Baby Bottle Tooth Decay

McKenzie Pediatrics 2009

What is BBTD?

This condition, also known as Nursing Caries, is a form of tooth decay that affects infants and toddlers. It involves many teeth, and the lesions develop rapidly. It results from the bacteria streptococcus mutans, which lives on teeth, metabolizing sugar to acid, which over time causes the demineralization (or erosion) of the enamel of the teeth. Baby teeth have very thin enamel as compared to permanent teeth, and thus are more susceptible to decay.

What Are The Causes of BBTD?

Putting Your Baby To Bed With A Bottle: This allows the bacteria to have a direct source of milk sugars during the night. There is also very little saliva produced during the night, so little �rinsing� occurs.
Excessive Juice Consumption: This, again, provides the bacteria with a repetitive source of sugar during the day. Juices and sodas with fructose syrup are the worst.
Lack of Fluoride: Most communities in Lane County do not add fluoride into the water supply, thus our county�s children are among the less than 10% of American children unexposed to fluoride for the protection of their dental enamel. Babies should start receiving supplemental fluoride, as a prescription for the doctor, by 6 months of age.
Dipping A Pacifier In Honey: Pacifiers, which should be discouraged for daytime use by 6 to 8 months of age, should never be coated with honey, or Karo Syrup, which provides the strep mutans bacteria with a constant source of sugars. These products also cause a small risk of causing Botulism in you baby, and are discouraged for this reason as well.
Prolonged Bottle Use: Begin introducing a �sippie� cup by age 6 to 9 months, with the goal of converting your baby off of the bottle by 9 to 12 months of age. Sippie cups are far less likely to lead to tooth decay, as the suction required to draw out the liquid allows the liquid to be swallowed immediately, rather than coat the teeth.
Lack of Dental Care: When your baby�s first teeth come in, begin daily brushing with a small toothbrush coated with a BB-sized pellet of toothpaste. Lack of daily brushing allows bacteria to continue to build up on the enamel of the teeth.

What Does BBTD Look Like?

This condition can be seen as early as 10 to 12 months of age, as a chalky while band of enamel parallel to the gum line, especially in the four top front teeth. Over time, the white areas turn brown, and eventually the entire tooth may be destroyed. Once early changes are seen, the teeth should be treated with fluoride varnish as soon as possible.