Nursing bottle dental decay or bottle caries is a type of decay associated with prolonged feeding of sugary fluids from a nursing bottle. Affected children are often put to bed with a bottle full of sweetened milk, juice or cordial, which remains in their mouth even when asleep. A dummy dipped in honey is another possible cause.
Sugar in the bottle liquid mixes with bacteria in the dental plaque to form acids that attack tooth enamel. Each time a sweet liquid is taken, acids attack the teeth for at least 20 minutes. When children are awake, the saliva is able to remove some of the liquid, however, during sleep, the saliva flow decreases and the sweet liquids collect around the teeth for prolonged periods, bathing the teeth in acids.
The earliest appearance of decay is the enamel turning a chalky white colour, usually around the gum line. Then as more calcium is lost from the tooth, a hole finally appears. In severe cases of bottle caries, the cavities can ring bark the teeth and cause them to break off. At the early stages, the cavities do not cause pain, but as they enlarge, increasing discomfort may be experienced and a dental abscesses may result.
Bottle caries may be treated by fillings or extractions, but because most children are not co-operative at such a young age, they usually need to be sedated. Very often, general anaesthetics have to be given. When the milk teeth are lost early, the appearance and speech may be affected and space for the second teeth may be lost. Dentists often refer such cases to a periodontist (children’s dentist) for special management.
The best form of treatment for nursing bottle decay is prevention. Children should not be allowed to sleep with a bottle of sweet liquid; if a child needs a bottle for comfort before falling asleep, fill the bottle with plain water, milk or formula, and remove the bottle as soon as the child is asleep. Dummies should never be dipped in honey. Fluoride supplements should be given if the local water supply is not fluoridated.