Tooth Decay: What are Nursing Caries?
Tooth Decay: What is Nursing Caries? | Baby Chick

By Ratna Bajpai

Dental and Oral Care Expert

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Dr. Ratna Bajpai is a dental surgeon and periodontist with over 15 years of experience as a healthcare provider. She has a background in teaching dental students and volunteers for community outreach programs that improve public health awareness. She looks forward to sharing her clinical experiences through writing.

It’s been a while since the “magic of motherhood” overwhelmed you, and you’re still on the roller coaster. In fact, there are days when you feel as if you’ve gone through the spin cycle of your washing machine. Your body clock says it’s one time, but the wall clock says it’s another! Amidst all the chaos, if there’s one thing that can make your spirits soar, it is your baby’s radiant smile. It sends a surge of energy through your toil-worn body, and you wouldn’t trade that feeling for anything else in the world.

But one night as you try to seek refuge in that angelic smile, your spirits nosedive at the sight of some dull, brown spots on your child’s recently erupted pearly whites. As you can barely keep your eyes open, and as your insides feel like curdled milk; you dismiss those unsightly spots as stains. You make a mental note to brush them a little harder and hope that they would soon disappear into thin air.


Life can get trying, at times. The “thin air” theory soon falls apart, and you recoil in horror, as the innocent looking spots transform themselves to cavities that completely outrage the eyesight!

I do not propose to dwell on the emotions that accompany this discovery. At this point, it would be more meaningful to address the issue at hand–“nursing caries,” a form of early childhood tooth decay associated with inappropriate nursing practices.

The American Academy of Pediatric Dentistry defines early childhood tooth decay as the presence of one or more decayed, missing, or filled tooth surfaces in any primary tooth in a child below the age of 6. In children younger than 3 years of age, any sign of smooth surface decay is indicative of severe early childhood caries.


How Do Nursing Caries Happen?

Babies like to feed off to sleep, either by breast or bottle. For a long time, milk remains a part of their bedtime routine. As the child falls asleep, the milk pooled around the baby’s front teeth acts as an excellent medium for bacterial growth. The bacteria breaks down sugars and create an acidic environment in the mouth. As salivary flow reduces during sleep, the clearance of milk from the mouth is slowed down. These changes result in a softening of enamel leading to tooth decay. The lesions appear as dull, brown spots that quickly progress to areas of decay. As the condition is progressive in nature, it may even lead to infection in the tissues around the teeth.

How Can Nursing Caries Be Prevented?

A review of several studies published in the International Journal of Dentistry in 2011, suggests that there is a strong correlation between early childhood tooth decay and inappropriate nursing practices. Nursing caries progress rapidly, and its consequences can affect the immediate and long term quality of the child’s life. Furthermore, children under the age of 5 years with a history of dental caries are also at high risk for future tooth decay.

The American Dental Association has provided some guidelines to prevent nursing caries:

  • Babies should not fall asleep to milk. Have your child finish the feed before going to bed.
  • The child should start learning to drink from a cup from the age of 6 months.
  • One should start brushing the child’s teeth as soon as they erupt.
  • Introduce other forms of dietary carbohydrates after the eruption of teeth.
  • Discontinue nursing as soon as the child can drink from a cup. The child should be completely off the bottle by 12-15 months of age.
  • Discourage snacking in-between meals, and repetitive consumption of milk and juices.
  • Plan the child’s first dental visit at 12 months of age.

Oral health means more than healthy teeth. It also influences the child’s growth and development, nutritional practices, general health, aesthetics, speech patterns, and self-esteem.

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One thought on “Tooth Decay: What are Nursing Caries?

  1. It’s a need post actually want same imformation for my little two yrs son. His tooth are started decaying and I am worried why is this happening with him. He use feeders for milk. And I think its the actually reason for his tooth decay. Your post gives answer for all my questions. Thanks for sharing.https://mommystimeline.com

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