Letting your baby sleep with a bottle in their mouth could cause tooth decay, affecting their oral and speech development.

Here’s a startling fact to, er, chew on: Nearly half ― 48 per cent ― of children in Singapore between the ages of 1½ and 4 struggle with milk caries. These 2018 findings are from the National Dental Centre Singapore.
Also known as baby bottle tooth decay, milk caries is common among children from 1 to 3 years old. NDC’s figures also show that older kids ― from ages 3 to 6 ― aren’t far behind with some 40 per cent of them suffering from tooth decay.
While Singapore fares better than countries like Laos and the Philippines, where as many as 90 per cent of kids aged 5 and 6 have tooth decay, we trail countries such as Sweden, where less than 12 per cent of kids ages 3 to 6 have this condition.
So, bring your munchkin to the dentist soon as their first baby tooth emerges, which typically occurs when they are about 6 months old.
“Particularly vulnerable are the top front teeth, because milk often gets trapped between the upper lip and teeth…. It’s therefore easier for sugars to stick to these teeth.”
Dental surgeon Dr Rachel Pang of T32 Dental Centre sets parents straight about baby bottle tooth decay, plus, has tips on how to protect your youngster’s pearl whites.
How milk caries develops
Dr Pang explains, “Milk caries, as its name implies, happens when milk starts to accumulate on a child’s teeth surface over a prolonged length of time.”
When a child’s sucks a milk bottle through the night, the sugars in the milk sticks to the surface of the teeth. When a biofilm of milk and bacteria in the mouth is formed on the tooth, it produces acid.
The acid not only attacks the calcium on the tooth surface, it also create plaque that weakens the enamel in the tooth. Decay is the result. The same may also happen to infants who are breastfed “on demand” through the night.
Signs of milk caries
Any white, yellow or brown spots on your toddler’s teeth are the earliest indicators of milk caries.
Dr Pang elaborates, “Particularly vulnerable are the top front teeth, because milk often gets trapped between the upper lip and teeth and between the palate and the tongue, as well as the first molars. It’s therefore easier for sugars to stick to these teeth.”
The good news is it rarely affects the lower front teeth, the mandibular incisors. As these are located close to the salivary glands, they form a shield against the sugar. The tongue’s position over the lower front teeth when the child suckles also provides adequate protection.
Ways to prevent baby tooth decay
Dr Pang offers advice on how to prevent this condition in your little one.
- If your baby still feeds from a milk bottle, gently massage their teeth and gums after feeding with a wet cloth. Or, get her to suckle on a bottle of water. This helps clean bacteria away and prevents it from accumulating.
- If you feel your child is ready, start weaning her off the bottle and encourage her to drink from a cup.
- Help your child develop good oral hygiene habits. Ensure that she brushes her teeth twice a day for at least two minutes each. When buying toothpaste, check that its fluoride levels are safe for kids.
If the condition is more serious, they may need fillings. In severe cases, when cavities have become too large to restore, the dentist may have to extract the problem tooth.
Treatment options for milk caries
There are different types of treatment to treat milk caries, depending on its severity.
If the decay is in its early stage, apply dental products containing calcium, phosphate and even fluoride, such as tooth mousse, to remineralise and strengthen the tooth surface. Remineralisation is intended to reverse cavities naturally.
“Help your child develop good oral hygiene habits. Ensure that she brushes her teeth twice a day for at least two minutes each.”
Of course, your child will start to lose their baby teeth between the ages of 6 and 12. But it’s crucial that you help them care for them, since healthy teeth are vital if they are to breathe, speak and eat well.
For instance, if milk caries causes pain, they might find it uncomfortable to eat. If their diet is affected, this will also impede your offspring’s nutrition, well-being and development. If there are deep cavities, it affects the nerves and infection occurs. Treatment might also bring about feelings of tremendous fear and anxiety in a child.
Dr Pang notes, “In the worst-case scenario, the dentist may have to remove a decayed baby tooth prematurely. This could cause the position of other baby teeth to shift, and in turn, affect the development of adult teeth and lead to problems such as crowding.”
Photos: iStock
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