Nursing bottle caries
Nursing Bottle Caries
Nursing bottle caries in infants and young children have a unique pattern of extensive involvement of the maxillary incisors and, to a lesser degree, the maxillary molars. The mandibular molars are rarely involved. These caries have been attributed to prolonged breast or bottle feeding, use of sugar-containing liquids in the bottle, the child falling asleep while feeding and a genetic predisposition.
Marino and colleagues studied the behavioral, nutritional and demographic factors associated with this disorder. Twenty-four consecutive patients with dental caries in a distribution typical of nursing bottle caries were identified in a private pediatric dental office and paired with age- and sex-matched children who were free of caries. All of the parents of these patients completed an infant behavior and nutrition questionnaire.
The authors found that the children with nursing bottle caries were more often living in a single parent household and were more likely to take the bottle to bed and continue bottle feeding longer than the control infants. Complete discontinuance of feeding occurred at a mean age of 21.2 months in the group with nursing bottle caries and 15.3 months in the control group.
Compared to the control group, less than half as many infants with caries were breast fed. Parents of the infants with caries also had received less professional advice about weaning from their primary physicians than did the parents of the control infants. In addition, fluoride supplementation was less commonly used in the infants with caries.
Behavioral analysis revealed that sleep difficulties and a strong temper were more common in cases than controls, which may have contributed to prolonged bottle feeding. Risk factors for nursing bottle caries are summarized in the table. The authors emphasize that physicians should be aware of these risk factors and provide anticipatory guidance. Providing professional advice about weaning and fluoride supplements offers the physician an opportunity to educate parents about dental health.
COPYRIGHT 1989 American Academy of Family Physicians
COPYRIGHT 2004 Gale Group