Desperately seeking solutions to infant decay


The head of dental services at Westmead Children’s Hospital, Associate Professor Richard Widmer, has called for parents to stop bottle feeding altogether in an effort to halt the rise in infant decay. Even as he made the call, researchers in the US announced the discovery of a new species of bacteria that may also cause caries.

A Prof Widmer was quoted in newspapers last weekend as saying prolonged feeding with bottles of breast milk and infant formula can lead to early childhood caries. At night, if children suck on bottles in their cots for extended periods, A Prof Widmer said naturally occurring lactose was present in both breast milk and formula. When combined with plaque in a baby’s mouth, it could erode the enamel of primary teeth.

“Ideally, children should go straight from breast to cup, avoiding bottles altogether,” Professor Widmer said.

Paediatric dentists had noticed a pattern of decay on the back of the upper front teeth, indicating the cause was drink from a bottle that had been held between the child’s tongue and teeth for prolonged periods.

“We see more kids with decay, and we’re struggling to get them all done,” Professor Widmer said.

The waiting time for dental surgeries under general anaesthetic is between nine and 12 months. Angus Cameron, the head of paediatric dentistry at Sydney University and Westmead Hospital, said tooth decay was so bad in some infants that they had to have every one of their primary teeth removed.

Meanwhile, as study in the February 2 issue of the Journal of Clinical Microbiology suggests that a species of bacteria, Scardovia wiggsiae, can cause cavities, even when S. mutans is not present. Up until now, Streptococcus mutans (S. mutans) has been considered the primary culprit in caries formation.

The new research Researchers from the Forsyth Institute and Harvard, Boston and Tufts universities did the study. They looked at bacteria found in the dental plaque of 42 children who had early childhood caries.

Five types of bacteria were much more common in the children with decay than in decay-free children. Four of these types were already known to be associated with cavities. S. mutans was one of these four. The other three are thought to only lead to cavities in partnership with S. mutans, and not to cause cavities on their own.

Scardovia wiggsiae was a surprise. It was found in children with decay even when S. mutans was not found. This suggests that it might cause tooth decay on its own.

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  1. Idealism is likely to destroy credibility in the real world of a highly stressed young mother. Practical advice on shortening contact time with lactose through timed replacement with bottle containing water is more real world advice.

  2. All mother’s need dental advice from health professionals.
    I believe bottles should be thrown out at 12 months, which as through my own children I realise can be difficult.
    Most child heath nurses recommend sipper cups from about 9 months, cups in general ASAP, and not to put baby to sleep with a bottle.
    The messages are clearly not being delivered or heard effectively.

  3. Maybe some parents are aware of the dental implications of giving their child a bottle in bed but are willing to take the risk in order to get some sleep themselves. A sleep deprived parent will try anything to get their child to sleep. Maybe we need to focus on giving parents/carers a set of skills to help ‘sleep settle’ their child especially for those who’s children are ‘bad sleepers’.

  4. As a currently breastfeeding mother of a 10 month old, I can vouch that it is possible to go from breast to sippy cup. It’s not possible to leave a baby on the breast for hours at a time, because it hurts Mum. Yet bottles do not remove themselves. They become an object of attachment, as a substitute for Mum. Give baby a real person, and they will not need to long for some other dummy for comfort. Respect to Mums who are unable to breastfeed, and thumbs up to Mums that do.


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