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baby bottle tooth decay

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Alternative Names
BBTD, baby bottle caries, baby bottle mouth

Baby bottle tooth decay is the progressive breakdown of teeth in an infant or toddler. The decay usually begins in the front teeth and moves back to the molars.

What is going on in the body?
Tooth decay occurs when the enamel, the protective coating on the teeth, breaks down. The mouth naturally has bacteria in it. When a baby drinks liquids through a bottle, the liquids may pool near the gums and teeth. Most liquids contain sugars. In fact, most foods that people eat ultimately break down to become sugar.

The sugars and bacteria combine to form a substance called dental plaque. When the bacteria break down the sugars, acids are formed. These acids are capable of eroding the enamel on the teeth. The result is damage to the teeth. As the damage progresses, the decay can lead to:
  • dental caries which are holes in the enamel, exposing part of the tooth.
  • severe pain, when the decay reaches the pulp or nerve of the tooth.
  • an abscess, which is an infection and swelling of the tooth and gum.
What are the signs and symptoms of the condition?
  • red gums
  • white spots on the teeth
  • pain or irritability
  • a lot of bleeding from the gums
  • fever from gum or tooth infection
What are the causes and risks of the condition?
Baby bottle tooth decay occurs when any liquid other than water is in contact with the teeth for a long time. Sweetened liquids are especially dangerous. Milk, formula, fruit juice, and soft drinks can all cause problems.

A child who has a bottle of sweetened liquids several times a day is at risk for tooth decay. Any child who is allowed to fall asleep with a bottle is also at risk.

What can be done to prevent the condition?
There are many ways to prevent baby bottle tooth decay. These include:
  • Never putting a child to bed with a bottle of milk, formula, fruit juice, or sweetened liquids. If a child needs a bottle in bed, only water should be put in the bottle.
  • Never allowing a child to walk around with a bottle in his or her mouth. The longer sweetened liquids sit in the mouth, the more likely baby bottle tooth decay is.
  • Teaching a child to drink from a cup as soon as possible. A cup can be given to a baby at 6 to 12 months old. Drinking from a cup avoids liquids pooling around the teeth and gums.
  • Wiping a baby's gums with a washcloth after each feeding. Once baby teeth have erupted, brush the teeth with a soft, child-sized toothbrush. Brush the teeth after each feeding.
  • Beginning dental checkups when the baby is 6 to 12 months old.
  • Asking a dentist about the need for fluoride.
  • Flossing the child's teeth as soon as all the baby teeth have erupted, usually when the child is 2 to 3 years old.
How is the condition diagnosed?
Baby bottle tooth decay symptoms are hard to recognise early on. The symptoms may not be obvious until the decay has caused quite a bit of damage to the teeth and gums. Regular dental checkups are important. The dentist can evaluate the teeth closely, and monitor:
  • the structure of the inside and outside of the teeth
  • the current condition of the teeth
  • the enamel
  • the condition of the gums
  • the sensitivity of the teeth
Dental x-rays may be taken to examine the extent of decay.

What are the long-term effects of the condition?
Research suggests that children who have baby bottle tooth decay are at risk for more dental problems later in childhood. These children may have more cavities , and adult teeth may erupt crookedly. Speech problems, ear infections, discoloured permanent teeth known as Turner's tooth, and nutritional problems from early loss of baby teeth can also occur.

What are the risks to others?
The bacteria that cause cavities can be passed from one person to another.

What are the treatments for the condition?
Prevention is the best treatment of all. If baby bottle tooth decay does develop, treatment depends on the extent of tooth decay. Follow-up care from a dentist is very important. Treatments may include:
  • filling
  • extracting a tooth or teeth in some cases
  • antibiotics for infection
  • teaching a caregiver how to provide tooth care
What are the side effects of the treatments?
Side effects from treatment may include:
  • allergic reactions to medications used while filling cavities or extracting teeth
  • allergic reactions or stomach upset caused by antibiotics given for infection
  • discomfort in areas where teeth are treated
What happens after treatment for the condition?
After treatment, the dental decay should be under control. Good dental hygiene and regular visits to the dentist will help prevent any more decay.

How is the condition monitored?
The best way to monitor for dental problems is to have regular dental check-ups. If any unusual symptoms develop, the caregiver should call the dentist.

Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.


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