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.

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.

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