Copyright 2006 Martin S. spiller, D.M.D. compliments of Dr. Ed Cataldo
Nursing bottle syndrome (most recently called Early Childhood Caries–ECC) is characterized by children, generally under the age of 3 who are put to bed with a baby bottle filled, usually with fruit juice or sweetened milk. (NOTE: Fruit juice is a MAJOR factor in the development of early childhood caries!) The pattern is severe decay of the front top teeth. If the bottle contained only water, or an artificially sweetened drink such as Crystal Lite or artificially sweetened Kool-Aid, the teeth would not be affected. No mom does this on purpose to her child, but it is quite common because mom simply doesn’t know that the sugar in the bottle can do this.
There are numerous reasons to repair baby teeth (see below), but when baby incisors are this badly damaged, it is usually best to extract them. Baby incisors are not essential for maintaining spacing in the adult dentition, as are the baby molars and canines. The “pimple” emphasized on the lower image is a gum boil, known technically as a parulis. The presence of a parulis means that the baby tooth it is associated with has an abscess due to the death of its nerve. An abscess under a baby tooth has the potential to damage the adult tooth which is developing under it.
Children need their teeth as much as you do to chew and smile. If the teeth are allowed to become decayed, that child will suffer pain and an inability to eat properly which can lead to lifelong eating disorders, or at minimum poor nutrition for the time during which the child is unable to eat properly. Children have social lives too, and the stigma of blackened stumps and bad breath can lead to derision (serious teasing) at school and at play, and could affect the child’s social development.
Bad baby teeth usually mean frequent visits to the dentist under very poor circumstances. The child has not slept well, he is in a bad mood, and the dentist is the last person he really wants to see. In addition, by the time they are seen, the dentist must usually remove the tooth, which is what the parents expect anyway. So his visits always amount to painful episodes from which he emerges missing a piece of his body! This sets the stage for not only bad behavior on succeeding dental visits, but for a person with a lifelong fear of dentists who will probably end up with dentures.
Finally, some of the baby teeth are essential for holding the spaces open so that the adult teeth can come into the correct position when they are finally developed enough to erupt (“erupt” means to come through the gums for the first time). If certain of the baby teeth are removed before nature intended, the adult teeth that develop earliest will move into inappropriate positions crowding out the space necessary for the eruption of other adult teeth which develop at a later date. This can lead to not only crooked teeth, but to real functional problems as well. These involve chewing difficulties, TMJ problems, and pronounced facial asymmetries (this means that one side of the face develops more than the other side due to the differences in the way that the muscles on either side are used in chewing and grinding the teeth.) A person gets two sets of teeth at different stages of life for very good reasons. The adult version will not fit into a baby’s mouth, yet that child must still be able to chew food. So while nature gave children a temporary set of teeth in order to fill a space that would otherwise have to remain vacant until age 12, she thought she might give them some extra work to do as well.
When should a child stop using a bottle? A child should be weaned from the bottle by 12 to 14 months of age.
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