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Baby-bottle tooth decay is a serious, but preventable, condition. It can occur when teeth are exposed to the sugars from carbohydrates for long amounts of time. Carbohydrates in liquids such as fruit juice and milk start to break down in the mouth into simple sugars. When these liquids are allowed to sit in the mouth, bacteria start feeding on the sugars. In the process, the bacteria produce acid, which can cause teeth to demineralize then decay if it remains in the mouth long enough.

This can happen if your baby is often:

• Put to bed with a bottle filled with formula, milk, fruit juice, sugar water, or any liquid other than plain water
• Given a bottle filled with sugary liquids or milk to calm or comfort him during the day
• Given a pacifier dipped in sugar, honey or any other sweet liquid

Human breast milk does not promote decay unless it is given with other sources of carbohydrates. Infants who get a mixed diet are at risk for dental decay. It’s not just what your baby is drinking, but how often. The more time he or she has liquids other than water in his or her mouth, the higher the risk of serious decay. This is why it is dangerous to let your baby go to sleep with a bottle or use the bottle as a pacifier during the day. The teeth most often affected by baby-bottle tooth decay are the upper front teeth, although others can decay, too.

Your dentist or pediatrician might refer to baby-bottle tooth decay as early childhood caries (cavities), nursing caries or nursing-bottle syndrome. They all mean the same thing.

Baby-bottle tooth decay can occur only if your baby’s mouth has a type of bacteria called Streptococcus mutans. While S. mutans constitutes less than 1 percent of the oral bacteria in a child with very little decay, it accounts for more than 50 percent in children with early childhood caries

S. mutans is common and is passed from parent to child, usually when the child is between 6 and 31 months old. This period is called the “window of infectivity.” Keeping your own mouth healthy and decay-free will do much to help your child stay cavity-free.

In baby-bottle tooth decay, the top incisors typically are affected first. Often, decay occurs on the back, or tongue side of the tooth, which can’t be seen easily. The top teeth in the back of the mouth are affected next, then the bottom back teeth. The lower incisors usually do not become involved because the tongue lies over them and keeps the liquid away from the bacteria on these teeth.

Decayed teeth that are left untreated can cause pain and infection. These may require extensive and complex treatment to be saved. Teeth that are very badly decayed may need to be removed to remove the infection, decrease the risk of infection spreading to the face and allow the permanent teeth to develop in an infection-free environment.

Any type of liquid that contain carbohydrates can cause baby-bottle tooth decay if it remains around the teeth. This includes formula, milk, fruit juice, fruit juice diluted with water, sugar water or any other sweet drink. Milk breaks down into simple sugars, which are food for bacteria. Water is the only liquid that is okay for your child to have in his or her mouth for longer periods of time.

Here are some tips on preventing baby-bottle tooth decay:

• Don’t put your baby to bed with a bottle filled with liquids that contain carbohydrates. This includes any liquid except plain water. Even watered-down fruit juice or milk can increase the risk of decay.
• Wean your infant, in consultation with your physician, when he or she is 12 to 14 months old.
• Don’t use a bottle during the day to comfort your baby unless it’s filled with plain water.
• Don’t dip your baby’s pacifier in sugar or sugary liquids.
• Don’t add sugar to your child’s food.
• Clean your baby’s teeth and gums after each feeding.
• Take your baby for his or her first visit to the dentist as soon as his or her first tooth erupts.
• Teach your baby to drink from a cup by his or her first birthday.
• Make sure your baby is getting the right amount of fluoride. If your town does not have fluoride in the drinking water, ask your pediatric dentist or pediatrician about fluoride supplements.