Many babies are soothed to sleep by sucking on a milk-filled bottle. But once there are teeth this can cause problems. Nursing caries (previously known as Baby Bottle Syndrome or Baby Bottle Caries) are fast becoming one of the most common paediatric dental problems. The main symptom of this syndrome is the rotting of the top four primary (baby) teeth.

This happens because the baby or toddler who has teeth goes to sleep with a bottle of milk, fruit juice or sugar-containing liquid (for example tea with sugar) or falls asleep at the breast or with a sweetened dummy.

While the child is sleeping, the flow of saliva and the frequency of swallowing diminish, allowing the fluid in the bottle to accumulate around the teeth. The plaque bacteria on the teeth then have enough time to produce the acid which will decalcify the teeth. This is how cavities are formed. The milk also sours in the mouth and this further contributes to the development of caries.

To avoid decay from bottles:

• Let the baby finish drinking before you lay him/her down to sleep. If the baby insists on a bottle, only give clean water.
• Do not add sugar to the liquid.
• Avoid fluids that contain acid, such as fruit juice. If your baby already goes to sleep with a bottle of juice, wean the baby by gradually diluting the juice with water.
• Try to switch your baby from a bottle to a cup before the age of one. Do not use a cup with a spout or bottles with nozzles (such as Energade bottles) as these have the same effect as a bottle.
• Do not dip dummies in sweetened substances – this can also cause decay.
• Always clean the baby's teeth before bedtime.

For more on nursing caries, visit Health24.