One of the saddest things I see in the dental office is very young kids, even infants with brand new teeth, who have severe decay problems. Almost without exception, this is caused by parents improperly using bottles at bedtime or naptime with their children and not practicing good dental hygiene habits with them. This condition is known as “Early Childhood Caries” or “baby bottle decay.”

Overall, the condition of childhood teeth decay has been classified as an epidemic in the United States, with 70% of very young children having cavities, and a higher prevalence occurring in rural and minority populations. It is my estimation that in Utah Valley, the prevalence of this condition pretty much mirrors national statistics. The severity of this problem ranges from mild (the presence of just one cavity) to extreme (major decay on all teeth; extractions needed), and various strategies have been employed combat it, but the most effective approach will always be education and prevention. Please share this on your Facebook walls and spread around the information. Let’s eradicate Early Childhood Caries in Orem and the surrounding areas!

Baby bottle decay begins with the transmission of mouth bacteria from parent to child. We all naturally have millions of bacteria in mouths, but are not born with the condition, per se. From the moment of birth onward though, we pick up the bacteria from our environment. Cavities are caused primarily by a nasty little bug called Streptococcus mutans, which only lives on teeth surfaces.   Infants acquire this germ from their caretakers through mouth-to-mouth contact after their first tooth erupts. Individuals with untreated dental problems or individuals at high risk for cavities have a much higher population of this bug in their mouths and present a much higher infection risk to their kids.

The presence of Strptococcus mutans alone is not enough to cause cavities. The next step in the chain of this disease is opportunity. This bug needs to eat simple sugars to produce its cavity-causing acidic byproducts. When fermentable carbohydrates such as milk, soda, juice, formula are given to kids, and are not cleaned off properly afterwards (brushing), the bacteria eat them, and produce acid. Constant acidic attacks will eventually cause teeth to decay. This is especially bad during sleeping periods because the sugar pools against the teeth and bacteria can go wild. Tooth enamel, although extremely strong and resilient, will always lose to bacteria when it is under constant siege.

To keep your infants and young children safe from cavities, follow these guidelines:

1. Clean your child’s teeth twice daily, including before bedtime.
2. Feed your children a balanced diet. Diets high in simple sugars and carbohydrates promote decay.
3. Don’t use bottles to get children to sleep. If you absolutely must do this, only give them water.
4. Even breastfeeding can cause decay after their first tooth erupts. Get kids on a regular feeding schedule and clean their teeth after feedings.
5. Begin preventive programs as early as possible (dental checkups, fluoride varnish, brushing with fluoride toothpaste).
6. Start using a cup by your child’s first birthday.
7. Children should not be allowed to carry around a bottle or sippy cup at will.
8. Watch out for medicines. Child medications often contain fermentable carbohydrates to make them sweeter and more palatable for kids.
9. Visit the dentist. Even young children should periodically visit the dentist for a checkup or “happy visit.” The ADA recommends starting this 6 months after the first tooth comes in.
10. Clean your child’s teeth twice daily. I can’t say this enough.

Nicolas K. Young, DMD