What you need to know about “Baby Bottle Caries”

“Baby Bottle Caries”  or “Nursing Bottle Caries” or “Early Childhood caries” as it is called is a type of rampant decay seen in children. The damage to the teeth of your little ones happen because of keeping the feeding bottle in the mouth of the child during sleep. Generally, mothers use sweetened water or milk in the feeding bottles and leave it in the child’s mouth in sleep. The bottle acts a pacifier for the child in its sleep. Well, this is quite understandable from the mother’s viewpoint, because she is so exhausted by night and wants to get her share of good sleep and rest. After all, she needs to gear up for the next day.

What you also have to know is that such a practice causes severe damage to your 1 or 2 year olds. Yes!!! the damage to the kids teeth can happen that early in life. It is important as  caregiver for you to understand these facts about early rampant caries in your child.

What causes baby bottle caries?

You are all well aware that the refined sugars in our diet is the main culprit in causing decay in teeth. With the diet shifting to more and more refined food and lesser fibrous foods, the incidence of caries or tooth decay is only on the rise especially in children.

Tooth decay works on the presence of 4 main factors—Host ( tooth ), time, substrate ( mainly sugars ) and bacteria. The presence of these factors makes the decay process happen. Sugar plays a major role in the occurrence of caries. As the sugars stay longer in the mouth the chances of decay is higher. If you do the math you will understand that,  if the child has the source of sugar ( sweetened milk or sweetened water ) in the mouth for a span of 8 to 10 hours the damage is exponential.

There is less salivary flow at night and hence less capacity for buffering and remineralisation. Each time a child drinks these liquids, acids attack for 20 minutes or longer. As a parent you are a major influence on the caries experience of your child, their feeding and dietary habits and food choices.

What does the decay look like?

  • The early decay process begins as white spot on the teeth. This is the early demineralisation phase. This stage may generally go un noticed by you. When preventive measures are not taken at this point, the decay progresses to the next stage. The teeth are rapidly destroyed and the brownish or blackish colour of the decay  is seen.
  • The upper front teeth are the most affected by the decay process. Generally, the lower front teeth are spared because of the tongue. The tongue rests against the lower teeth and acts as a barrier.
  • The decay progresses rapidly breaking the tooth fully. This leaves behind only the roots of the teeth, tooth pain and abscess formation in the gums.
  • The destruction of the early milk teeth leads to difficulty in eating, sleeping and speech in the child.

How can you prevent Nursing Bottle Caries?

Avoid Sippy cups or bottles

Using bottles or sippers at night is the main contributing factor in causing the decay. This is an absolute NO-NO for your child. When the continuous supply of sugar is not present, the mouth can return to neutral and therefore reduce acidity. It I best to introduce cups to your child as the approach their first birthday and reduce the use of feeding bottles.

Healthy nutritional diet

The micronutrients like vitamins and minerals play a major role in the health of the teeth. Foods rich in calcium, phosphates, fluoride and vitamin A,D, C and B12 help your child build strong teeth and gums. These nutrients taken as fibre rich foods also help in the mechanical cleaning of the teeth.

Optimal plaque removal

Care for the teeth begins even before its eruption. You have to clean the gum pads of the infant. When the first teeth are seen in the mouth you have start brushing. Use age and size appropriate toothbrush and tooth paste for twice daily brushing. Children below 2 years may not need tooth paste. Your child needs assistance in brushing till the age of 6 years and supervision in brushing till the age of 8 years.

Use of fluoridation on the tooth surface once erupted

Fluoride is an easily available mineral. It is effective in remineralisation of tooth enamel, often repairing tooth surface and reducing the risk of caries. It is therefore an active ingredient in many tooth pastes. Daily use of fluoridated tooth paste in children is beneficial. Using a pea size is sufficient. You have to ensure though, that your child spits and does not swallow the paste. Fluoridated pastes may not be recommended for children less than 2 years of age.

Care taken by the mother during pregnancy

The diet of the mother during pregnancy plays a key role in the growth and maturation of the tooth enamel. A well-balanced diet of high nutritional value during the first 3 months of pregnancy an during the first year of the child is important. This is the prime time of all teeth development. If the teeth enamel does not grow and mature properly with the required minerals during this time, the tooth becomes a weak structure.

Regular dental visits

Your child’s first visit to the dentist should be scheduled when the first tooth appears in the mouth. The dentist will guide you on proper oral hygiene measures for your child. Children who have seen a dentist early in the lives have lesser dental related issues and incur lower dental related costs throughout their lives.

What is the treatment for nursing bottle caries?

In severe cases, where the teeth are fully broken down and only the root is remaining, the tooth has to be removed. The tooth is also removed when it is infected and causing pain. Space maintaining appliances may be given depending on the case requirement.

In moderate decay cases, the carious teeth are cleaned and filled with a restorative material. Your dentist may recommend topical fluoride application at planned intervals. Your dentist may also do pulpectomy (Rct in children) and place stainless steel caps in infected teeth. Meticulous brushing and good dietary habits go a long way in preserving the dental health of your child.

If you can detect the problem in the early stages, preventive measures like fluoride application, good oral hygiene habits and discontinuing the bottle habit will prevent further damage. Talk to your dentist or the hygienist, who will guide you on preventive measures specifically for your child’s requirement.


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