ABSTRACT
Unsightly or discoloured primary incisor teeth will often be the reason why, for the first time, parents seek dental treatment for their children. Such teeth may be carious, discoloured due to a congenital defect or trauma, or simply malformed. Caries of upper primary incisors is a consistent feature of ‘nursing caries syndrome’ (also known as ‘nursing bottle caries’ or ‘bottle mouth caries’), and will often need restoration. Nursing caries is seen in pre-school children and results from frequent or prolonged consumption of fluids containing fermentable carbohydrate from a bottle or feeder cup. Fruit-based infant drinks are most commonly involved, but similar patterns of caries can also be seen with milk-based drinks and in infants breast-fed on demand. Such infants are often allowed to suck on the bottle as a pacifier throughout the night. During sleep, there is a considerable reduction in salivary flow rate, and consequently salivary buffering and mechanical cleansing are reduced to minimal levels. This results in rapid demineralization and clinically rampant caries. Typically, the maxillary incisors and first primary molars are most severely affected. The lower incisors are rarely affected, since they are protected during suckling by the tongue and directly bathed in secretions from the submandibular and sublingual glands.
