Research Gap in Identifying the Relationship Between Breastfeeding and Early Childhood Caries in The United States: A Systematic Review




Shah, Dishani
Raiyani, Chandni
Rich, Dr. Alisa PhD, MPH


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Objective: To demonstrate the current research deficit, involving the association between breastfeeding and early childhood caries in the United States (U.S), as compared to other countries through a systematic review. Method: The PubMed database was searched for previously conducted studies relating to the effect of breastfeeding on occurrence of early childhood caries (ECC). Keywords used included “Breastfeeding” “Dental caries” and “dental decay”. Results were further narrowed by searching keywords “Breastfeeding” and “Early childhood caries”. PubMed search resulted in 355 articles published from 1890-2015, and of that 59 articles were selected for the review. References cited in the articles were also selected. Articles were retrieved and categorized according to the country where research study was conducted. Results: Studies conducted in U.S. contributed to only 5% (n=3) in comparison to Brazil, which led the research marathon at 17% (n=10). Research studies conducted in Asia (n=22), Europe (n=12), and Africa (n=7), contributed approximately 67% collectively. 53% of the studies found significant relationship between either prolonged breastfeeding ([greater than] 12 months) or nocturnal breastfeeding and early childhood caries, while 15% were inconclusive. Conclusion: Study results indicate a clear gap in the research conducted in the U.S. investigating association between breastfeeding and early childhood caries when compared internationally. Although many studies have found significant association, it is a highly complex relationship and additional research needs to be done for the U.S. population involving children from different racial, ethnic, educational and socioeconomic background to reach definitive conclusions and decrease the burden of dental caries.