Prolonged demand breast-feeding and nursing caries.

The aim of this study was to study the characteristics and to explore risk factors within a group of Dutch children breast-fed on demand over a prolonged period, whose mothers attended the meetings of La Leche League. Ninety-six children, 55 boys and 41 girls (mean age 28.8 months, SD 8.8), were examined. Most of the parents belong to a higher socio-economic working class. The examination included a questionnaire and dietary sheet, combined with the caries status of the child. On average the children were breast-feed for 21.5 months (SD 9.8). The mean age at which the parents started brushing the children's teeth was 11.7 months (SD 5.1). Fluoridated toothpaste (250 ppm fluoride) was used by 70% of the children. The children were divided into three groups according to their caries pattern: 1 caries-free; 2 caries, and 3 nursing caries. Dentine caries was found in 14 (14.5%) of the children, of which 9 (9.3%) met the criteria of nursing caries. The mean dmfs of all children examined was 1.2 (SD 4.8). Up to 18 months of age the breast was given significantly more frequently during the night and up to 24 months during the day time, to the children of the nursing caries group compared to the children in the other two groups. The children still being breast-fed at the time of investigation more frequently slept in their parents' bed. The children of the nursing-caries group used fluoridated dentifrices less often. The majority of children of the caries and nursing-caries groups did not receive fluoride from other sources. The results of the present study demonstrate that prolonged demand breast-feeding does not lead to a higher caries prevalence although comparison between the groups demonstrates that frequent breast-feeding and low additional fluoride use should be considered as contributing factors in the process of nursing caries.