Severe baby bottle decay

This weekend we had our two year old granddaughter over for a visit. My husband and I were shocked to see that all her top front teeth were missing their enamel. She looked like she had been eating chocolate and had a light film of it left on her teeth. I immediately called our family dentist who stated our beautiful granddaughter had a severe case of bottle decay and recommended a specialist. We will be taking her there in two days!

What can we do on a daily basis to help this child? Would you recommend fluoridated water to strengthen what is left, or is it too late? Are there any dietary changes you can suggest to help? And lastly, what effect will the 'bottle decay' have on her permanant teeth?

Thank you so much for your assistance.


"Baby bottle" tooth decay can be a quite a problem. She can still go to bed with a bottle if she needs to, but it should only have water in it, no milk or juice. She can still have milk or juice during the day, but care should be taken to brush and floss her teeth during the day and at night before she goes to bed.

Fluoride supplements would be a good idea only if the tap water in your area is not already fluoridated or if she doesn't drink the water from the tap. Please check with your local water district or your dentist or pediatrician for water fluoridation information. The dentist or pediatrician can give you a prescription for fluoride supplements, if necessary. Please refer to my colums about fluoride for more information on fluoride supplements and proper dosages. Fluoride supplements may help the primary teeth to a certain extent if they are allowed to touch the teeth, but mainly they will help strengthen the permanent teeth. If proper care is taken when the permanent teeth erupt, they have a good chance of being healthy.

The specialist has gone through extra years of training to learn how to treat children specifically and to handle their unique problems. Some children as young as your granddaughter handle the exam and treatment just fine, while some are a little more challenging. Occasionally, a dentist needs to give the child a sedative shortly before the treatment time to allow the necessary work to be done. Two important things to keep in mind: good communication between you and the dentist, and treating the problems as soon as possible, depending on the severity of the decay and the dentist's judgement regarding her age and abilities to handle the treatment.

The best things you can do for your granddaughter again are to only give her water at night, cut back on sweets, brush her teeth at least twice daily using a pea-sized amount of fluoride-containing toothpaste, floss her teeth at least once a day, and check into fluoride supplements. Taking her to the dentist was definitely the right decision!

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