Dental Caries and Fluorosis in Breast-Fed and Bottle-Fed Children

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Abstract
A total of 370 children aged 2–13 years, each possessing apparently reliable records of pattern of infant feeding and consumption of optimally or suboptimally fluoridated water, was examined for caries experience and fluorosis. Only 16% of children had been breast-fed exclusively and the majority had been bottle-fed with infant formula and/or cow’s milk. Among children with primary dentitions, the caries experience was directly related to the history of fluoridated water but was unrelated to the duration of breast-feeding. Those bottle-fed for more than 12 months had a, significantly greater caries experience than those bottle-fed for briefer periods. Regardless of fluoride and feeding histories, no primary dentition showed fluorosis. Among mixed dentitions, 35% showed questionable to mild fluorosis. Ranking of feeding patterns indicated the lowest mean fluorosis index (0.08) for children breast-fed for 3 months or more; those breast-fed for less than 3 months were similar to those bottle-fed for less than 12 months (0.14, 0.16), and the highest index was for those bottle-fed more than 12 months (0.27). Dentitions with a fluorosis index of 0.12 or less showed a statistically significant association between their feeding histories and the water consumed. The study demonstrates the importance of total dietary intake of fluoride in the early years and indicates the need for awareness of all the potential sources of fluoride in a child’s diet.

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