Baby bottle Caries or Early childhood caries is a major health concern that continues to negatively affect the oral health and eventually overall health of infants and children today.

Dental caries, commonly known as Cavities, is a chronic disease that in children is five times more common than asthma and seven times more common than hay fever. 

How it appears

Approximately 40% of children have dental caries by the age of 5, and 8% of 2 year old children have some form of decay or previous restoration. When left untreated,this carious (decayed) lesion can lead to , disruption of growth and development of teeth and jaws, pain,life threatening infections and expensive treatments.

Why Delay ?

Early childhood caries:

It is defined as the presence of 1 or more decayed (cavitated or non-cavitated lesions),missing (due to caries), or filled tooth surfaces in any primary tooth in a child of 71 months of age or younger.It is a frequently encountered problem in children, affecting 3 to 45% of the pre-school population worldwide.

It is also known as-

  1. Nursing bottle caries 
  2. Baby bottle tooth decay 
  3. Nursing bottle syndrome 
  4. Milk bottle syndrome 
  5. Maternally Derived Streptococcus Mutans Disease (MDSMD)

Etiology (Reason of Occurrence of disease)

  1. Dental plaque 
  2. Inappropriate role of baby bottles 
  3. Streptococcus mutans
  4. Poor diet 
  5. Bad oral health habits 
  6. Low socioeconomic status 
  7. Immunocompromised children 
  8. Fermentable carbohydrate


ECC can be treated by many different ways ,depending on the progression of the disease, the child’s age, as well as the social, behavioral, and medical history of the child. 

Dental examination of a child by his or her first birthday is ideal in the prevention and intervention of ECC. During this initial visit, conducting a risk assessment can provide basic  data necessary to counsel the parent on the prevention of  dental decay. 

  • Children at low risk may not need any restorative therapy. 
  • Children at moderate risk may require restoration of progressing and cavitated lesions, While white spot and enamel proximal (contact area of adjacent teeth) lesion should be treated by preventive techniques and monitored for progression. 
  • Children at high risk, however, may require earlier restorative intervention of enamel proximal lesions, as well as intervention of progressing and cavitated lesions to minimize continual development of caries.

The current standard of care for treatment of ECC usually requires general anesthesia with all of its potential complications because the level of co-operative behavior of babies and pre-school children is less than ideal.

Stainless steel (preformed) crowns are pre-fabricated crown forms which can be adapted to individual primary molars and cemented in place to provide a definitive restoration. 

Another approach of treating dental caries is Atraumatic restorative treatment. The ART is procedure based on removing carious tooth tissues using hand instruments alone and restoring the cavity with an adhesive restorative material. At present, the restorative material is glass ionomer cement. ART is simple technique with many advantages, such as it reduces pain and fear during dental treatment, it does not require electricity; and it is more cost-effective than the traditional approach using amalgam. It is an alternative treatment available to a large part of the world’s population. In addition, it is mostly indicated for use in children, as it is reportedly atraumatic because no rotary instruments are used and in most cases no local anesthesia is needed. 


  1. Create awareness to parents about the condition and its causes. 
  2. Sealing of all caries free pits and fissures.
  3. Professional fluoride programs. 
  4. Use of antimicrobial therapy topically
  5. Supervised home care should be taught. 
  6. Systemic fluoride programme.
  7. Parents should be educated –how and when to introduce solid foods-when and how to feed the child during the earliest stages of the child-breast feeding should be encouraged.