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Early Childhood Caries

Baby bottle decay

If mothers had untreated tooth decay, their children had four times the risk of decay compared with children of other mothers. If mothers consumed large amounts of sugar, their children had four times the risk of tooth decay compared with children of mothers with low sugar consumption.

Bacterial causing bacteria is transmitted from mom to baby

The type of decay that occurs soon after a primary or baby tooth has erupted is call early childhood caries or baby bottle tooth decay.  It is the presence of one or more decayed surface in a baby tooth in children under 3 years of age.  This disease process develops much more rapidly than cavities or decay in older children or adults!***


     Baby bottle decay or syndrome is a form of tooth decay that can destroy the teeth of an infant or young child. This decay may even enter the underlying bone structure, which can hamper development of the permanent teeth.** The teeth most likely to be damaged are the upper front teeth.  These teeth are critical to your child's smile and health!

     It is caused by frequent and long exposure of your child's teeth to liquids containing sugar such as milk, formula, fruit juices, pop and other sweetened liquids. This sugary liquid can cling to teeth or gums for long periods to cause destruction of enamel, pain, sensitivity and even nerve infection. 

     This liquid sugar is fuel for the bacteria in your child's mouth.  This bacteria produce acids that attack tooth enamel.  The length of time these liquids are in contact with their teeth is critical.  The longer and more frequent the exposures allow greater damage to occur!

     The relationship between a  mother's oral health and that of her child is important.   Dental cavities are an infectious disease and reducing a mother's cavity-causing bacteria will limit the amount of bacteria that is passed on to her baby.

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     Early childhood decay dramatically increases a child's risk of future dental decay.  These children may develop:


poor eating habit


speech problems


low self-esteem


social problems


low weight


slowed growth



     One of the best predictors of future cavities is past caries experience.  With children under the age of 5, a history of previous dental decay will classify a child as highest risk for future decay.  A history of cavities in baby teeth is the best and most consistent predictor of future cavities.*

     5-10 % of young children have early childhood cavities. Treatment of of this condition may require extensive dental work, crowns and tooth extraction.  The cost can range from $1,000-3,000.00 per child.  If general anesthesia is used the cost can be as much as an additional $6,000.

Baby bottle decay can cause your child allot of unnecessary pain

     Children who have nursing bottle cavities have a high incidence of developing future cavities!

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These are things you CAN DO to PREVENT baby bottle decay:


Wipe their teeth and gums with a damp washcloth after each feeding.


Brush their teeth as soon as the first tooth appears.


Remember to continue to clean and massage their gums in all the other areas that remain toothless.


Floss their teeth as soon as the teeth begin to touch.


Examine their teeth by lifting a child's lip to look for decay on the outside and inside surfaces of the four upper front teeth once a month.


Do not put your baby to bed with a bottle at night or at nap time.  During sleep the flow of saliva decreases so it can not "wash" away the sugar. Sleeping with a bottles or a cup also allows these liquids to pool around their teeth for long periods of time to cause decay.


If you must put them to bed with a bottle fill it with water or give them a clean pacifier.


During the day do not give your baby a bottle filled with sweet drinks to use like a pacifier.


Reduce frequent sugar consumption.


Don't add sugar to your baby's food to make it taste better


Do not dip a pacifier in anything sweet like sugar or honey.


By their 1st birthday teach them how to drink from a cup.


Don't let them drink juices, milk or sugar containing drinks from a sippy cup all day.


Drink fluoridated water or if your water does not have fluoride ask your dentist for vitamins with fluoride.


See your dentist between the ages of 6-12 months.


If you suspect that your child has a dental problem take them to see their dentist as soon as possible.

Good oral health should begin at birth and last a lifetime!

Children see dentists to late and too seldom.  Dental home care is not adequately reinforced by parents according to the oral surgeon's report.*

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DID YOU KNOW? Early Childhood Caries
The four upper incisors are usually the most severely affected, since they are among the first teeth to erupt and therefore have the longest exposure to the cariogenic challenge. Moreover, the nursing liquid always pools around these four teeth. The mandibular incisors are more resistant to decay.+

Click here for information on infant dental care:

Baby Teeth Care

Oral Healthcare for Babies

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Fluoride Varnish Helps Prevent Tooth Decay in Very Young Children

Fluoride varnish reduces the incidence of early childhood tooth decay in combination with oral health counseling for parents, according to a study by investigators at the University of California San Francisco (UCSF) School of Dentistry.

