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Preventing Baby Bottle Tooth Decay

The Oral Health Hazard of Baby Bottle Syndrome

Baby bottle tooth decay is a condition resulting from frequent and long-term exposure of baby teeth to sugar-containing liquids, from sodas and sweetened drinks to baby formula, milk, fruit juice, and even breast milk. It doesn't matter whether the liquid is artificially sweetened or contains natural sugars. Breast-fed infants with prolonged feeding habits are also at risk in developing this condition. Baby bottle tooth decay may also be called baby bottle syndrome or bottle rot.

Bacteria found in plaque feed off the sugar in these liquids producing an acid byproduct. Acid attacks the gums and teeth, putting children at risk of tooth decay. If left untreated, the potential for pain and infection exists. Long-term effects include crooked teeth, speech problems, poor eating habits, and damaged adult teeth with the potential for tooth loss.

Tips to preventing baby bottle tooth decay or baby bottle syndrome

• Do not put a child to bed with anything other than water. While an infant may suck on a bottle while falling asleep, it is very important to remove bottles containing either artificial or natural sugars before napping or at night. During sleep, the amount of saliva decreases, and sugars from the drink coat the gums and teeth for an extended amount of time, increasing the chance of cavities.
• Daily cleaning and massaging a child's gums help establish healthy teeth, as well as provide special comfort while teething. At least once a day, moisten a gauze square or washcloth and gently rub your baby's gums.
• As baby teeth appear, brush them gently with a soft toothbrush and do not use toothpaste until two years of age.
• Wean children from bottles whenever they can drink from a cup. However, pediatric dentists recommend waiting until children are at least 6 to 12 months to provide adequate time for strengthening facial muscles developed by the sucking motion from a bottle or breast.
• Take "baby" steps for achieving good oral health. To help in the weaning of sugar-containing liquids, gradually dilute the bottle's contents with water over a two- to three-week period. If your child still is using a bottle after that time, fill it with water since it's the only liquid which doesn't pose any risk for baby bottle tooth decay or baby bottle syndrome. You could also give your child a clean pacifier recommended by your child's dentist. Be sure to check with your child's physician regarding any changes in feeding routines.
• Between the ages of 6 to 12 months, schedule your child's first visit to the pediatric dentist.

Stop baby bottle tooth decay or baby bottle syndrome before it starts! Follow these prevention tips for optimal oral health.

By Brian J. Gray, DDS, MAGD, FICO

Pediatric Dentist and Tooth Decay FAQs

Q. Should you give a baby a fluoride supplement?

A. Babies living in areas where the water supply is fluoridated do not need fluoride supplements. If the water supply is not fluoridated, or if the baby is breastfed, the physician or pediatric dentist may recommend supplements starting at the age of six months.

Besides tap water, and often bottled water as well, fluoride also is found in juices (especially cranberry juice) and baby foods (especially chicken). These sources may provide enough fluoride without the need for supplements, so discuss the need for fluoride supplements with your child's physician and/or pediatric dentist

Q. What causes "baby bottle tooth decay"?

A. Frequent, long-term exposure of a child's teeth to sugary liquids (including breast milk, formula, and milk) causes baby bottle tooth decay. The sugars in these liquids pool around the teeth and feed the bacteria in plaque.

Q. When should an infant's oral hygiene begin?

A. Even without teeth, oral hygiene should begin soon after birth. After each feeding, wipe your baby's gums, inside the cheeks, tongue, and roof of the mouth with a clean, damp washcloth or wet gauze pad. This removes plaque, the sticky film containing decay-causing bacteria.

Q. What are the white patches sometimes found in a newborn's mouth?

A. Yeast infections in the mouth occur frequently in newborns. White patches can spot the tongue, cheeks, gums, or roof of the mouth. If they are removed, some bleeding will occur. Treatment is usually unnecessary; however, your doctor should be notified of this condition.

Q. What is the condition known as "tongue-tie"?

A. A piece of tissue connects the tongue to the bottom of the mouth, and if it's too short, a condition known as ankyloglossia results. This is common in newborns and usually resolves itself over time. The only reason to have the tissue cut is if the infant cannot nurse.

