Early Childhood Caries

Nursing or bottle caries describes a condition of rampant dental caries found in young children feeding from a bottle during the night. The same condition is also seen in children who frequently breast feed and may also sleep with the mother at night and feed “at will”.
The reported prevalence of early childhood caries ranges from 2.5-15%.

Decay develops when sugars (present in milk, juice, cordial, fizzy drinks and other substances) are left to remain on the teeth for prolonged and frequent periods. Plaque (a sticky, almost invisible film of bacteria present on teeth) uses these sugars to produce an acid that attacks teeth. After many acid attacks the teeth can decay.

This decay may present as follows:

  • A dull white band on the tooth surface closest to the gum margin. This is the first sign and usually remains undetected by parents
  • A yellow, brown or black band on the tooth surface closest to the gum margin indicates the progression to dental caries

Teeth that look like brownish-black stumps indicate that the child has advanced caries. The upper four incisors (front teeth) are usually involved, while the lower incisors remain relatively unaffected. The back teeth may also be involved.

Many children with this pattern of disease are not picked up until the decay is well advanced.
By this stage the child will often require a significant amount of treatment. Due to the age and the complexity of the treatment this often means that the child needs to be admitted to hospital to have the treatment completed under a general anaesthetic.

A dental check can detect this pattern of dental decay and it is recommended that a child should be examined by a dentist before the age of one.

How can you prevent decay?

  • Do not allow a bottle containing milk or sweet drinks to remain in the mouth after your child has fallen asleep.
  • If your child needs a bottle to go to sleep with for comfort, then only water should be used.
  • Do place cordial or juices into the bottle.
  • Encourage your child to use a bottle or sipper cup around 6 –12 months of age. In most cases, the bottle can be discarded when the child is 12 months old.
  • If your child uses a dummy then do not it dip in any sweetened substances (i.e. honey).
  • Avoid sweet and sticky snacks. Remember that there are many hidden sugars in such snacks as muesli bars, fruit sticks and dried fruit.
  • Clean your child’s teeth twice daily using an appropriate sized toothbrush and a child’s toothpaste.