Baby bottle tooth decay is a fast-progressing type of decay in babies and young children, linked to milk, formula, fruit juice or sugary drinks from a bottle staying in the mouth for long periods, especially during sleep. It is a common form of early childhood caries.
How does it develop?
Saliva flow drops during sleep. Sugary liquids from the bottle stay around the teeth for a long time, and bacteria turn these sugars into acid. The acid quickly weakens the thin enamel of baby teeth.
Why does it start on the upper front teeth?
While the baby sucks on the bottle, the tongue partly protects the lower front teeth; the liquid pools mostly around the upper front teeth. This is why baby bottle tooth decay typically starts on the upper incisors and can then spread to the molars. The lower front teeth are usually affected later.
Signs
- Chalky white lines or spots on the upper front teeth near the gum
- Brown or black discolouration
- Broken teeth and loss of tooth structure
- Fussiness or pain when eating
- In advanced cases, swelling or an abscess in the gum
Treatment
Treatment is planned according to the stage of decay: in the early stage, fluoride applications and changes to feeding habits; a filling if a cavity has formed; in advanced cases, root canal treatment of the baby tooth or extraction may be needed. In young children, extensive treatment sometimes has to be done under general anaesthesia, which makes prevention all the more important.
Effects of losing baby teeth
Baby teeth lost early can affect chewing, speech and keeping the space needed for the permanent teeth to come through. For information on loss of space and later orthodontic problems, see our article on decay in baby teeth and crowding.
How can it be prevented?
- Do not put your child to sleep with a bottle; clean the teeth after the bedtime feed.
- Put only milk or formula in the bottle; no fruit juice or sugary drinks.
- Do not dip a dummy in honey, sugar or jam.
- Encourage drinking from a cup from around age 1.
- Start brushing with fluoride toothpaste when the first tooth appears.
- Make the first dental visit around the first birthday.