The children were randomized into three groups: those receiving fluoride varnish twice per year, those receiving it once per year, and those not receiving it at all. Of the initial 376 children enrolled, 280 completed the study.

The study found that the children who did not receive any fluoride varnish were more than twice as likely to develop tooth decay as the children who were assigned to the annual fluoride varnish group. Children who did not receive fluoride varnish were nearly four times more likely to develop tooth decay than those assigned to receive it twice per year (four treatments over two years).

Study results appear in the February 2006 issue of the Journal ofDental Research and online at http://

First, the results support the use of fluoride varnish to prevent tooth decay in very young children. Second, the results support parents bringing children for their first dental visit at age 1, when they are getting their first teeth. Fluoride varnish is relatively inexpensive, easy to brush onto a child's teeth, and can be part of a positive first dental visit to help prevent tooth decay. In contrast, when very young children get cavities, it is difficult for them to sit still for dental treatment. Often, young children needing many fillings receive care in the operating room, at great expense to their family and with the additional risks posed by general anesthesia. We now have an easy, low-cost way to keep teeth healthy.

Fluoride varnish is a resin containing concentrated fluoride that is brushed on teeth the same way that nail polish is painted onto nails. It is meant to enhance fluoride's potential therapeutic benefit by keeping the tooth enamel in contact with it. Other studies have shown that fluoride varnish helps prevent tooth
decay for older school-age children who have their permanent teeth.

 Source: UCSF News Services cited

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Sippy Cups Alert

      The increased caries risk for toddlers who use the duck-billed cups, often carrying with them and sipping throughout the day can cause cavities.  Spill-proof cups are more like a bottle than a cup. These cups are an effective tool for shifting children from baby bottles to regular cups, but parents should use the cups only as a transitional device because tooth decay remains the most common chronic childhood disease-five times as
common as asthma
     Prolonged use of the cup also inhibits the development of muscles needed for proper speech.  You should not to allow your child to suck on the cups throughout the day. "Sippy cups are great; however a traditional cup is even better." 

In response to the “sippy cup dilemma”…..

As a licensed practicing Speech Language Pathologist, I have observed the damaging impact on oral-motor musculature, swallowing patterns, dentition, and speech/articulation development as a result of chronic sippy cup use.  This is especially true with the "new" totally spill proof sippy cups that have a stopper and the only way to drink is to suck.  Maintaining a sucking pattern while drinking interferes with the development of adult swallow patterns and directly impacts on oral-motor muscle development, speech, and articulation development.  Sippy cups were/are meant to TRANSITION a child from bottle to regular cup.  A child is transitioned from a bottle at a certain age to encourage proper oral-motor musculature development and development of an adult swallow pattern.  In my opinion, chronic use of a pacifier, bottle, and/or sippy cup during this time FREQUENTLY results in oral-motor and/or speech disorders, malocclusion, and "tongue thrust" swallowing patterns.   I also agree that chronic use of a sippy cup may be one of several contributing factors for a particular child with speech/articulation delays.  Once a child has been identified as having oral-motor/speech/articulation deficits, removing pacifiers, sippy cups, and/or thumbs will at least contribute to increased rate of progress in therapy.  Many parents continue chronic use of sippy cups until age 3 to 4 (or later).  It is not the sippy cup that is the problem, but in how it is used, and how parents are not informed as to the dangers and risks of not using it properly: as a transitioning tool rather than as a "pacifier for the carpet or car". 

Lori Johnston, M.A., CCC-SLP ; Licensed Speech Language Pathologist '
New Jersey, USA

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-Promoting Awareness, Preventing Pain: Facts on Early Childhood Caries

+ Church, Management of Early Childhood Caries. Oral Health. January 2001: Courtesy of Hygiene Cyber Notes
* Dental Economics, Feb 2001
**AGD Impact July 2001
How To Win The Battle against BBTD; Dentistry Today; March 2002.
***Oral Healthcare for Infants; Dr. Lott; Dentistry Today; pgs  64-67 August 2002

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National Institute of Dental And Carniofacial and Research National Institutes of Health.
Maternal and Child Health Bureau.

February 06, 2008  

Pictures: Ms.Flossy
*Caries Risk Assessment and Prevention.  Dr. Kanellis, University of Iowa College of Dentistry, 8/02.

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PLEASE NOTE: The information contained herein is intended for educational purposes only.  It is not intended and should not be construed as the delivery of dental/medical care and is not a substitute for personal hands on dental/medical attention, diagnosis or treatment.  Persons requiring diagnosis, treatment, or with specific questions are urged to contact your family dental/health care provider for appropriate care.
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