Baby Bottle Tooth Decay (Early Childhood Caries)

Children may develop visible decay, pain that makes eating or talking difficult, and problems affecting nutrition or general development when severe disease remains untreated.

The pattern is associated with frequent sugar-containing drinks, regular sipping, putting a child to sleep with a formula bottle, and falling asleep with the breast nipple in the mouth. These habits maintain repeated carbohydrate exposure around erupting teeth.

Early disease can be stopped with prevention, education and protection of unaffected teeth. Severe untreated disease has a poor prognosis and may impair nutrition, cause chronic anaemia and contribute to growth retardation.

Risk increases with on-demand or night-time bottle feeding beyond 12 months, frequent sweet liquids or foods, bedtime bottles and regular sipping of juice or other sugar-containing drinks. Sugar-containing medicines can also add exposure.

Diagnosis uses the child's clinical pattern together with medical, demographic and dietary history. Developmental defects such as fluorosis or inherited enamel disorders can resemble caries, and a child may have both conditions.

Preventive care and active monitoring are central. Moderate to advanced disease may require pulp treatment, extensive restoration or extraction. Prefabricated stainless steel crowns are preferred for many carious primary teeth, while severe treatment may require deep sedation or general anaesthesia because young children may not cooperate.

Early disease may be managed with prevention and monitoring, whereas moderate or advanced disease can require pulp treatment, restoration, crowns or extraction. The amount of care needed rises with severity.

Untreated severe disease can cause significant pain, make eating and talking difficult, impair nutrition, contribute to chronic anaemia and affect growth and quality of life.

Brush with a soft brush and fluoridated toothpaste from the first tooth. Avoid regular sweet drinks, bedtime bottles and frequent sugar exposure. Children aged 6 to 12 months can be encouraged to drink water, and fruit juice should be avoided before 12 months.