Baby Bottle Tooth Decay: Shielding Your Baby's Teeth

Tooth decay is a transmissible disease of the teeth. The development of tooth decay involves an interaction between cariogenic (cavity causing) and noncariogenic (non-cavity causing) bacteria, fermentable carbohydrates and components in saliva, which collectively destroy tooth enamel surfaces. Tooth decay occurs in infants and toddlers when harmful plaque bacteria is passed from the mother (or primary caregiver) to the infant through the saliva. This typically occurs when bacteria from the mother's mouth comes in contact with a spoon or pacifier that is then given to the baby.

Baby bottle tooth decay or baby rot tooth is a type of tooth decay found in babies, usually on the front teeth. Baby bottle decay develops when baby teeth come into frequent contact with too much sugar, because of nighttime bottle feeding. Bacteria in the mouth feed on the sugar, multiply, and produce acid as a waste product. The acid attacks the teeth and tooth enamel, resulting in tooth decay. When a baby is put to bed with a bottle (or sippy cup) filled with sugary drinks such as fruit juice, milk (even breast milk) or formula, their teeth are exposed to the sugars (natural or not) in these drinks for a prolonged period. This sugar coats the teeth and can cause baby bottle tooth decay.

Tooth decay can affect teeth as soon as they emerge. It usually affects the upper front teeth; however, other teeth in the mouth are also susceptible. There are different factors that contribute to an infant's risk of developing tooth decay:

• Early exposure of bacteria in the primary dentition (baby teeth)
• Frequent bottle feeding at night
• Frequent sugar consumption and snacking
• Poor oral hygiene
• Enamel hypoplasia (a breakdown of the protective layer of teeth)
• Inadequate amounts of fluoride

Usually, you will see signs of decay on the front teeth which may appear as dark or brown spots on the teeth. As the decay worsens, children might experience pain and swelling around the teeth.

Baby teeth (primary teeth) are important because they allow children to adequately chew their food and speak and they hold the space in the jaw for the permanent teeth. Baby teeth usually appear by six months of age and can be susceptible to tooth decay. Unfortunately, tooth decay can contribute to tooth pain and harm the erupting permanent teeth. Complications of baby bottle decay may include crooked adult teeth, interference with development that can contribute to speech problems, difficulty chewing as well as infection. This is why it is essential to take care of baby teeth even though they are in the mouth temporarily before they fall out.

In the United States, baby bottle tooth decay is highly prevalent among children younger than six years of age. In fact, 44 percent of 5-year-old children have experienced tooth decay. The prevalence of dental caries is primarily in minority and low socioeconomic groups.

• Never allow a baby or toddler to fall asleep with a bottle that contains fruit juices, formula, milk, sweetened liquids or a pacifier dipped in honey or sugar as it can rot teeth or cause baby bottle decay.
• Avoid sharing saliva with the baby through feeding spoons or licking pacifiers.
• Clean the baby's teeth and gums with a clean gauze pad, washcloth or xylitol wipe.
• Brush the baby's teeth using a child-sized toothbrush with water when they first come in. You should get a consultation from your child's dentist or physician if you plan on using fluoride paste prior to age two.
• Children should be supervised when they are brushing, so they can spit without swallowing toothpaste, usually around ages six or seven.
• Encourage your child to drink from a cup before his first birthday.
• Promote healthy eating and drinking habits.

Talk to your dentist about scheduling a dental visit for your child once the first tooth appears. During the first visit, the dentist can demonstrate the proper technique for cleaning your baby's teeth.

Oral Care Center articles are reviewed by an oral health medical professional. This information is for educational purposes only. This content is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your dentist, physician or other qualified healthcare provider.