Chapter 10- Nursing bottle tooth decay. 

What is Nursing Bottle Caries?

Nursing bottle caries is a type of tooth decay which can be seen affecting upper teeth and lower back teeth in a baby’s mouth and it progress very quickly. Nursing bottle caries has been called by a number of names including nursing caries, nursing bottle syndrome, milk bottle syndrome, baby bottle caries, and baby bottle tooth decay. 

How to identify Nursing Bottle Decay ?

The key feature of nursing bottle caries is that the decay will leave the lower front teeth usually untouched. It is because of the presence of the tongue which covers the lower front teeth and stops it from getting decayed.

At the starting the decay will have chalky white appearance. At this stage the decay can be stopped or be reversed. When left untreated it will progress to dental decay which is brown or black in color. In advanced cases it will form a collar around the teeth and causes the breakage of the teeth leaving behind a stump. 

When and Why does it happen?

Nursing bottle caries can usually start at age 2-3 years and progress if left untreated. This occurs when the child is put to sleep with the nursing bottle as a pacifier. During sleep the flow of saliva is less causing the contents of the drink to be stuck on the teeth. The exposure of sugar in the drink to the teeth for a longtime causes nursing bottle caries. Many at times the liquid can be milk, juice or formula. 

What about milk without sugar?

Even milk without sugar has sugar in it. Milk has macro-nutrients like protein, carbohydrates, fat and along with it also has sugar. Even breastmilk has a small amount of sugar in it. So we are not saying milk is bad, but avoid giving milk with added sugar in it especially at night time.

What will be the treatment? 

Giving proper treatment at the right time is necessary. When the caries is at it’s starting stage it can be fixed with simple fillings but when it has progressed to advanced stages we may do treatment under conscious sedation or general anesthesia or laughing gas.

Why is treatment needed for milk/deciduous teeth?

If there is tooth decay present treatment is required for milk teeth even if it falls out as they grow. It is because milk teeth has to stay in your child mouth until the permanent tooth erupts. The milk teeth acts as spacer and makes sure the next tooth has adequate space to erupt.

  • Loss of milk teeth can cause permanent tooth to erupt crowded.
  • Milk teeth infection can spread to the below lying permanent teeth.
  • Infection can cause pain and swelling.
  • The early loss of teeth can cause problems in chewing and speaking for the child.
  • It can also diminish the self confidence and cause social problems for the child in school because of the appearance of their smile and decayed front tooth.

So early treatment is the best choice. 

How to prevent nursing bottle caries?

  • Stop using feeding bottles as pacifier.
  • Never let the baby sleep with bottle in their mouth. Use alternative methods using soft toys, white noise etc.
  • After feeding make sure to clean your child’s teeth. Use a clean and wet cloth and gently wipe their teeth. 
  • Begin dental visits for your child at age of 1.

Our Mogappair dental clinic is equipped to treat toddlers and preschool children. If you have any questions regarding your toddler’s dental health we are happy to help you.

Keep Smiling & Stay Happy

Dr. Gnanaraj Jayabal
Dental & Implant Surgeon
Denticare Chennai

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