Baby bottle tooth decay (BBTD) is a type of tooth decay in infants or toddlers. Infants that are allowed to have a bottle in bed or older toddlers that are allowed to carry around a bottle or sippy cup during the day are at risk for BBTD.
Symptoms
It is most common to start seeing symptoms around age 1, but can sometimes occur before then. The earliest sign is white spots on the baby teeth starting at the gum line. If it is not noticed and treated during the white spots phase, decay can progress to edges of teeth and appear brown or yellow in color. The upper front teeth are usually damaged first. Depending on how long your child has had BBTD, the teeth may even break off at the gum line or cause damage to the root! This can be very painful for your child and can cause new teeth to come in crooked.
Causes
BBTD occurs when sugar in liquids is in contact with the teeth for a prolonged time. Milk, formula, juice, and soft drinks all contain sugar. If a child falls asleep with a bottle in the mouth or constantly drinks from a bottle during the day, the sugar coats the upper teeth. The sugar changes into an acid, which gradually dissolves the enamel and allows tooth decay to occur. Many parents are not aware that leaving a bottle with a child constantly can lead to this type of damage.
Treatment
If the problem is detected at an early level, the teeth can be covered with stainless steel caps. If the decay is severe, the teeth will need to be pulled out in surgery.
Prevention
1. Don’t let your baby keep a bottle. Don't let your baby fall asleep with a bottle in his mouth, and do not let your baby constantly keep the bottle. It is best to let your child have the bottle while eating, and take it away when finished. This will help alleviate bottle dependency.
2. Wean your child to a cup. Introducing a cup is the best way to prevent bottle dependency. It takes gradual exposure to a cup over 3 months or longer for a child to learn to prefer the cup over the bottle. Most parents start around 6 months of age.
3. Replace with water. Water does not have the sugar that other liquids have. So, if your baby cannot seem to let go of the bottle, replace with water.
When to call the doctor
Call your primary care doctor if your child cannot give up the bottle, if you see white spots on the baby teeth, or if you think your baby might have BBTD.
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Jeri Ford, RN, BSN, CPN
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