Breastfeeding duration and dental caries under fluoridation coverage-A population-based study

Objectives: Conflicting evidence exists for the potential effect of early feeding practices such as breastfeeding (BF) duration on child dental caries experience. It is hypothesised that such effects can be modified by use of fluoride in early childhood. The study aimed to investigate effects of breastfeeding duration on caries experience of a five-year-old population-based sample, stratified by use of fluoridated water.
Methods: Participants aged 5 years of the National Child Oral Health Study 2012-14 were dichotomised into fluoridated water users (WF users) and non-users (WF non-users) based on residential history and parent-reported use of tap water during the birth–two-year period. The main exposure, breastfeeding duration, collected by questionnaire, was defined as Never BF; 1Results: Some 4.6%(3.3–6.3) of children were still breastfed at age 24 months. The prevalence and severity of caries were significantly higher among WF non-users than the users. Mean dmfs for the non-users vs users among Never BF were 6.3(4.4–8.2) vs 1.6(0.6–2.6); and among BF-at-24-month were 8.4(4.1–12.7) vs 2.7(1.2–4.2). SSB consumption was associated with caries. For WF users, breastfeeding was not associated with caries prevalence in multivariable models. However, for non-users, the Never BF and the BF-at-24-month groups had significantly higher prevalence (PR 2.0(1.3–3.3) and PR 2.5(1.5–4.0) respectively) and mean dmfs (MR 2.8(1.2-6.7) and MR 3.7(1.4-9.6) respectively) than the 6≤BF<24-month group.
Conclusions: Use of fluoridated water early in life modified the relationship between breastfeeding duration and dental caries in children.