NURSING CARIES

These are anterior caries in the pre-school child, due to prolonged and improper feeding habits.

Causes

  • Frequent and prolonged consumption of fluid containing fermentable carbohydrates from a bottle, feeder cup, or on demand nightly breast feeding after 15 months of age

Clinical features

  • Rapid progression of decay commencing labially and quickly encircling the teeth
  • Teeth are affected in order of eruption
  • Lower incisors are rarely affected as they are protected by the tongue during suckling and directly cleansed by
    secretions from sublingual and submandibular salivary glands

MANAGEMENT

  • Discontinue night feeding
  • Gently brush teeth with a toothpaste approved for children (avoid swallowing)
  • Build-up of the teeth should be done using composites to restore shape and function
  • Disc affected teeth interproximally to create self cleansing areas
  • Regular fluoride applications

Prevention

  • Educate care taker to avoid frequent on-demand liquids at night including breastfeeding, after 15 months