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Task – This client asked me to write a promotional news article for mothers to educate them about the dangers of a night time feed and tooth decay. Here’s the result

Early infant dental care 0-2 – How A Bedtime Bottle of Milk Can Wreak Havoc On Your Baby’s Teeth 

Did you know that two in every ten children suffer from tooth decay (early childhood caries) before they reach the age of two?  In fact, baby teeth can start to decay just as they appear. One of the most common causes of this avoidable problem is putting a baby to bed at night with a bottle of milk. 

So why is this an issue?

Other than water, anything the baby drinks, including breast milk and formula, contains sugar – typically, 7 grams of natural sugar (in the form of lactose) for every 100 grams of milk. 

Unfortunately, natural bacteria contained in the mouth will feed off the sugar. As they do so, they excrete an acid that attacks the enamel, similarly to acid erosion. All too often, as pediatric dentists, we regularly see patterns of decay in children that occur because of a bedtime feed.

The pattern of childhood tooth decay 

Early childhood decay has a distinct pattern. In the past, this phenomenon was commonly known as ‘baby bottle tooth decay‘. Nowadays, however, the accepted term is ‘early childhood caries‘ or ECC for short. 

Typically, ECC starts with a visible dull white band on the upper front teeth near the gum line. In addition, the gums may also appear a darkened colour. Brown spots may also be visible as it progresses.  

Some parents will ignore these signs thinking these are not cavities, but as the disease advances to other areas and teeth, it becomes more noticeable with small blackened holes appearing.

While you might think that only the primary (milk) teeth are affected, the truth is that if young children need to have their milk teeth removed, any remaining teeth will shift to fill the space. When this happens, their permanent adult teeth won’t be able to grow into their natural position. The result is that future teeth alignment is very likely to be affected.  

What can you do to prevent tooth decay in your baby or toddler?

The first thing you can do is to avoid giving your baby bottled formulated milk overnight. Instead, consider water if you have to.

But in addition, you should look to practice the following.

  • When no teeth are present, wipe the tongue and gums with a small piece of dampened gauze wrapped around your finger 
  • When there are only a few front teeth, clean the teeth and gums by firmly wiping them with gauze or a clean washcloth. Once more teeth and molars erupt, you should use a baby toothbrush. 
  • Brush teeth twice a day with a smear of fluoride toothpaste – specifically in the morning after breakfast and at night before bed. Also, clean between teeth with a gentle floss.
  • Do not let the baby sip on a bottle all day long. Instead, limit their bottle use. As a rough guide, your baby should empty a bottle in 5 to 6 minutes or less. Remember, drinks flow very slowly through a teat, meaning that any sugary substances, including milk, will remain on the teeth longer. The bottom line is that prolonged comfort sucking can cause tooth decay
  • Avoid giving your child sugary, chewy, sticky food like candy, cookies, chips, crackers or juice and be mindful of sugar content in snacks like protein bars 
  • After breastfeeding, wipe the baby’s gums and teeth with a clean gauze or washcloth. 
  • Finally, book a dental check-up as soon as the first tooth erupts or, at the very least, by your child’s first birthday.

Top tips for weaning your child off a bottle and on to a cup

Stopping a bottle is critical for oral care. Pediatric dentists advise that parents should look to give up their child’s bottle around their first birthday. Try to introduce your baby to a cup or beaker from the age of around six months by getting them to sip water with meals. An open or free-flow cup without a valve will help your baby learn to take sips. While it might be a little messy initially, be patient because adopting such steps will be better for your toddler’s teeth. Keep monitoring progress, and as soon as your child is ready, encourage them to shift from a lidded beaker to an open cup.

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