Dear Dr. Ellie,
I have a 2 year old daughter and am trying to ensure her teeth are healthy. We have established a good brushing routine (2x a day with fluoride toothpaste -she can swish and spit). We also do not give her many sweets and she eats a healthy diet. My main concern is that she wants milk before nap and bedtime (after brushing). Usually only a few ounces but I have heard this is bad for her teeth.
Your website mentioned Cow’s Milk is not problematic. (We rarely ever give her juice and never before bedtime.) I have heard that milk is a key contiributor to decay. Is that incorrect?
I would like to consider adding xylitol to the milk or just replacing it with xylitol enhanced water. Is the water option better? or would adding xylitol to her milk protect her teeth just as well? How much should I add to the milk (2-3 oz)? Is there a maximum amount a 2 year old should consume? Is it totally safe? What product should I purchase?
Thanks so much!
Thank you so much for this great question about milk. There is so much misunderstanding about milk and teeth!
First there is a big difference between fresh cows milk and formula milk. (Also soy milk is not safe for teeth). Anyone who has prepared formula milk knows how sticky it can be on your fingers. The different sugars in formula milk will not be safe for a child’s teeth during a nap or before bed time.
Cow’s milk is completely different. Cow’s milk is actually protective of teeth and can be classified as safe. Research shows that if you consume cow’s milk in combination with products that would otherwise damage teeth (cookies perhaps ) the milk will be protective.
Most of the confusion began in the 1960s and has been perpetuated ever since! I think it started because lactobacillus is the name of bacteria found in tooth decay and it sounds similar to lactose.
Lactose is the sugar present in milk.
The good news is that lactose sugar does not break down to be acidic enough to damage teeth so it does not damage them and will not contribute to tooth decay. The minerals that are present in milk calcium and phosphates are actually healing for teeth (These are the main ingredients in the new dental paste sold for many dollars by dentists to repair soft teeth. Ha! Ha!)
So the quick answer is yes cow’s milk is safe and I would not worry about giving it to a child in a bottle before nap-time. I used to dilute cows milk with water something you may also want to consider.
On the other hand, you can take this information to a new level as you suggest. If we add just a quarter to half a teaspoon of xylitol to the milk we will make it even better for teeth! Plain water with xylitol would also work well your choice! The xylitol will work to rid your daughter’s mouth of harmful plaque bacteria and offer long term protection.
Thanks again for this question. So many people are afraid to put milk in baby bottles. They select other things like apple juice or fruit juices and are frustrated to find that their kids teeth have dissolved away with large cavities in them. These fruit juices are very acidic whereas the milk is healing and alkaline.
Hope this helps,
Just wanted to say thanks for your blog. 🙂 I’m still an avid reader and learn so much!! 🙂
Dr. Ellie:I have a 15 month old who is happy to let me brush her teeth, but she doesn’t have the ability to keep her tongue out of the way and I have a terrible time getting her top teeth.In an effort to preserve the positivity we’ve established over brushing, I back off once she’s frustrated. I try to model for her how to open her mouth, but she is not there yet.So her top teeth are yellow and it doesn’t come off when I am able to brush it. Would xylitol in a sippy cup of water help? And could I dip a q-tip in ACT and swab her teeth (assuming I can reach them!)?Also, how long has xylitol been on the market?Thanks!M
You say Lactobacillus is the bacteria of tooth decay, yet I often eat yogurt with active cultures including Lactobacillus. Is this the same bacteria? I have been using your program to get rid of the unhealthy bacteria in my mouth. Am I undoing it by eating yogurt? And is it true that this same bacteria is bad for the teeth yet good for the gut? I also sometimes take Probiotics for my gut heath. I’m confused!Thank you for your ongoing efforts to educate me.EW
I will start with your last question first if that is OK! Xylitol was used as a sugar alternative for diabetics over a hundred years ago – before artificial sugar alternatives.During World War II it was used as table sugar – in the homes of Europeans who could not access “regular” sugar. Xylitol is expensive to produce – far more expensive than sugar or artificial sugar alternatives – and so it have never had much of a place in the US until recently.Most people do not know the difference between artificial sweeteners like sorbitol and xylitol – why pay more……etc! Now we know there is a world of difference between xylitol and artificial sweeteners like sorbitol. Sorbitol can grow harmful bacteria since these bad bacteria can use it as an energy source to grow and multiply