Nursing bottle syndrome mainly affects babies and young children. This is because tooth decay can develop as early as babyhood, and several or even all of the baby teeth are affected by tooth decay.
What is nursing-bottle syndrome?
Nursing bottle syndrome is also known colloquially as teat bottle caries or bottle tooth decay. It is a form of early childhood caries that can develop as early as the first baby tooth. Vial caries develops in the case of incorrect nutrition in the form of drinks that are too rich in carbohydrates, sugar and fruit acids, which are drunk with a bottle, and inadequate oral hygiene. Most often affected are the molars and incisors.
Causes
Caries is triggered by drinks that are too sweet and rich in carbohydrates, such as fruit juices, sweetened teas and also milk, which children consume with a bottle or sippy cup. Children suck on the bottle for a very long time and so the sweetened drink remains in the mouth for longer. Especially at night, when a child falls asleep with the bottle in his or her mouth, the risk of tooth decay increases. During this time, saliva production is limited, which naturally protects teeth by allowing saliva to neutralize acid.
Symptoms, complaints and signs
The upper incisors are the first to be affected in this form of tooth decay. Due to the fact that the tongue protects the lower incisors, it is rather rare that they are affected. The first signs of caries are brownish discolorations on the teeth. The teeth are sensitive to sweet and cold when carious destruction begins. The first signs are when the child complains of pain when drinking or eating, if they can already express it. Often, children also refuse to drink or eat when they are already in pain. If nothing changes in the drinking behavior, the caries can spread to the entire child’s dentition.
Diagnosis and course of the disease
If parents discover the first signs of early childhood caries, a trip to the pediatrician or dentist is inevitable. With just one look inside the mouth, the doctor can make the diagnosis. This includes an analysis with the parents of the child’s usual drinking and eating behavior. In the beginning, only the enamel (outermost layer of the teeth) is affected. However, if the caries progresses further, it can penetrate into the tooth nerve (pulp). This causes severe pain and, in particularly bad and persistent cases, can lead to an abscess (suppuration) in the bone. This can damage the germ of the underlying tooth. Nursing-Bottle Syndrome may progress to the point where the teeth do not extend more than above the gum level. If the second, permanent teeth erupt when there is still an untreated cavity in the mouth, there is a high risk that the new teeth will be affected by decay more quickly. For the children, this type of oral disease can also lead to secondary diseases. For example, missing teeth can lead to a speech disorder later on. Especially the absence of the incisors is of great importance in the development of speech in order to be able to pronounce the s-sounds correctly. The dentition also loses an important placeholder for the coming second teeth. A malocclusion of the teeth can be the consequence of this.
Complications
Due to the Nursing-Bottle-Syndrome the small babies or children suffer from caries. This thereby affects the milk teeth, whereby especially the incisors of the patient are affected. Furthermore, the teeth turn brown or black and there is pain when taking liquids or food. Children may scream continuously if the pain cannot be relieved. Cold and hot food can also cause pain and have a significant negative impact on the quality of life of the child and parents. Furthermore, refusal to eat may also occur if the pain is too severe due to Nursing Bottle Syndrome. This results in malnutrition and various deficiency symptoms. If treatment is not received, Nursing Bottle Syndrome may spread to the other teeth. Usually, the treatment of Nursing Bottle Syndrome is done with the help of a dentist. The procedure is performed without any complications and the discomfort is completely removed in the process. The life expectancy of the child is also not affected due to Nursing-Bottle syndrome. In severe cases, some teeth may need to be removed.
When should you go to the doctor?
Nursing bottle syndrome is an urgent case for an experienced dentist. Already the pediatrician can recognize that it is caries, but he can not offer treatment. Important in choosing the appropriate dentist is his suitability for young patients. This is not due to the type of treatment of Nursing-Bottle syndrome with the damage to the permanent teeth that may already be present. From a purely medical point of view, any dentist can already treat caries even in a (young) child. It is more important that the child does not become afraid of visiting the dentist because of the treatment. The treatment of caries is unpleasant and, depending on the extent and progress of tooth decay, it may be necessary to make drill holes, insert fillings or even extract destroyed milk teeth so that the permanent teeth underneath suffer as little damage as possible. A dentist experienced with children will work in such a way that the little patients take away from it as little pain and unpleasant memories as possible. Failure to do so can lead to anxiety problems at the dentist, which can have consequences even in adulthood, such as complete avoidance of necessary checkups. Many dental offices now specialize in treating children or anxious patients, so Nursing Bottle Syndrome is possible without unpleasant experiences and pain. Parents should be upfront about this when making an appointment.
