Dental care - preventing infant tooth decay

Early childhood caries (decay) is a severe form of dental decay that affects the baby teeth of infants and young children. Other names given to this condition include nursing bottle caries, infant feeding caries and baby bottle decay. The upper four front teeth (incisors) are most commonly affected whereas the lower front teeth are usually not as they are protected by the tongue and saliva.

What causes early childhood caries?

Early childhood caries is an infective process initiated by the transmission of oral bacteria (mutans streptococci) from mother to infant. This transmission of bacteria by saliva could be caused by the mother using her eating utensils to feed the infant or by washing the dummy in her mouth then giving it to the infant.

Once the transmission of bacteria from mother to baby has occurred the bacteria can multiply. When an infant is allowed to suckle on a nursing bottle contaning milk during the night the saliva flow is reduced.. The milk pools around the baby teeth enabling the bacteria to convert the natural sugars in milk to acids which dissolves the enamel of the baby teeth.

There is evidence to suggest early childhood caries can occur if babies are settled to sleep with a bottle of milk. They might also occur if toddlers constantly sip on sweet drinks (such as fruit juices and soft drinks) during the day.

How to tell if your infant has early childhood caries

Early childhood caries can be difficult to detect. Its appearance will depend on how advanced the condition is. Early childhood caries may show up as:

• A dull white band on the tooth surface closest to the gumline. This is the first sign and usually remains undetected by parents.
• A yellow, brown or black band on the tooth surface closest to the gumline indicates the progression to caries (decay).
• Teeth that look like brownish-black stumps indicate that the infant has advanced caries. The upper four incisors (front teeth) are usually involved, while the lower incisors remain relatively unaffected. The back teeth may also be involved.

Importance of early tooth caries detection

Unfortunately, in most cases, early childhood caries is not picked up until the child is about 20 months of age. By this stage, many children need significant dental treatment and may require hospitalisation to have this treatment completed.

Feeding tips to prevent early childhood caries

Babies under four to six months need only breastmilk or formula.
If breastfeeding:

• Remove the baby from the breast after feeding
• If bottle feeding
• Take the bottle away when the child has had enough.
• The bottle should only contain breast milk or appropriate infant formula.
• Introduce the child to a feeding cup between six and eight months of age. In most cases, the bottle can be discarded when the child is 12 months old.
• Encourage children to drink water rather than fruit juices or sweet drinks when thirsty.

Dummies and early childhood caries

Avoid dipping dummies in honey, glycerine or other foods or liquids. All natural sugars that are not easily cleared from the mouth, including honey, can lead to tooth decay.

Medicines and early childhood caries

If your child needs medicine, ask your doctor or pharmacist to prescribe a sugar-free form.

Dental checks

Dental checks can help detect early childhood caries. Oral health professionals recommend that your child should have an oral health assessment by the age of two.

Talk with your oral health professional about your child’s risk level and how frequently they should visit for an oral health check.

Tooth brushing

Tips on brushing your baby or toddler’s teeth include:

• Start as soon as the first tooth appears. Wipe the front and back of each tooth using a finger wrapped in a clean damp face washer or gauze.
• Introduce a soft toothbrush at 12 months (earlier if tolerated by the infant).
• Brush along the gum line twice a day.
• Introduce an appropriate toothpaste (as recommended by your oral health professional) at about 18 months of age.
• Use a pea-size amount of toothpaste.

Fluoride helps protect teeth against caries

Most Victorians have access to fluoride in their water. If your drinking water is not fluoridated, seek professional dental advice about the use of fluoride toothpaste for children. A dental professional may advise more frequent use of fluoride toothpaste. They might also suggest that your child needs to use adult toothpaste.

Fluoride supplements in the form of drops or tablets are to be chewed or swallowed. They are not recommended for use in Australia as they tip the fluoride balance in a child’s diet and cause dental fluorosis (staining of teeth).

Where to get help

• Your dentist or oral health professional
• Your Maternal & Child Health Nurse
• Your doctor
• Your pharmacist
• Your public oral health service
• Community dental clinic Tel. 1300 360 054
• The Royal Dental Hospital Melbourne, general dental enquiries Tel. (03) 9341 1000 or 1800 833 039 (from rural Victoria) Monday to Friday, 8:30am to 5pm
• Emergency Service Tel. 1300 360 054 Monday to Friday; 8.30am to 9.15pm, weekends and public holidays 9am to 9.15pm.

All children who are 12 years and under are eligible for priority public oral health services. Children receive general oral health advice as well as dental check-ups and treatment. For eligibility information, Dental Health Services Victoria, Tel. 1300 360 054

Things to remember

• Early detection of early childhood caries may prevent the need for dental treatment.
• Babies under 4 – 6 months need only breastmilk or formula.
• Tooth cleaning should begin as soon as your infant’s first tooth appears.

You might also be interested in:

• Dental care - common conditions - 0 to 5 years.
  
• Dental care - dummies.
  
• Dental care - fluoride.
  
• Dental checks - 0 to 6 years.
  
• Dental fillings.
  
• Dental sealants.
  
• Teeth care.
  
• Toothbrushing - start it young.
  

Want to know more?

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Last reviewed: November 2011

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your doctor or other registered health professional. Content has been prepared for Victorian residents and wider Australian audiences, and was accurate at the time of publication. Readers should note that, over time, currency and completeness of the information may change. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions.

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<a href="http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Dental_care_preventing_infant_tooth_decay?open">Dental care - preventing infant tooth decay - Better Health Channel</a><br/>
Babies and toddlers need care for their teeth and gums. Dental caries (tooth decay) can occur in babies. Bottle feeding should be monitored. Babies and toddlers should not drink juices or soft drinks. Babies and toddlers should have their teeth brushed when their first tooth appears.

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your qualified health professional. Content has been prepared for Victorian residence and wider Australian audiences, and was accurate at the time of publication. Readers should note that over time currency and completeness of the information may change. All users are urged to always seek advice from a qualified health care professional for diagnosis and answers to their medical questions.

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