Understanding Baby Bottle Tooth Decay

Baby bottle tooth decay

We all know how easy it is to put our child to bed with a bottle. The idea seems especially tempting after a long day of work, and your little one is having a hard time settling down. But did you know that bottle-feeding babies can impose a risk of tooth decay?

To recognize the importance of preventing tooth decay, especially amongst infants and toddlers, we must first understand what tooth decay really is.

Tooth decay

What is Tooth Decay?

In a superficial sense, tooth decay refers to the layer of bacteria that encompasses your teeth.

Over time, this could cause plaque and other damage to the surface of your teeth. Now, imagine, how tooth decay can severely impact your child’s oral health!

When the decay presents itself within the child’s tooth, it is referred to as “Early childhood caries” or popularly known as, “Baby bottle tooth decay”. So, when your baby is put to bed with a bottle of sweetened liquids or those with natural sugars like milk, formula and fruit juice, the sugar contained within these beverages will pool into your baby’s mouth.

As a result of this, the enamel of your child’s tooth is exposed to bacteria, which breaks down these sugars, producing the acid that attacks the teeth. In most cases, this decay usually occurs on the upper front teeth of the child’s mouth. However, since the salivary flow is decreased during sleep, there is even lesser protection on your baby’s teeth, making them vulnerable to infections in other parts of their teeth.

Now that we have basic knowledge of baby bottle tooth decay, let us identify the causes that lead to this problem.

What causes baby bottle tooth decay?

1 – Prolonged exposure of the baby’s teeth to sugary drinks

When this happens, the bacteria can proliferate into your child’s teeth and can erode their enamel. This could cause a rapid succession of cavities in your child’s teeth.

According to research conducted by the National Library of Medicine[i], many groups of people, including children with habitually high consumption levels of sugars, are more prone to tooth decay or dental caries.

2 – Addition of Non Milk Extrinsic Sugars (NMEs)

NMEs are the sugars that are naturally present in table sugars or honey, syrups, fruit juices etc. Examples are sucrose, table sugar, etc. In contrast to milk sugars (sugar that is naturally found in milk), the NMEs are the real bad guy here.

This is because, according to the report produced by World Health Organization[ii], the added sugars or sucrose (NMEs), form plaque over the surface of the tooth. When these layers of plaque thicken over time, it may damage your child’s dental health.

3 – Transference of Saliva from one person to another

This means that, when your child is fed using a used feeding spoon, the transference of saliva from parent or caregiver to the child, may expose the latter to the risk of bacterial infections that may damage their teeth.

4 – Using pacifiers for an extended period

Pacifiers are also a major factor in tooth decay among children. According to our paediatric dentist, it can also cause prolonged problems with the development of adult teeth.

Now that we are aware of tooth decay and its causes, let us learn to recognize the symptoms of tooth decay in children before it’s too late!

How do I know when to take my child to the Dentist?

When you detect the following symptoms in your infants or toddlers, you may need to take them to a pediatric dentist:

When you notice white spots in your child’s teeth: White spots refer to the demineralization or in simple words, erosion of the enamel covering your child’s tooth. Due to the extensive build-up of bacteria, this demineralization may indicate tooth decay.

Bad Breath: When cavities occur in the upper side of the teeth, it can cause bad breath. Thus, you will need to take your child to the dentist if they have persistent bad breath, despite maintaining standard oral hygiene.

Black or Brown spots on the teeth: If you notice brown or black spots prevailing within your child’s teeth, then they most likely suffer from cavities. Hence, it is important to rush to your pediatric dentist once a cavity is discovered, or else it may spread to adjacent healthy teeth and impair your child’s overall oral health.

Bleeding or Swollen Gums: Bleeding or swollen gums are a direct indication of tooth decay. If your child finds it difficult to maintain oral hygiene, has recurring toothaches, and is unable to consume food normally, then they may be suffering from dental caries.

A reddened gum area is also an indication of upcoming gum disease. Hence, give your child immediate dental care to avoid any further complications from impeding their oral health.

Although these symptoms may seem apparent to the naked eye, they may go unnoticed by you and your child. When this happens, it gives rise to an array of complications that can affect both, their primary teeth, as well as their developing adult teeth.

What are the complications arising from Baby Bottle Tooth Decay?

Chronic pain in the teeth and jaw: Your infant or toddler may feel extremely anxious with the chronic pain in their mouth. This may discourage them from feeding, talking, playing, and enjoying other activities of their childhood.
Thus, untreated teeth decay can potentially compromise the quality of your kid’s life.

Chewing Difficulties: Since tooth decays tests your child’s pain threshold, they will naturally depict emotions of unhappiness and reluctance to consume their food. As a result of the chewing difficulties, their general eating habits may deteriorate as the intake of their nutritional value declines.

Dental Infections: The repercussions of a decaying primary tooth are dental infections and tooth loss. Premature loss of the primary tooth due to extractions (in the event of teeth infections), may cause gaps in your child’s teeth, leading to the need for complicated orthodontic treatments in the future.

Treating the Baby Bottle Tooth Decay

Your infant or toddler may be eligible for treatments if their dental problems have been detected in the early stage. In this context, the early stage would be defined as the appearance of white spots on the surface of your child’s teeth. Listed below are some of the treatment options recommended by our expert paediatric dentist:

  1. Application of dental Fillings over the cavity.
  2. Implanting Dental Crowns over the damaged tooth.
  3. Using Space Maintainers to preserve the growth and alignment of permanent teeth.
  4. Using prosthetic teeth or pediatric partials to fill the gaps residing between the lost front teeth.

However, as the saying goes, “prevention is better than cure”.  Thus, we encourage you to be aware of the preventive measures that can be implemented to protect your baby’s oral health for the long term.

Preventing Baby Bottle Tooth Decay

  • Massage and wipe your baby’s gums with a clean damp gauze pad or washcloth after each feeding.
  • When your child’s first tooth comes in, brush it gently with a child-size toothbrush and water. Use just a “smear” of toothpaste for children younger than 3 years old and a pea-size amount for children 3 to 6.
  • Start flossing daily as soon as two teeth touch each other.
  • Never put your baby to bed with a bottle containing anything but water. If your baby sleeps with a bottle, gradually wean him or her off by removing it as soon as he or she falls asleep. Dilute the bottle contents with water over 2 to 3 weeks. Once that period is over, fill the bottle only with water.
  • Place only formula, milk, or breastmilk in bottles. Never fill bottles with liquids such as sugar water, juice, or soft drinks.
  • Never give your child a pacifier dipped in anything sweet like sugar or honey.
  • Wean your baby off of juice (yes, this includes those labelled 100% freshly squeezed). Once your child is old enough to carry around a sippy cup try filling it with just water. Limit the consumption of juice to meal times only. Here are some guidelines for sippy cup use.
  • Book your baby’s first visit to the dentist after the first tooth emerges and no later than the first birthday.

Although your child’s primary teeth are not permanent, they are an integral part of their oral health. Children need healthy teeth to eat, speak and have attractive smiles. The function of the baby teeth is to hold space in the jaw for permanent teeth. Teeth that are lost too early due to tooth decay may cause the adult teeth to become crooked and misaligned.

Check out our website if your child is showing indications of baby bottle teeth decay. Our pediatric dentists are dedicated to providing your kid with the best dental care available.


[i] https://pubmed.ncbi.nlm.nih.gov/15153701/

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