Early childhood caries is a common problem among children under the age of five. It is also frequently referred to as “baby bottle tooth decay” as it is most often caused by the frequent and prolonged bottle or breast feeding especially at night. The decay may affect any of the teeth but is most prevalent on the upper anterior teeth due to the milk stagnation in this area.”
How does it progress?
When a carbohydrate source such as breast milk, formula, juice, or even a pacifier dipped in syrup, is given at nap time or bed time, the sugars remain on the teeth. The buffering protection that saliva usually provides is reduced during sleep thus the teeth are more prone to decay. Cavity causing bacteria turn the sugars into acid which erode the tooth enamel and the decay process begins.
Acid producing bacteria are usually transmitted from the mother or father to the child through saliva. This is usually through sharing utensils, blowing on food or cleansing a pacifier with your mouth.
Infants who are not receiving an appropriate amount of fluoride are at increased risk for tooth decay. Fluoride works to protect tooth enamel, simultaneously reducing mineral loss and promoting mineral reuptake.
Importance of baby teeth
There is often a misconception that baby teeth are temporary so you don’t have to pay too much attention to them. This couldn’t be further from the truth.
It is important to keep baby teeth clean and healthy because baby teeth:
· Aid enunciation and speech.
· Make eating and chewing easier.
· Help form the shape of the child’s face.
· Hold spaces open for the permanent teeth to come in.
· Possible damage to the permanent teeth.
Tooth decay causes:
· Pain and discomfort.
· Loss of the space needed for permanent teeth to come in.
· Missing school or needing emergency care.
· Infections that can affect overall health.
The best approach to early childhood caries is prevention. If your child does experience early childhood dental caries, your dentist can work with you to determine the best treatment options.
How to prevent early childhood caries
Bottle fed or breastfed babies:
· The American Academy of Paediatrics wisely recommends that parents only give bottles during feedings and not allow their children to carry a bottle between meals.
· Don’t put liquids that contain sugar in your child’s bottle when you put them to bed. It’s best never to give a baby a bottle in bed.
· Avoid all-night feedings. And don’t let baby go to sleep while nursing.
· Don’t use the bottle as a pacifier.
· Sucking is a natural need for all babies. If your baby seems to need more time for sucking after being fed, give him either a pacifier or a bottle of plain water.
· Use the bottle for feedings only.
· For toddlers, other liquids should be given in a cup.
· Wean your baby from the bottle to a cup by 12 months of age.
· Avoid feeds that last more than 30 minutes.
· Avoid frequent, on-demand feedings.
It’s never too late to break bad habits. If your child drinks sweetened liquids from the bottle and/or sleeps with a bottle, break the habit now and cut the risk of baby bottle tooth decay by:
· Gradually diluting the bottle contents with water over 2 to 3 weeks.
· Once that period is over, fill the bottle only with water.
Cleaning Your Child’s Mouth:
· Tooth decay can be prevented both by strengthening the enamel and by reducing prolonged exposure to acidic foods.
· Try not to transmit bacteria to your child via saliva exchange. Rinse pacifiers and toys in clean water, and use a clean spoon for each person eating.
· Schedule regular dental visits from your child’s first birthday.
· Ask your dentist about sealants, which can help prevent tooth decay in children.
· Do not dip pacifiers in sweet liquids.
· Review your child’s eating habits. Eliminate sugar-filled snacks and encourage a healthy, nutritious diet.
These changes should always be made in coordination with your child’s paediatrician. Depending on your child’s age, overall health and nutritional needs, some dietary changes could be undesirable.
Treatment for early childhood caries
Treatment differs based on your child’s age and the severity of the condition. It is important to take your child for dental visit from an early age so that any problems can be detected and treated at the initial stages.
White spots on a tooth’s surface are early symptoms of decay and at this stage, fluoride treatment or calcium rich pastes can be used to remineralize the teeth. This treatment reverses decay in its earliest stages by helping to rebuild the surface enamel.
More progressive forms of decay such as brown or black spots on the teeth, bleeding or swollen gums, pain or swelling, will require more extensive treatment. This can include fillings, root canal treatment, crowns or extractions.