Differences between Nursing Bottle Caries and Rampant Caries

Nursing Bottle caries is a type of Rampant caries which is demarcated because of the age factor, Nursing Bottle caries is seen in Infants and Toddlers and Rampant caries is seen in any age and seen in both Primary and Permanent Teeth.
As the name suggests Nursing Bottle Caries is caused mainly due to the feeding habits seen in Bottle feeding, it was named and renamed many times before ending up with Nursing Bottle caries – Nursing caries, nursing bottle mouth, Nursing Bottle Syndrome, bottle propping caries, Night bottle syndrome, Baby bottle caries, Nursing Mouth, Nursing Bottle Caries, Milk Bottle Syndrome.

difference between nursing bottle caries and rampant caries

Mandibular Anterior’s are not affected in Nursing bottle Caries

Bovine milk and Human Breast milk have Lactose contents which are the cause for Nursing bottle caries, Nursing bottle directly blocks the salivary access to the tooth surfaces, thereby increasing the cariogenicity of the oral flora.

Nursing Bottle Caries Rampant Caries
Type / Nature Specific form of Rampant Caries, Acute Generalized spread of caries and pulpal involvement in selected teeth of Dentition Acute, Generalized spread of caries and pulpal involvement in all teeth
Age Infants and Toddlers At any age, both primary and permanent teeth are involved and no specific teeth in particular
Cause / Etiology Feeding Children with Milk Bottles while the child is lying down or sleepingBreast feeding whenever the child asks and at will for prolonged durations of time

Use of Pacifiers which are coated with Honey or any Artificial Sweeteners to stop the baby from crying

It involves only the feeding factor

Frequent intake of Sweet, Sugary and Sticky Food substances throughout the dayDecreased Water intake through the day and decreased Salivary flow

Genetic predilection if seen in parents or family members

It is a combination of many factors coming together

Characteristic Features Specific teeth are involvedMandibular Incissors are not affected at all (because of the constant flow of Saliva from Sub Mandibular gland and the constant cleansing movement of tongue tip) No Specific teeth are involved as all the teeth are equally involvedMandibular incisors are also equally affected as the other teeth

Seen at any age, as Nursing Bottle caries is a type of Rampant caries, if seen in toddlers and infants it is called NBC and if seen after that age it is called as Rampant Caries.

Treatment Treatment plan depends on the stage and time of detection and intervention by the parents and dentistIf Diagnosed at an early stage – Fluoride Application and Parent Education

Pulpotomy and Pulpectomy and Space Maintenance are decided based on the Signs/Symptoms until the Transition occurs

Educating the parents about the feeding habits

Treatment plan depends on the stage of interventionEarly intervention requires removal of Caries and restorations / Crowns depending on Stage of Tooth decay.

In case of Pulpal involvement -> Pulp therapy / Root canal treatment is Required

Permanent Treatment options like Root Canal Treatment, Fixed partial denture or Extraction and replacements are done in case permanent teeth are involved

Prevention It is seen in infants and toddlers hence educating the parents or new mothers is important to prevent Nursing Bottle cariesFeeding habits should be explained in detail:

  1. Timings should be maintained for feeding
  2. Prolonged feeding is not recommended
  3. Try to avoid feeding in sleeping position
  4. Make the child drink water after feeding to cleanse off the milk
Rampant caries has many factors which are involved in leading to the disease.As Rampant caries occurs at any age, patient education to identify any carious lesions and get immediate dentist intervention.

Patient education with the help Camps or Community Centres

Why are Mandibular Incissors not affected in Nursing Bottle Caries ?

Because of the constant flow of Saliva from Sub Mandibular gland as the Salivary duct opens here and the constant cleansing movement of tongue tip on the lingual surface of the lower incisors.

Latest Comments
  1. anu priya

    I want to know about radiation caries nd rampant caries….just wanna know basic differnce

  2. Varun

    One of the main differences between – Radiation caries and Rampant Caries is the Etiology. The findings are similar in both cases – The teeth which are thought to be less susceptible to caries are usually affected. The main Etiology is Xerostomia or lack of Saliva, in case of

    Radiation Caries – The Xerostomia is caused primarily due to Radiation therapy where production of saliva is decreased.

    Rampant Caries – There are multiple causes which can lead to Rampant caries such as – Radiation Therapy, Xerostomia (due to other reasons), Stressed children and certain Genetical causes. Certain food habits in children like – feeding through the night, sweetened pacifiers.

    Radiation Caries is seen only in patients who are exposed to radiation while Rampant caries can occur in any age group but the most prevalent age group is 4-8 years and 11-19 years.

  3. Mahdi Gholami

    Is there any relation between maternal blood group or breast milk’s ingredients and nursing bottle caries?

  4. Varun

    That is a pretty interesting question, will look it up as discuss with others and let you know.

  5. Varun

    In general, Nursing bottle caries is caused due to feeding of milk through a bottle and due to the prolonged exposure of milk to the anterior teeth which are the most commonly affected teeth, caries is seen in such cases. But there can be a link between the breast milk ingredients to caries in cases where breast milk is given in bottles.

  6. Kalyani

    Hi my sons age is about 4 years. He lost all his front teeth due to caries. So can u please tell whether it effects to permanent teeth.

  7. Varun

    As there is still 2 years for the permanent teeth to erupt, it is important to make sure that the caries affected decidious teeth are not infected, as infected decidious teeth do not exfoliate by themselves which prevent the permanent teeth from erupting in the correct position.

  8. tushar borania

    What questions should ask for caries risk assessment in 8 years old child with rampant caries

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