Maintaining the health of primary (baby) teeth is exceptionally important.  Although baby teeth will eventually be replaced, they fulfill several crucial functions in the meantime.

Baby teeth aid enunciation and speech production, help the child to chew food correctly, maintain space in the jaw for adult teeth, and prevent the tongue from posturing abnormally in the mouth.  When baby teeth are lost prematurely due to decay or trauma, adjacent teeth shift to fill the gap.  This phenomenon can lead to impacted adult teeth, years of orthodontic treatment, and a poor aesthetic result.

Babies are at risk for tooth decay as soon as the first primary tooth emerges – usually around the age of six months.  For this reason, the American Academy of Pediatric Dentistry (AAPD) recommends a “well baby check up” with a dentist around the age of twelve months.

What is baby bottle tooth decay?

The term “baby bottle tooth decay” refers to early childhood caries (cavities), which occur in infants and toddlers.  Baby bottle tooth decay may affect any or all of the teeth, but is most prevalent in the front teeth on the upper jaw.

If baby bottle tooth decay becomes too severe, the dentist may be unable to save the affected tooth.  In such cases, the damaged tooth is removed, and a space maintainer is provided to prevent misalignment of the remaining teeth. Scheduling regular checkups with a dentist and implementing a good homecare routine can completely prevent baby bottle tooth decay.

How does baby bottle tooth decay start?

Acid-producing bacteria in the oral cavity cause tooth decay.  Initially, these bacteria may be transmitted from mother or father to baby through saliva.  Every time parents share a spoon with the baby or attempt to cleanse a pacifier with their mouths, the parental bacteria invade the baby’s mouth.

The most prominent cause of baby bottle tooth decay however, is frequent exposure to sweetened liquids.  These liquids include breast milk, baby formula, juice, and sweetened water – almost any fluid a parent might fill a baby bottle with.

Especially when sweetened liquids are used as a naptime or nighttime drink, they remain in the mouth for an extended period of time.  Oral bacteria feed on the sugar on and around the teeth and then emit harmful acids. These acids attack tooth enamel and wear it away.  The result is painful cavities and pediatric tooth decay.

Infants who are not receiving an appropriate amount of fluoride are at increased risk for tooth decay.  Fluoride works to protect tooth enamel, simultaneously reducing mineral loss and promoting mineral reuptake.  Through a series of questionnaires and examinations, the dentist can determine whether a particular infant needs fluoride supplements or is at high-risk for baby bottle tooth decay.

What can I do at home to prevent baby bottle tooth decay?

Baby bottle tooth decay can be completely prevented by a committed parent.  Making regular dental appointments and following the guidelines below will keep each child’s smile bright, beautiful, and free of decay:

• Try not to transmit bacteria to your child via saliva exchange.  Rinse pacifiers and toys in clean water, and use a clean spoon for each person eating.
• Cleanse gums after every feeding with a clean washcloth.
• Use an appropriate toothbrush along with an ADA-approved toothpaste to brush when teeth begin to emerge.  Fluoride-free toothpaste is recommended for children under the age of two. Speak with the dentist for your specific recommendations.
  
• Use a pea-sized amount of ADA-approved fluoridated toothpaste when the child has mastered the art of “spitting out” excess toothpaste.  Though fluoride is important for the teeth, too much consumption can result in a condition called fluorosis.
• Do not place sugary drinks in baby bottle or sippy cups.  Only fill these containers with water, breast milk, or formula.  Encourage the child to use a regular cup (rather than a sippy cup) when the child reaches twelve months old.
• Do not dip pacifiers in sweet liquids (honey, etc.).
• Review your child’s eating habits.  Eliminate sugar-filled snacks and encourage a healthy, nutritious diet.
• Do not allow the child to take a liquid-filled bottle to bed.  If the child insists, fill the bottle with water as opposed to a sugary alternative.
• Clean your child’s teeth until he or she reaches the age of seven.  Before this time, children are often unable to reach certain places in the mouth.
• Ask the dentist to review your child’s fluoride levels.

If you have questions or concerns about baby bottle tooth decay, please consult your dentist.