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Excessive bottle-feeding and allowing a baby to drink from a bottle in bed have extreme oral health risks. If the substance in the bottle is high in sugar, the teeth will bathe in it, ultimately causing baby bottle tooth decay (cavities).
The leading cause of baby tooth decay is from drinking fruit juice or milk from a bottle for a long period of time. The mouth’s environment changes the longer and more often teeth are exposed to sugar, which leads to the buildup of dental plaque and cavity-causing bacteria.
Primary tooth decay can affect developing permanent teeth in two ways:
A baby’s first primary tooth erupts around 6 months of age. As they reach infancy (12 months old), the two bottom front teeth erupt. After all of the incisors erupt in the upper and lower jaws, a child’s “12-month” primary molars grow in. Then the canines erupt, along with the “24-month” molars. All baby teeth typically erupt by 3 years of age.
All baby teeth are more susceptible to tooth decay (cavities) because the enamel is thinner. It is crucial to take extra care of baby teeth during the infancy years to prevent cavities and other oral health conditions.
To reduce the chance of decay, oral care habits should begin as soon as a child is born, throughout infancy, and beyond.
During pregnancy, women should eat a nutritious diet and practice good oral health. This includes brushing twice a day, flossing every night, using fluoride, and visiting the dentist regularly to prevent cavities.
A child is three times more likely to develop cavities if his or her mother has untreated tooth decay.
To prevent baby bottle tooth decay, it is essential to practice good oral hygiene and follow these baby feeding practices:
Before a baby’s first baby tooth grows in, it is important to clean the gums twice a day with a washcloth. This ensures bacteria and sugars are removed from the mouth.
Tooth decay is less likely to occur once the baby teeth begin to erupt. It also helps the baby become accustomed to a parent cleaning his or her mouth daily.
Other tips to prevent baby bottle tooth decay include:
Fluoride is a naturally occurring mineral found in rocks and soil that helps prevent tooth decay. Fluoride has been added to water supplies, toothpaste, mouthwashes, and professional dental materials to help strengthen tooth enamel in children and adults.
Studies have shown that fluoride reduces the risk of decay by up to 50 percent in primary (baby) teeth. It also reduces decay by up to 65 percent in permanent teeth of children exposed to fluoridated water since birth.
To help prevent early childhood caries (ECC), children need fluoride in their diets. If the water supply in an area is not fluoridated properly, a fluoride supplement is necessary.
The American Academy of Pediatric Dentistry recommends that children between 6 months and 3 years of age need .25mg of fluoride per day. Children between 3 and 6 years of age need .5mg of fluoride per day.
The upper front teeth are more prone to decay because the substances gather there when a baby falls asleep with a bottle. Early childhood caries (ECC) appear as dark brown spots or small holes on teeth. Common symptoms of major decay include:
If the decay has become severe, symptoms may include:
If a child is experiencing any of the symptoms listed above, they will likely need a dental restoration to treat the infected tooth. Depending on the severity of the decay, a pediatric dentist will recommend a stainless steel crown or tooth extraction:
Stainless steel crowns (SSCs) are used to restore decaying, damaged, or fractured baby teeth. If a baby’s tooth is decaying, but not severely decayed, SSCs help prevent further damage. These crowns are durable, strong, and rarely need follow-up treatment after placement.
The surgical removal of a tooth (extraction) is necessary when a baby tooth becomes severely decayed. Untreated tooth decay can lead to more serious oral conditions later on. For example, the bacteria from the decaying baby tooth can spread into the jaw, airway, bloodstream, or brain.
Front teeth are more prone to baby bottle decay than molars. However, front teeth are easier to extract because they have a single root, rather than multiple roots.
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Brown, Judith E. Nutrition through the Life Cycle. Brooks/Cole, 2019.
Emerging Trends in Oral Health Sciences and Dentistry. InTech, 2015.
Fluoridation Facts. American Dental Association, 2018.
Koch Göran, et al. Pediatric Dentistry: a Clinical Approach. John Wiley & Sons Inc., 2017.
Nowak, Arthur J. Pediatric Dentistry: Infancy through Adolescence. Elsevier, 2019.