Diseases & Conditions

Baby Bottle Caries - Baby Bottle Tooth Decay


Overview, Causes, & Risk Factors

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, which is 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 can 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 can erode the enamel on the teeth. The result is damage to the teeth. As the damage progresses, the decay can lead to:

  • an abscess, which is an infection and swelling of the tooth and gum
  • dental caries, also known as cavities, which are holes in the enamel that expose part of the tooth
  • severe pain, when the decay reaches the pulp or nerve of the tooth
  • 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 harmful. 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.


    Symptoms & Signs

    What are the signs and symptoms of the condition?

  • fever from gum or tooth infection
  • a lot of bleeding from the gums
  • pain or irritability
  • red gums
  • white spots on the teeth

  • Diagnosis & Tests

    How is the condition diagnosed?

    Baby bottle tooth decay symptoms are hard to recognize 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 condition of the gums
  • the current condition of the teeth
  • the enamel
  • the sensitivity of the teeth
  • the structure of the inside and outside of the teeth
  • Dental X-rays may be done to examine the extent of decay.


    Prevention & Expectations

    What can be done to prevent the condition?

    There are many ways to prevent baby bottle tooth decay.

  • Never put a child to bed with a bottle of milk, formula, fruit juice, or sweetened liquid. If a child needs a bottle in bed, only water should be put in the bottle.
  • Don't allow 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.
  • Teach a child to drink from a cup as soon as possible. A cup can be given to a baby at age 6 to 12 months. Drinking from a cup avoids liquids pooling around the teeth and gums.
  • Wipe a baby's gums with a washcloth after each feeding. Once baby teeth have erupted, brush the teeth and gums with a soft, child-sized toothbrush. Brush the teeth and gums after each feeding.
  • Begin dental checkups when the baby is 6 to 12 months old.
  • Ask a dentist about the need for fluoride.
  • Floss the child's teeth as soon as all the baby teeth have erupted, usually when the child is 2 to 3 years old.
  • 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 gum disease, and adult teeth may come in crooked. Speech problems, ear infections, discolored permanent teeth known as Turner 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 through kissing or biting, although this is not common.


    Treatment & Monitoring

    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:

  • antibiotics for infection
  • filling dental caries
  • pulling a tooth or teeth in some cases
  • 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 medicines used while filling cavities or pulling teeth
  • allergic reactions or stomach upset caused by antibiotics given for infection
  • discomfort in areas where teeth or gums 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 checkups. If any unusual symptoms develop, the caregiver should call the dentist.


    Attribution

    Author:Eileen McLaughlin, RN, BSN
    Date Written:
    Editor:Crist, Gayle P., MS, BA
    Edit Date:05/15/02
    Reviewer:Daniel C. Pizzi, DMD
    Date Reviewed:07/27/01

    Sources

    Preventing Baby Bottle Tooth Decay, American Dental Association Online, 1998. www.ada.org/consumer/bottle.html

    Baby Bottle Tooth Decay -- How to Prevent It, American Academy of Pediatrics, 2000 www.aap.org/family/toothdec.htm

    Mayo Clinic Family Health Book, D Larson, 1996.