What is bottle caries?
Bottle caries (Early childhood caries, Circular caries) is a form of carious lesion characterized by predominant localization on vestibular surfaces and in cervical areas of the frontal group of primary teeth.
Etiology (cause)
Prolonged contact of teeth with carbohydrates, primarily during nighttime bottle feeding with formula, milk, or sweetened beverages. This creates conditions for acid-forming activity of cariogenic microflora (primarily *Streptococcus mutans*), leading to enamel demineralization.
Pathogenesis (development) and clinical presentation:
1. Demineralization stage (initial caries): Appearance of chalky spots — foci of enamel demineralization.
2. **Destruction stage:** Dentin involvement with cavity formation. Circular caries is characterized by circumferential damage to the tooth neck, often leading to crown fracture.
3. Complications: Pulpitis, periodontitis, premature extraction of primary tooth.
Consequences:
* Impairment of chewing function (mastication).
* Formation of occlusion pathology (dentoalveolar anomaly) as a result of early tooth loss.
* Risk of damage to permanent tooth germs.
* Impairment of articulation and speech development.
Thus, bottle caries is a rapidly progressive infectious pathology requiring a comprehensive approach, starting with parent education and ending with timely dental intervention to prevent serious odontogenic and orthodontic complications.
Disease history
Bottle caries was described in the 1960s as a form of early childhood caries when using bottles with sugar-containing liquids. Develops in children during nighttime feeding with formulas, juices. Classified as circular caries with cervical area involvement of primary teeth.
Classification and developmental stages
By location: cervical, circular, multiple variants. By depth: **Initial** — chalky spots; **Superficial** — yellow-brown enamel defects; **Deep** — dentin destruction, pulpitis risk. Rapid progression over several months.
Disease symptoms
Early signs: white spots in cervical area of upper incisors. With progression — yellow-brown discoloration, enamel defects. Increased sensitivity, chewing pain, bad breath, crown destruction. Sleep disturbance, refusal of solid food, irritability.
Causes of development
Prolonged exposure to sugar-containing beverages at night. Streptococcus mutans bacteria metabolize carbohydrates, forming acids that reduce pH and cause enamel demineralization. Risk factors: nighttime feeding, pacifiers with sugar solutions, insufficient hygiene, colonization of pathogenic microorganisms from parents.
Diagnostic methods
Visual examination with lesion assessment, defect localization. Radiological examination determines depth, proximity to pulp. Periapical radiographs, orthopantomograms. History of nutrition, feeding, oral hygiene.
Disease development
Enamel demineralization from acid exposure. Cervical area involvement with dental plaque. Enamel loses strength, defects form with transition to dentin. Circular spread around the neck. Without treatment — crown destruction, pulpitis.
Complications
Early loss of primary teeth disrupts occlusion, speech, chewing. Inflammatory complications: pulpitis, periodontitis, abscesses. Orthodontic problems — impaired permanent tooth eruption, pathological occlusion. Damage to permanent tooth germs, enamel hypoplasia.
Tactics depend on the lesion stage and child's age. At Corona Dental clinic in Barcelona, a comprehensive European approach to bottle caries treatment is applied using modern technologies and conservative techniques.
Initial stage — Corona Dental specialists in Barcelona perform professional remineralizing therapy with fluoride gels and varnishes. Modern preparations are used to restore the mineral composition of primary tooth enamel.
Superficial defects are treated using minimally invasive techniques. The clinic uses quality composite materials of European production, ensuring long-term sealing and aesthetic results. Russian-speaking doctors at the Barcelona clinic work with children in a comfortable environment.
Deep lesions require a comprehensive approach — preparation with subsequent filling or pediatric crown placement. Corona Dental uses modern equipment for precise diagnosis of dentin lesion depth and pulp proximity.
In case of pulpitis, the specialist team performs conservative endodontic treatment using biocompatible materials and modern techniques, allowing preservation of the primary tooth until natural replacement. Extensive destruction — when conservative treatment is impossible, extraction is performed with subsequent prosthetics using pediatric crowns to preserve chewing function and proper occlusion formation.
Recovery
Follow-up examinations at 2 weeks, 1, 3, 6 months. Assessment of fillings, inflammation. Soft diet, hard food restriction. Teaching parents tooth brushing with soft-bristled brushes, hygiene products. Nutrition correction, abandoning nighttime feeding.
Prevention
Proper nutrition — avoid nighttime feeding with sweet beverages, abandon bottle after one year. Hygiene from the first tooth — soft brushes, wipes. Water after feeding. Dentist visits from 6 months, professional hygiene, fluoride preparations. Parental sanitation prevents pathogenic bacteria colonization.
