dental instruments and oral health

What is Baby Bottle Tooth Decay?

Improper infant feeding and poor oral care promote the growth of Streptococcus mutans, a cavity-causing bacteria. Excessive bottle-feeding and allowing a baby to drink from a bottle in bed have extreme oral health risks. For example, if the substance in the bottle is high in sugar, the teeth will bathe in it, ultimately causing baby bottle tooth decay.

The leading cause of baby tooth decay is from habitual consumption of fruit juice or milk from a bottle for a long period of time. This is because the mouth’s environment changes the longer and more often teeth are exposed to sugar, which leads to the buildup of bacteria and dental plaque.

How Does Primary Tooth Decay Affect Permanent Teeth?

Primary tooth decay can affect developing permanent teeth in two ways:

  1. Permanent teeth cannot get an infection from a primary tooth when they are under the gums. It is only through direct contact with the bacteria in the oral cavity that they, too, could become affected by tooth decay. When the teeth remain under the gums, they are in a sterile environment.
  2. If a primary tooth is removed due to severe decay, permanent teeth will grow into the open space, causing an incorrect bite and crowded teeth. Children will typically need orthodontic treatment, such as braces or aligners, once all permanent teeth grow in. If primary teeth are lost prematurely, space maintainers can be used to keep permanent teeth in alignment as they grow in.

Preventing Baby Tooth Decay

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 canines erupt, along with the “24-month” molars. All baby teeth typically erupt by 3 years of age.

All primary teeth are more susceptible to demineralization (decay) because the enamel is thinner. It is crucial to take extra care of baby teeth during the infancy years to prevent decay and other oral health conditions later on. To reduce the chance of decay, oral care habits should begin as soon as the child is born and into infancy.

Proper Baby Feeding Habits

  • During pregnancy, women should eat nutritious foods and practice good oral health, such as 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 have tooth decay or cavities if their mother has high levels of untreated tooth decay.
  • Before a baby’s first primary 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 and decay is less likely to occur once teeth begin to erupt. It also helps the baby become accustomed to a parent cleaning the mouth regularly.
  • Once the first tooth erupts, babies should begin visiting a pediatric dentist at least twice a year for teeth cleanings and dental exams.
  • As teeth grow in, they should be brushed lightly twice daily to remove any plaque, decay-causing bacteria, and sugars. Flossing should also begin once all primary teeth have grown in.
  • Replace bottles with cups between 6 months and 1 year of age.
  • Reduce the intake of sugary foods, such as artificial sodas and juices.
  • Breast-feed babies more frequently.
  • Do not let babies sleep with a bottle in their mouth and gradually reduce the amount of liquid in the bottle by nighttime.
  • Use naturally sweetened juices or teas.
  • Eliminate pacifier use around 4 years of age and never dip them in honey or other sugary substances.
bottle of fluoride and fluoride supplements for cavity prevention in baby teeth

Role of Fluoride in Cavity Prevention

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. On the other hand, children between 3 and 6 years of age need .5mg of fluoride per day.

Symptoms of Primary Tooth Decay

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:

Treatment Options

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 crown covering a primary tooth
Stainless Steel Crowns (SSC)

Stainless steel crowns (SSCs) are used to restore decaying, damaged, or fractured primary teeth. If a baby’s tooth is decaying, but not severely decayed, SSCs help prevent further damage. The crowns are durable, strong, and rarely need follow-up treatment after placement.

extracting a permanent tooth due to decay or disease
Primary Tooth Extractions

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. Although, front teeth are easier to extract because they have a single root, rather than multiple roots.