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This one is about: Baby Bottle Tooth Decay and Weaning

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Typically, I tell parents that I like to see the child weaned off a bottle by 12 - 18 months of age. I certainly caution all parents about sending their child to bed with a bottle at bedtime. This is when the cavities can really be formed in a major way. It is often called "Baby Bottle Tooth Decay".

This is where a child is allowed to go to bed with a bottle usually with milk, formula or juice in it, till they are 2 years old. The cavity pattern that these children get are very distinctive. The upper four front teeth are usually the most decayed with the bottom front teeth, hardly decayed if at all. The number of cavities can range from a few to 10 or more. I've even seen cases where all 20 of the baby teeth are decayed!

Why is bedtime bottle so destructive? Well, when a child is allowed to go to bed with a bottle, he/she will typically fall asleep with some of the milk, formula or juice still coating all the teeth. This provides the bacteria with ample food to feed on and multiply. And, because your saliva production decreases at night, (that's why we wake up with dry mouth in the morning) there is no saliva to help protect the teeth. Saliva has been shown to neutralize the acids that bacteria produces as well as keep the level of bacteria in one's mouth to a manageable level. Most times, if you are sending your child to bed with a bottle, you are not waking them up to brush their teeth.

Breast milk can cause the same thing whether or not it is pumped and put in a bottle or directly from breast feeding. It is the bedtime use of feeding to put the child to sleep that can cause the problems. Personally, I think that often we as adults probably need a snack at bedtime or eat really late at night, which isn't really good for us, because we were fed as children at bedtime with a bottle.

To keep this from getting too long and boring some of you, I will save my thoughts on how to raise a child totally cavity-free next time.

John R. Liu, DDS
Dental Consultant, Wide Smiles

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