Preventing rotten teeth

juice teethThis drives us crazy: Listed on  many pediatric developmental milestone charts, there is the six month milestone, ” can hold their own bottle. ”  Unfortunately, this is the last thing we want our patients to do. Babies who feed by holding their own bottle tend to suck for a longer period of time than when they are at the breast or when a parent holds the bottle.  Prolonging the time any sweet substance, whether breast milk, cow’s milk,  or watered down juice is in the mouth can produce cavities. Even in toothless babies, the sugar can seep through gums and rot the teeth producing cavities called “bottle rot” in the two front teeth. As shown above, sucking on a sippy cup constantly can also produce the characteristic damaging pattern .

Sippy cups are like daytime bottles. In the “old days” if a child wanted a drink, the parent would give him a cup, he would take his drink, and then the cup would be put away so it would not spill. Sippy cups are easier to leave around for kids to grab when they need it. They are easy for kids to carry and graze from while playing. They don’t make a mess in the car. But because kids can nurse a sugar-containing drink all day, it becomes easy for a sweet drink to have constant contact with teeth, thus producing the problem you can see in our photo.

How to prevent rotten teeth:

  • Once they are toddlers, give your kids beverages at meal or snack times only.  Let them drink and then put the cup away. Otherwise, forward to the future, and imagine your sippy-cup-toting toddler becoming the perpetually-drinking-coffee office coworker down the hall.  We’re sure your coworker’s teeth are not pretty. The only exception to giving a beverage only at meal or snack times is the quick after dinner cup of milk when they are very young (toddlers). If your toddler drinks a cup of milk before bed, make sure he brushes his teeth before going to sleep. Brush-book-bed is a good routine to institute.
  • Limit juice. Whether 100%, or organic, or  watered down,  juice contains enough sugar to rot teeth over time. Dr. Kardos remembers a friend lamenting, “I bought only 100% juice for his sippy cup and had no idea it could hurt my son’s teeth like that!” Eventually, her friend’s son underwent a tooth repair under anesthesia.
  • Encourage good tooth brushing at least twice a day with fluoride-containing toothpaste, starting when your child gets his first tooth. Before that point, wipe out your baby’s gums with a wet gauze or wash cloth. 
  • Schedule regular dental visits for your child starting around or soon after his first birthday.
  • Ask your pediatrician or dentist if supplemental fluoride  may be helpful.  

Some final food for thought: snacks of pouch-pureed fruits and vegetables are increasing in popularity. We don’t think we need to wait for a scientific study to say that prolonged sucking on a packet of  “healthy” fruit puree will probably result in the kind of teeth pictured above .

For more tips check out the American Academy of Pediatrics and the American Academy of Pediatric Dentistry.

Julie Kardos, MD and Naline Lai, MD

©2016 Two Peds in a Pod®

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