Also called: Severe Early Childhood Caries, Bottle Mouth, Early Childhood Tooth Decay
Baby bottle tooth decay is a condition in which children develop cavities very early in life. In most cases, it results from tooth damage caused by too much exposure to sweetened liquids in a baby bottle. However, children are also at risk when they drink liquids regularly from a sippy cup or consistently eat sugary foods.
Baby bottle tooth decay primarily results from damage to the tooth enamel caused by long-term exposure to almost any type of liquid other than water. The sugars in such liquids – including cow’s milk, formula, breast milk, fruit juice, punches and gelatin – cling to teeth for a long period of time, allowing bacteria to feed and creating acid that damages tooth enamel.
Cavities early in life can jeopardize a child’s long-term dental health. When baby teeth are lost prematurely, other adjacent teeth may begin to drift into the empty space. This can prevent permanent teeth from coming in straight later on, or may prevent them from erupting at all (impaction). Children with early tooth decay are at risk for pain and infection and may have lifelong problems with their teeth or develop other conditions such as speech impediments.
A dentist will often diagnose baby bottle tooth decay. There are several characteristic signs of this condition. Teeth may become pocked, pitted or discolored. Early on, teeth may develop small white spots or lines, especially near the edges of the gums. Over time, these patches may become brown or chipped.
By the time baby bottle tooth decay is obvious enough to be diagnosed, it may be too late to save the teeth. Dental treatment and restoration may be necessary. In severe cases, children may develop cavities that are so serious that they require teeth extraction.
To help prevent baby bottle tooth decay, parents or caregivers should avoid giving their child a bottle continually. Parents are urged to never allow a child to fall asleep with a bottle containing any fluid other than water during naps or at night. Washing an infant’s gums regularly, and brushing and flossing teeth once they erupt are other important prevention methods.
About baby bottle tooth decay
Baby bottle tooth decay is a condition that occurs when a child’s tooth enamel is gradually damaged by overexposure to sweetened liquids in a baby bottle. Most often, the child’s upper front teeth are damaged. However, other teeth also can be affected. Children who drink liquids regularly from a sippy cup or who eat excessive amounts of sugary foods are also said to have baby bottle tooth decay if they develop early cavities. According to the U.S. Centers for Disease Control and Prevention (CDC), 17 percent of children aged 2 to 4 years have experienced tooth decay.
About six months after children are born, the primary teeth begin to come in. These teeth are only temporary, and over the years they will fall out and make way for the child’s permanent, adult teeth. Nonetheless, some baby teeth may remain well into a child’s teen years.
Baby teeth serve a couple of important purposes. They help children to chew food and they fill a space in the jaw until adult teeth come in. If these teeth are lost prematurely, other adjacent teeth may begin to drift into the space. This can prevent permanent teeth from coming in straight later on, or may prevent them from erupting altogether (impaction).
Tooth decay is caused by a combination of sugar exposure, mouth bacteria and lack of tooth strength. Prolonged sucking on a baby bottle that contains any liquid other than water exposes children to sugars that can damage the teeth. Children are born with an instinct to suck, making them naturally prone to sucking on a bottle for excessively long periods of time.
Once decay develops in one or more teeth, it tends to spread rapidly. Children with early tooth decay are at risk for pain and infection, and may have lifelong problems with their teeth. In addition, children may develop associated long-term disorders such as speech impediments, psychological damage, and crooked or crowded teeth.
Baby bottle tooth decay can be difficult to treat. For this reason, it is important that parents or caregivers take measures to protect their children from developing this condition in the first place.
Potential causes of baby bottle tooth decay
Baby bottle tooth decay is the result of damage to the tooth enamel caused by long-term exposure to almost any type of liquid aside from water. The sugars in such liquids – including cow’s milk, breast milk, formula, fruit juice, punches and gelatin – cling to teeth for a long period of time.
Bacteria feed on these sugars, which in turn produces acids that attack tooth enamel for 20 minutes or longer after each meal. When children frequently suck on bottles or sippy cups, their teeth can undergo an almost constant process of decay.
Saliva is a protective fluid that helps to neutralize acids in the mouth and cleanse the teeth. Saliva production drops during sleep. If a child is allowed to fall asleep with a bottle of milk, formula or other sugary liquid, the protective effects of saliva on the teeth are reduced.
In most cases, prolonged sucking on a baby bottle is the primary cause of baby bottle tooth decay. However, breastfeeding continually throughout the night has also been associated with early childhood cavities. This is especially true if sugary foods or beverages are consumed in addition to breast milk. In fact, the combination of breast or bottle feeding and eating sugary foods may be more likely to produce tooth decay than merely drinking sugary beverages alone.
