Baby-Bottle Tooth Decay

Baby-Bottle Tooth Decay

Former Surgeon General C. Everett Koop, M.D., once said, “If you don’t have oral health, you’re simply not healthy.” As with many health topics, the basis for a lifetime of good oral health begins when we’re very small.

The earliest threat to your child’s teeth is caused by giving your baby something that might be the right thing, but at the wrong time. Giving a child a bottle at bedtime can result in a condition called baby-bottle tooth decay. Baby-bottle tooth decay is the specific form of severe decay found in the teeth of infants and toddlers who habitually fall asleep with a bottle of milk, juice, or any sweetened liquid in the mouth. I’ve also seen it a few times in babies who fell asleep sucking on a pacifier dipped in honey. It is the most common severe dental disease found in children under three years of age.

Cavities result from the interaction between normal mouth bacteria and carbohydrates in the diet. The sugars are converted to acids as they are fermented by the bacteria. The acid then etches the enamel of the teeth if there is prolonged contact. Saliva helps to prevent cavities by diluting the sugars and by washing the teeth.

When one falls asleep, saliva production decreases rapidly. Swallowing also decreases, and liquids present in the mouth at the time of falling asleep tend to pool for long periods. Giving the bedtime bottle a bit earlier, so that your child is awake for even fifteen minutes after finishing, can significantly protect the teeth.

Unlike adult cavities, which are largely invisible to the untrained eye, baby-bottle tooth decay causes cavities which are easily visible on the front teeth. The top four central teeth are the ones most often affected. Their counterparts in the lower gum, protected by the tongue during sucking and washed by saliva, usually remain sound.

The process of tooth decay is quite gradual. Over time the teeth are weakened. Usually, the enamel is finally breached sometime between 12 and 18 months of age. The cavities first appear at the gum line as subtle, white, decalcified streaks. The process then begins to accelerate. In advanced cases, the crowns of the four upper incisors are completely destroyed, leaving decayed brownish-black stumps which distort the spacing of the permanent teeth. I have seen this way too often.

Even though it may seem loving to offer a bottle for going to sleep, it may be more loving to help him or her to fall asleep in other ways, or by giving a bottle with plain water instead of milk, juice, or sugar-containing liquid.

Dr. Alan Greene

Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.

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