Breastfed toddler with ECC

Hi Dr. Ellie,

I am a mother to a 2.5 boy with ECC. He has always been an avid breastfeeder since birth and night nursed the whole time. His upper 4 front teeth are in mild – moderate decay. One has begun to chip away and there are some yucky yellowish decay in between them, I am afraid that we may have to get them pulled. Is there any chance of remineralizing to a point where they won’t have to be extracted? I have always brushed his teeth regularly, but not with any fluoride containing paste, and we have a dug well with unknown flouride levels if any. I have read your blog and have bought some granulated xylitol which I started giving him 1/4 teaspoon with a bit of water after every meal and the ACT rinse on a Q-tip. Do you think that with his regular brushing routine that we will see any improvements? I also have begun night weaning to limit his exposure to breastmilk on his teeth at night. Do you have any other suggestions? thanks so much for your time.


Hi E,

I think you have already understood the most important things to do. I cannot tell you if these teeth are already too damaged to repair – but your efforts will stop future damage – and we hear many success stories from other mothers like yourself.

You and your family need to understand this damage must NOT be blamed on milk – it was NOT the milk that damaged these teeth. The damage is caused by harmful germs – harmful mouth bacteria. These germs feed on sugars or carbohydrates and turn them into acids that corrode and damage teeth.

The problem is disease bacteria in your child’s mouth. These bacteria are infectious, contagious and grow on wet surfaces and on toothbrushes! This means they are passed around from person to person: any caretaker of your child needs to know this. Ensure that your family and network of friends knows this.

Make sure you clean your toothbrushes and store them safely so they air dry every day – away from the toilet area of your bathroom. Harmful bacteria are transferred during kissing or sharing food. Harmful germs will infect your child – so make sure the people around your child ‘clean’ their mouths with xylitol.

6 grams of xylitol each day eradicates harmful mouth bacteria from the mouth in six months.
This will happen even if the person has unfilled cavities or has not had regular cleanings at the dentist. This is the simplest way to turn a damaged and infected mouth into a ‘clean” one!

You need to split the “dose” of xylitol into three or four separate times during the day.
After meals is the ideal time for xylitol (because after meals is when plaque bacteria multiply).

You can use granular xylitol (on a spoon), or eat mints or gum (like Zellies) or you can dissolve a teaspoon of xylitol in a bottle of water (or milk) and give it to your child (and to the rest of your family) to sip during the day.

Without harmful mouth germs – breast milk will not damage your child’s teeth. This is an amazing concept – and even more amazing – is that if you do this work now – you will give your child benefits that will last for years.

Please let me know if you have any more questions

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