How Long Should Breastfeeding Last? A Systematic Review of Its Effects on Dental Caries and Malocclusion in Primary Teeth

Abstract This systematic review explores whether the duration of breastfeeding affects the occurrence of dental caries and malocclusion in primary dentition. It aims to provide clinically relevant evidence that can help guide recommendations on the optimal duration of breastfeeding to support both oral health and early childhood development. The review question was: Does the duration of breastfeeding have an impact on the occurrence of dental caries and malocclusion in primary dentition? A systematic review was conducted following PRISMA guidelines. Searches were performed in PubMed, Scopus, cochrane library and Web of Science .A total of 10 cohort and cross-sectional studies met the inclusion criteria. The results showed a trend toward increased risk of dental caries with prolonged breastfeeding beyond 12 months, particularly when nocturnal feeding and lack of oral hygiene were reported. The risk appears to rise progressively up to 18 months and becomes more significant by 24 months. Conversely, longer breastfeeding duration (> 12 months) was associated with a reduced prevalence of malocclusions, especially compared to early weaning or prolonged bottle-feeding. Breastfeeding duration appears to have a differential impact on oral health: while extended breastfeeding may slightly increase caries risk under specific conditions, it may protect against the development of malocclusions.