in your body-(UGH) I am told that sorbitol is used in laboratory culture mediums that GROW bacteria! Xylitol, on the other hand, will get rid of the bad bacteria. Xylitol also helps to heal and remineralize damaged tooth enamel.I would apply xylitol to your child’s teeth – at least one and a half teaspoons each day for six months.It is best if you use a little xylitol five or more times a day – especially at the end of meals or after drinks. You can make a solution in warm water ( so it dissolves) and then apply it on a brush, cloth or as a drink in a cup or bottle.Spiffies are xylitol impregnated cloths designed by a Pediatrician called Ray Wagner – specifically to clean teeth.These little swabs come in fun flavors that kids enjoy. Nice people – nice product – an alternative to brushing for little kids. I think your idea of a little ACT is also a good one – the dilute fluoride in ACT will also help to heal and strengthen this tooth.You could apply with a brush, cloth or Q tip. Bubblegum ACT is a great flavor that kids like. One drop is enough. Be patient -tooth healing takes time! You need to wait a couple of months to assess your progress, but if you are consistent the results can be amazing.Please let me know if you have more questions – we have lots of information for parents on the site:http://www.zellies.com/store.asp?pid=9836 Ellie
Dr. Ellie,My 3 year old daughter just had her first dental cleaning today and they found 3 cavities. My heart is broken for her and I am confused where to turn and furious with myself.I have 3 older children that I used fluoridated toothpaste, rinses and dentist treatments for. They had excellent oral health while they were young and still do. I stopped using fluoridated products about 2 years ago and am afraid this is what has led to her cavities. We have a very healthy diet and eat about 80% organically, no fruit juices, no sodas, no gummy candies or treats and the kids are good about brushing. We drink raw milk and are all in good health. The only thing is we’ve been more lax with the youngest’s teeth brushing than we should have and I found your piece on milk sugar interesting…. she has gone to bed several times with her sippy of the raw milk. There may have been a couple nights a week that we didn’t brush her teeth, and I know that’s completely our fault.The dentists said she had decalcification near her gumline on several of her teeth and a small cavity on her left bicuspid and 1 on each of her very rear back molars. I cried all the way home and just sent my husband to the store to buy “regular” toothpastes and fluoride rinses. We’d been using xylitol toothpastes and mouthwashes and I need to know what you think we should do. I’m rambling, I know. I’m usually more composed than this, sorry.Time is of the essence as my daughter, Savannah, has an appointment in two days for her fillings… Do you really have faith that xylitol can reverse the damage?
Two days is not enough to reverse these decalcified area.If you were to start now it would probably take six months for the cavities to remineralize. I cannot diagnose on the internet how serious your daughter's cavities are – especially the ones on the gum line.Would you be able to have a serious chat with your dentist and ask if you could possibly wait a couple of months before doing the fillings? – I do not understand the rush. I would suggest the following home care: Use a tiny (pea size) amount of Crest Original toothpaste or use a drop of ACT anticavity rinse on the toothbrush to brush her teeth. At three years old she is probably too young to rinse and spit safely – so if you use the Crest you could brush a drop of the ACT onto her teeth after brushing with the toothpaste. I would suggest getting her the bubblegum ACT that kids love! Xylitol will help remineralize the deeper layers of the teeth. I would expect her to like the Zellies fruit mints – they are fruity and delicious – or the kids chewing gum. She does not need to chew for long – just enough time to get the sugary xylitol flavor off the gum and then she can spit it out. If you are diligent with the twice a day brushing with either the Crest Original or ACT and combine this with Zellies gum or mints ( throughout the day) I would expect to arrest and possible reverse the caries. If you arrest and reverse the situation, you will get natural repair – but it is difficult to say if the teeth will repair completely. Perhaps your dentist would be interested to monitor this – for his own experience. If you were a new patient of mine, I would have you work on this for about 8 weeks and then check the progress. If it looked better I would let you go another couple of months and perhaps check again. There is a great product – called fluoride varnish – that is also an idea for helping get fluoride onto the cavities by the gum margin. I hope this information is useful. I would be happy to answer more of your questions – but again, I am not in a position to advise you about a clinical problem.Ellie http://www.zellies.com26 Corporate WoodsRochester, NY 14623(585) 272-1270