. I was getting opinions left and right about what I should and shouldn't do, but I knew what I had to do. I wasn't sure if it was the perfect choice, but I followed my heart, and it all worked out in the end.

Ben has been brave throughout it all, sitting in the dentist chair month after month, being patient as we stick that finger toothbrush in his mouth over and over again. And yes, he still enjoys his nighttime and naptime milk. What a good boy. What a beautiful smile.