Mouth bacteria are an important component in the development of tooth decay. Bacteria normally reside in the mouth, but can also be passed from one person to another. Parents or caregivers can transmit the bacteria in their mouths to a child. This can occur if the parent pre-chews food or places a pacifier, bottle or spoon in the mouth before giving it to the child.
Family history also influences tooth decay in children. Children from families with a known history of primary teeth decay, extensive tooth decay or early tooth extraction have a greater risk for early tooth decay.
Signs and symptoms of baby bottle tooth decay
There are several characteristic signs of baby bottle tooth decay. During early decay, the teeth may be sensitive to temperature changes and sweets. Teeth may become pocked, pitted or discolored and small white spots or lines may appear, especially near the edges of the gums. Over time, these patches may become brown or chipped.
A child’s top front teeth are the most likely to be affected. This is because these teeth are among the first to erupt, giving them the longest period of exposure to sugars from a bottle. In addition, the lower front teeth tend to be protected by the child’s tongue during the time when the child sucks on the nipple of the bottle or breast. However, baby bottle tooth decay tends to spread rapidly, and all primary teeth are at risk.
Diagnosis/treatment of baby bottle tooth decay
Baby bottle tooth decay will often be diagnosed by a dentist during a dental examination. However, it is important to note that by the time tooth decay is visibly obvious enough to be diagnosed, it may be too late to save the Teeth. Dental treatment and restoration (e.g., crowns) may be necessary. Sometimes, parents or caregivers identify abnormalities in a child’s teeth that require prompt consultation of a dentist or physician. Researchers are investigating new ways to detect early baby bottle tooth decay.
In severe cases, children may develop cavities that are so serious that they require pulling of the teeth. This usually occurs before a child’s third birthday and is performed in a hospital operating room while the child is under general anesthesia.
Prevention of baby bottle tooth decay
To help prevent baby bottle tooth decay, parents should avoid giving their child a bottle too frequently during the day. Parents or caregivers are urged to never allow a child to fall asleep with a bottle during naps or at night unless the bottle only contains water. Children should also not be allowed to walk around for extended periods of time with a bottle that contains any liquid other than water.
Children should not receive sugary drinks before naps or bedtime. During sleep, the flow of saliva decreases. This allows sugary liquids to linger on a child’s teeth for a longer period of time.
Parents or caregivers are urged to wipe their baby’s gums with a clean gauze pad after every feeding. This can be performed from birth until the teeth start to erupt. Once the child’s first tooth erupts, brushing with a soft toothbrush should begin on the tooth, and the areas of gum that remain toothless should be massaged. Flossing should begin as soon as two teeth are in contact or all the baby teeth have erupted.
Complete tooth eruption typically occurs sometime after a child turns age 2. A dentist may also recommend varnishing a child’s teeth with fluoride to strengthen teeth and discourage decay. Regular dental care is an important part of maintaining a child’s oral health.
Other tips to discourage baby bottle tooth decay include:
- Try to switch a child from a bottle to a cup before the child reaches age 1.
- Never dip a pacifier in any sweet liquid.
- Never use a baby bottle as a pacifier.
- Do not fill a baby bottle with sugar water or soft drinks.
- Avoid placing food or objects in a parent or caregiver’s mouth and then giving the object to a child. This can transmit mouth bacteria that contribute to tooth decay from adults to children.
- Find out whether the local water supply contains fluoride. If it does not, consult a dentist about fluoride supplements for children who are at least 6 months old.
- Avoid breastfeeding on demand at night during sleep. Scientists do not fully understand the cavity-causing potential of breast milk, and breast milk is widely acknowledged to be healthy for infants. However, breastfeeding whenever the child wants during the night can promote a constant supply of milk-based sugars on the teeth.
- Schedule regular dental visits after the child’s first birthday.
Questions for your doctor
Preparing questions in advance can help patients and parents to have more meaningful discussions with their physicians and dentists regarding their or their child’s treatment options. The following questions related to baby bottle tooth decay may be helpful:
- How can I best prevent baby bottle tooth decay in my child?
- I’m breastfeeding my child. What steps should I take to make sure I don’t overfeed my child and cause baby bottle tooth decay?
- How will I know if my child has signs of baby bottle tooth decay?
- How will you diagnose my child’s baby bottle tooth decay?
- What are my child’s treatment options?
- Are there drawbacks to these treatments?
- Are there certain foods or drinks my child should avoid?
- Will my child have dental problems for the rest of his/her life? How can I minimize these problems?
- Will my child need to see the dentist more often due to his/her baby bottle decay?
- How can I find out if my water is fluoridated?