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Dr Sylvia Amede: Let’s Talk About Nursing Caries



Nursing caries is a form of tooth decay that is caused by children sleeping with their feeding bottles in their mouth. This is also called baby bottle or nursing bottle tooth decay.

It is caused when a child goes to bed with a bottle filled with milk or juice—anything except water. It usually affects children between the ages of one and two years. Breastfed infants who fall asleep while breastfeeding are also at risk, and it occurs mostly on the upper teeth but other teeth can also be affected.

How Does It Come About?
Baby bottle tooth decay happens when sweetened liquids or those with natural sugars (like milk, formula, and fruit juice) cling to an infant’s teeth for a long time. Bacteria in the mouth thrive on this sugar and make acids that attack the teeth.

At risk are children whose pacifiers are frequently dipped in sugar or syrup. Giving an infant a sugary drink at nap time or nighttime is particularly harmful because the flow of saliva decreases during sleep.

Although baby bottle tooth decay typically happens in the upper front teeth, other teeth may also be affected.

What Are The Signs & Symptoms of Nursing Caries?
The following are the most common signs and symptoms of nursing caries:

  • White spots on the teeth
  • Early development of cavities (brown areas on the tooth that lead to tooth destruction)

The Effect of Nursing Caries on a Baby
You think baby teeth are temporary, and therefore, not important? Think again. Baby teeth are necessary for chewing, speaking, and smiling. They also serve as placeholders for the adult teeth. If baby bottle tooth decay is left untreated, pain and infection can result.

Severely decayed teeth may need to be removed. If teeth are infected or lost too early due to baby bottle tooth decay, your child may develop poor eating habits, speech problems, crooked teeth, and damaged adult teeth. In addition, the chances that adult teeth will end up being crooked are greatly increased.

What Can Be Done About It?
You can begin implementing good oral hygiene at an early age. Here’s how:

  • Wipe the baby’s gums with a clean gauze pad or washcloth after each feeding.
  • Begin brushing your child’s teeth, without toothpaste, when his or her first tooth comes in. If you choose to use toothpaste, use
    a fluoride-free one.
  • Clean and massage gums in areas without teeth.
  • Floss once all the baby teeth have come in.
  • Make sure your child is getting enough fluoride, which helps lessen cavities. If your local water supply does not contain fluoride, ask your dentist or doctor if you need to use a supplement.
  • Schedule regular dental visits by your child’s first birthday.

Dentists also offer special sealant coatings, which can help prevent tooth decay in children.

Other techniques to help prevent baby bottle tooth decay:

  • Don’t fill bottles with sugar water and soft drinks. Bottles are for milk, water, formula, and special electrolyte-containing solutions when the child has diarrhea. Juices, mixed half and half with water to avoid empty calories, are a way to interest your child in a “sippy cup.” Soft drinks are not recommended for children, as they have no nutritional value.
  • Never allow your child to fall asleep with a bottle containing anything but water.
  • Never give your child a pacifier dipped in anything sweet.
  • Reduce the sugar in your child’s diet, especially between meals.
  • It’s never too late to break bad habits. If your child drinks sweetened liquids from the bottle and/or sleeps with a bottle, break the habit now and cut the risk of baby bottle tooth decay by gradually diluting the bottle contents with water over two to three weeks, and once that period is over, fill the bottle only with water.

Remember that healthy baby teeth will lead to healthy permanent teeth.

Photo Credit: Dreamstime

My name is Dr Sylvia Amede, a dentist currently practising in Abuja. I attended University of Ghana. my love for dental health education and awareness has lead me to volunteer in several rural communities Both in Nigeria and Ghana, providing free dental health services and education.


  1. obehi

    February 20, 2019 at 8:24 pm

    Quite informative. Thanks doctor

  2. Pheee Obiechina

    February 20, 2019 at 8:26 pm

    Who knew babies could get decay, now I know!

  3. Edith

    February 20, 2019 at 8:47 pm

    Nice write up

  4. Ehi

    February 20, 2019 at 9:09 pm

    Great Awareness

  5. Kate Okoh Kpina

    February 20, 2019 at 9:25 pm

    Well done Dr. Sylvia. Beauty and brains! Kudos to career driven women who strive to educate the populace on basic information in plain language. Super proud of you dear.

  6. Vick

    February 21, 2019 at 7:07 am

    Nice one didn’t know babies can have have tooth decay but what happens when the teeth falls off

  7. Vick

    February 21, 2019 at 8:33 am

    Good didn’t know babies can have tooth decay

  8. Otivbo

    February 21, 2019 at 8:36 am

    Nice one ! I guess this explains why my second daughter has dental issues. Thanks for this .

  9. Ogieva

    February 21, 2019 at 1:56 pm

    I actually learnt alot from this, thanks Sylvia..

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