NURSING BOTTLE SYNDROME

also known as nursing bottle caries
baby bottle caries

it is characterised by
severe caries pattern
beginning with maxillary anteriors
in a healthy bottle fed infant
usually 2-4 years of age
sequence of teeth involvement-max ant ,max moalrs ,mand molars ,
mand anteriors mainly unaffected because of protection by the tongue
seen as white or yellow or dark brown collar of caries around the neck of teeth

diagnosis
clinical examination-white or yellow or dark brown collar of caries around the neck of teeth
history -child is put to bed with bottle of milk or sugared beverages

stages in the development of nursing bottle caries
initial :
10-20 months max ant -opaque white demineralisation in the cervical or interproximal region

damaged 16-24 :
max ant-yellow brown discolouration
max first molars -first stage

deep lesions 20-36 months
max ant :enamel affected and pulpal irritation
max molars :2nd stage
mand molars -first stage

traumatic 30-48months
max ant :loss of large amount of enamel and dentin,crown fractures
max molar-third stage
mand molars-second stage

mangement
parent counselling
1.child should not be bottle fed when put to bed
2.milk should be without sugar
3.if fed ,child should be burped ,mouth rinsed with water or teeth wiped with clean cloth
4.child's teeth should brushed as soon a s they erupt
discontinue nursing with bottle as soon as child can drink from cup(12-15months)
diet modification
1.no nursing when child is put to bed
2.no suger in bottle
definitive
1.oral prophylaxis
2.caries excavation
3.provisional restorations
4.fluoride therapy
5.final restorations
6.recall 2-3 months