Q. When do babies start getting primary teeth?

A. The average age for the first primary tooth is five to six months; however, there is great variation.

Q. What are the signs of teething?

A. Fussiness, excessive drooling, rash, diarrhea, changes in sleep and feeding patterns, and fever can signal a baby's discomfort. However, don't assume that a fever or these changes are caused just from teething. They also can be symptoms of other health conditions. Check with your doctor to ensure your baby receives proper medical care.

Q. What remedies are recommended for teething pain?

A. Your children's dentist or pediatrician may recommend a pacifier, teething ring, or a special numbing ointment for the gums. Some teething rings and pacifiers can be chilled to extend their numbing effect. Older children will enjoy the soothing relief that popsicles provide.

Q. How can you help your child's teething pain?

A. To help your child's teeth pain, gently massage the infant's gums with a clean, wet finger, a small, cool spoon, or a clean, wet gauze pad. This often soothes the child's teeth pain and irritation. A cold rubber teething ring also helps.

Q. Can decay-causing bacteria be passed to an infant?

A. Yes, babies are exposed to bacteria from a variety of sources, such as a caregiver blowing on food to cool it, tasting food, sharing utensils, kissing the infant on the mouth, sharing a cup, or sucking on the baby's fingers. Care should be taken not to expose the infant to bacterial exposure from these sources.

Q. How should you care for a child's primary teeth?

A. As soon as the first tooth erupts, with a clean, wet washcloth or wet gauze. The gums also should be gently wiped. If a toothbrush is used, it should be an appropriate size.

Q. When should you start caring for your child's teeth?

A. As soon as primary teeth appear, they are at risk for decay and need to be brushed twice daily with a soft-bristled brush. Do not use toothpaste until your child is two years old.

Q. How can you prevent baby bottle tooth decay?

A. You can prevent baby bottle tooth decay by wiping the child's teeth and gums with a clean, moist washcloth after each feeding to remove plaque. You should never let your child go to sleep with a bottle containing a sweetened liquid. Among these are milk (including breast milk), formula, fruit juice, and other sweetened liquids. Constant use of a sipping cup containing sweetened liquids also can cause baby bottle tooth decay.

Q. Why is it important to care for primary (baby) teeth, since they will fall out anyway?

A. Primary teeth serve as the foundation for a healthy mouth, including the gums and the proper positioning of permanent teeth. They serve as natural space maintainers, holding the space open until the permanent teeth are ready to take their place.

If primary teeth become broken or decayed and are not properly treated, problems can occur with permanent teeth, which may contribute to other health problems. The result can be costly orthodontics and other pediatric dentistry treatments.

Q. Can juices hurt your child's teeth?

A. Because of the sugar content, juice and juice products have much greater potential to cause decay. Apple juice may cause staining of the teeth and should be diluted with water. Any beverage other than water has the potential to cause tooth decay, especially if the child drinks it frequently.

Q. What problems occur from baby bottle tooth decay?

A. To repair the decay, extensive treatment or extraction of the teeth may be required. Because the children are usually around 18 months to 2 years of age, hospitalization with general anesthesia is often required to perform these procedures.

Q. Is sucking harmful for teeth?

A. While sucking is a natural reflex, sucking on thumbs and pacifiers can cause problems after the permanent teeth erupt. Continued sucking after this time affects the proper growth of the mouth, alignment of teeth, and the development of the roof of the mouth that can result in the need for orthodontic treatment and other pediatric dentistry treatments in the future.

Q. How can parents encourage a child to stop thumb sucking?

A. Set a positive tone and praise the child when they're not sucking. Thumb sucking is a stress-reliever and offers comfort. Look for any factor that might be causing discomfort or anxiety and seek solutions to correcting them, rather than focusing on sucking as the issue.

Reward the child when he or she doesn't fall back into the habit, especially during stressful situations. Schedule an appointment with the child's pediatric dentist to talk about what is likely to happen if the habit continues.

Q. What can parents do if a child has difficulty breaking a thumb sucking habit?

A. Finding ways to take away the pleasure of thumb sucking reduces or eliminates the satisfaction gained from it. Bandage the thumb or put a sock over the hand at night. A pediatric dentist or pediatrician can prescribe a bitter-tasting medication to coat the thumb. A mouth appliance can be used to block the ability to suck.