[baby gear] Can Pacifiers and Baby Bottles Ruin My Baby's Teeth?

Can Pacifiers and Baby Bottles Ruin My Baby's Teeth?

Sucking is an innate reflex that babies develop and practice in the womb as they prepare for their first meal. Sucking is so important to a child's development that it is comforting well into a child's first years of life — long after he or she no longer needs to get nourishment from a breast or bottle.

While sucking is tailor-made for an infant's nutrition, most children will also find comfort by sucking on hands, fingers or pacifiers. This "non-nutritive sucking" is soothing, but is it a problem?

Are Pacifiers a Problem?
During a child's first few years, sucking habits are unlikely to cause significant damage to a child's mouth. But persistent and long-term sucking, especially after the permanent teeth begin to come into the mouth around age 6, can cause:

* The top front teeth to slant out.
* The bottom front teeth to tilt in.
* The upper and lower jaws to be misaligned.
* The roof of the mouth to be narrowed.

Here are a few things you can do:

* If your infant uses a pacifier, buy only products that are constructed as one piece. There shouldn't be any parts that can break off and potentially be swallowed or breathed into the lungs.


* Never fasten a pacifier on a strong or necklace around your child's neck. Your baby could accidentally be strangled.


* Offer your child a pacifier that is marketed as "orthodontically correct because this type may cause less distortion to the teeth.
* Don't try to calm a fussy baby by dipping the pacifier in honey or sugar water.This will increase your child's risk of tooth decay.
* Use positive reinforcement to encourage older children to give up the pacifier or thumb.

Early Childhood Tooth Decay: The Role of the Bottle
Many children satisy their desire to suck by continuing to use a bottle or sippy cup as a pacifier or by breastfeeding long after these habits are no longer needed for nutrition. If the bottle or cup contains anything other than plain water, the frequent sucking or sipping may put the child at very high risk of developing early and extensive tooth decay.

The more often sugars or other carbohydrates stay in the mouth, the more food they provide for cavity-causing bacteria and the more likely it is the child will develop early childhood tooth decay (also called early childhood caries). This early decay is particularly worrisome because it spreads rapidly, often causes pain and infection, and puts the child at risk of having cavities throughout life.

The U.S. Centers for Disease Control and Prevention (CDC) reports that 28% of children 2 to 5 years old in the United States have had some tooth decay. Many of these children have the severest form of early childhood caries, which causes pain that interferes with eating, sleeping and normal play. Children with extensive early tooth decay may need to have teeth extracted before their third birthday and often need to have their teeth repaired in the hospital operating room under general anesthesia.

In the earliest stages of early childhood caries, the teeth may appear to have small white spots or lines, especially along the edges of the gums. As the disease advances, these patches become brown and chipped. Since this form of tooth decay can progress very rapidly and cause severe dental problems, parents should seek the advice of a dentist as soon as they notice these discolorations.

The best way to learn about your child's risk of early childhood caries is to start dental care early. The American Academy of Pediatric Dentistry suggests that a child's first dental visit should be scheduled around the time the child's first tooth emerges and no later than the child's first birthday.

Long-Term Consequences
Baby teeth remain in children's mouths long after the children are no longer babies. In fact, these teeth continue to function into the early teen years. For this reason, it is important to keep the baby teeth healthy and to take care of cavities if they develop. As with permanent teeth, tooth decay in baby teeth can lead to pain and trouble eating and speaking. If baby teeth are severely decayed or are lost early, other teeth can move into the space, which causes the adult teeth to come in crowded or crooked.

Preventing Decay
Decay can almost always be prevented by keeping the mouth in a state of health. This requires healthy eating, good oral hygiene using a carefully controlled amount of fluoridated toothpaste after a child's first birthday and regular professional attention.

Here are several things parents can do to prevent cavities in their children:

* Don't let your infant walk around with go to sleep with a bottle or sippy cup that contains anything other than plain water.


* If your infant uses a bottle as a pacifier, fill it with water instead of milk, or substitute a pacifier.


* Whether you're breastfeeding or using a bottle, wipe your child's gums and teeth with a damp washcloth or gauze pad at least twice a day.


* If you've had problems with cavities, take special care to avoid sharing your mouth's bacteria with your infant or toddler. Bacteria that lead to early childhood caries are typically passed from mothers to children. This can happen several ways, for example if you taste the child's food with a spoon that you then use to feed your child, allow your child to suck on his or her finger after putting it in your mouth, or lick a pacifier that fell on the floor before giving it to your child. These are normal behaviors for parents, but if you have had many cavities, you can help your child avoid the same problem by trying to prevent transmitting the bacteria in your mouth to your child.


* Call your public health department to make sure your local water contains an optimal level of fluoride, which helps prevent tooth decay. If it doesn't, ask your dentist or pediatrician how your child's fluoride needs should be managed.

©2002-2005 Aetna, Inc. All rights reserved.
Reviewed by the faculty of Columbia University College of Dental Medicine