Bottle Decay:

If I could have one wish, it would be to wipe out bottle decay for good! I truly hope that this book can get this message out to new mums. Most of the tooth decay I treat in children has its origin from putting fruit juices, cold drinks, or sugary drinks into nursing bottles. Why do mums continue to do this? I believe it is out of ignorance and I hope the pictures in this section will convince everyone who sees them that we must teach all new mums to stop this habit by not starting it in the first place! How is baby bottle decay caused?
It comes back to acid attack on the teeth. Consider what happens when a baby has a feeding bottle in its mouth. The teat is placed against the palate. The tongue covers the lower front teeth. Liquid from the bottle pools around the upper teeth, particularly the back surface of the upper front ones. If the bottle contains only milk or milk formula, which is given at feeds and stopped by one year, this shouldn't be a problem. However, if the bottle contains fruit juice or cold drink, these acids attack the enamel which, over time, is lost. Baby bottle decay, therefore, has a specific pattern: the back surface of the upper front teeth are seriously affected as are the upper first baby molars. More moms are returning to work after their babies are born. Bottle feeding is the norm, especially at night. Often moms leave bottles in the cot for their baby if he wakes in the night. A pattern of bottle-habit for comfort, rather than bottle- habit for hunger, is established. This habit, once started, is very hard to break!
Advertising plays a huge part. There are whole ranges of products: baby juices, baby flavoured-waters and baby milk-drinks. Many moms start these thinking, mistakenly, they aware giving “healthy” products.
Weaning is delayed. The child should progress to a cup at six months. If a bottle is given after this time, it should contain only plain, boiled water.
Many children are said to have a milk (lactose) intolerance. Rather than giving water to drink, moms give fruit juice. Many moms give the juice in the bottle, unaware of its dangers.
HIV infection precludes breast-feeding.

How can baby-bottle tooth decay be prevented?
It is far easier not to start giving your baby sugary and acid drinks in a bottle than to stop the habit later! Give only formula/plain milk during feeds and plain, boiled tap water at other times. Never give flavoured milk drinks. They are high in sugars (sucrose or fructose). Never give fruit juices or cold drinks in a bottle. They are high in sugar and extremely acidic. Many mums dilute these juices as they are so concentrated. Although that reduces the sugar content it does not affect the pH (acidity) as the table below shows. (Remember: at pH5.5 the enamel starts to dissolve!)
A further factor is the role of saliva. Often the child falls asleep with the bottle in the mouth. When we sleep our salivary glands also rest. The combination of low saliva with plaque and dietary acids results in a rapid tooth breakdown.