Treatment and therapy
Treatment in young children often proves difficult. Due to the fact that severe pain is the consequence of treatment and the children are afraid, this is usually done under general anesthesia. If the destruction by the caries is rather superficial and not yet deeply penetrated into the tooth, these teeth are drilled out and provided with a filling. The dentist tries to avoid the extraction of teeth as much as possible, because otherwise an important signpost for the following teeth is missing. Root canal treatment is necessary when the caries has already progressed to the tooth nerve. In this way, we try to preserve the tooth as long as possible without having to extract it. It is possible to treat the tooth with a filling afterwards to prevent further infection. This must be done in consultation with the parents, because if no dental care is performed, this method is useless. In addition, the milk tooth root must be almost completely intact again. However, in many cases it is inevitable to remove the teeth.
Prevention
To prevent the occurrence of Nursing-Bottle Syndrome, special attention is required on the part of parents and pediatricians. Since dental examinations are not yet common at this age, the pediatrician should provide a referral to the dentist at the first abnormality. To protect the child from early childhood caries, care should be taken to ensure that the child does not suck on the bottle continuously. Remove the bottle from the mouth before going to sleep and after the first year of life, the bottle should be discontinued. No sweetened liquids are offered, but water or unsweetened tea. Daily tooth cleaning (morning and evening) from the eruption of the first tooth with a brush is also an important preventive measure to counteract tooth decay. It is recommended by the pediatrician to give fluorine tablets or to brush later with a fluorine-containing toothpaste. Parents should be well informed about prophylaxis and animated to carry it out.
Follow-up care
In most cases of nursing bottle syndrome, only limited aftercare measures are available to those affected. The primary need for this condition is a quick and early diagnosis of the disease to prevent further complications or other medical conditions from developing. The earlier a doctor is contacted, the better the further course of the disease usually is. In most cases, the affected children have to undergo a surgical procedure on the mouth, during which the teeth are removed. As a rule, there are no particular complications or other discomforts, so that this operation generally proceeds without difficulties and completely alleviates the discomfort. After such a procedure, regular check-ups and examinations by a dentist are very important in order to avoid inflammations and infections. Further aftercare measures are usually no longer necessary in the case of Nursing Bottle Syndrome.In general, parents should pay attention to proper and intensive care of teeth in their children to avoid the occurrence of Nursing Bottle Syndrome. The life expectancy of children is unaffected.
Outlook and prognosis
The prognosis of nursing bottle syndrome is favorable under optimal conditions. If a physician is consulted at regular intervals, the first irregularities can be noticed quickly. Treatment is then initiated immediately so that relief can occur. Infants and toddlers are affected by this disease. Therefore, for a good prognosis, parents should visit a doctor with their offspring at continuous intervals. If these intervals are too long or if a visit to the dentist is avoided, irreversible damage to the teeth can occur. The germs present in the mouth destroy the enamel, cause suppuration or damage the teeth and gums. In an advanced stage of the disease, dentures must be inserted, otherwise there is a risk of tooth loss or progression of the disease. If the disease progresses unfavorably, the formation of pus in the mouth can lead to blood poisoning. This is a potential threat to human life. In acute cases, cooperation with an emergency team is therefore particularly important to ensure the survival of the child. For an improved outcome, nutrition should be changed and optimized. Parents are responsible for the food ingested by the child. Therefore, they can have an immediate influence and should make optimizations for long-term improvements.
What you can do yourself
Once Nursing Bottle Syndrome has been diagnosed, the first thing to do is to adjust the child’s diet. The first thing to do is to eliminate sugar, fructose and carbohydrates. The pediatrician can prescribe appropriate nutritional supplements if necessary. Drinking habits must also be adjusted. The child must take in enough mineral water (at least one to two liters per day) and should also drink enough tea, milk and spritzers. After diagnosis, children should no longer consume overly sweet or cold foods, as the teeth are sensitive to these stimuli. Depending on how far the damage has progressed, either medicinal or surgical measures must be initiated. In the case of lighter damage, a mild pain medication is sufficient, as the damaged milk teeth will loosen on their own after a few years. In the case of severe damage, which may have already spread to the roots of the teeth, surgical intervention is necessary. After such an operation, it is essential to follow the doctor’s instructions regarding dietary measures and oral hygiene. Parents should make sure that this does not scratch the wounds excessively, so that they can heal well. If, despite all measures, the caries increases, a visit to the pediatrician is recommended.
