OHRA - Substrate: Contributing Dietary and Feeding Habits

Course Outline > Anticipatory Guidance

Substrate: Contributing Dietary
and Feeding Habits

	Frequent consumption of carbohydrates, especially sippy cups/bottles with fruit juice, soft drinks, powdered sweetened drinks, formula, or milk

	Sticky foods like raisins/fruit leather (roll-ups), and hard candies

	Bottles at bedtime or nap time not containing water

	Dipping pacifier in sugary substances

	Frequent consumption of carbohydrates provides substrate for bacteria to grow and no time for enamel to remineralize. Sticky foods such as raisins, fruit leather (roll-ups), and chewy vitamins may be worse because of the tendency to remain on the teeth longer. Hard candies that are sucked bathe teeth in sugar for a long period. When reviewing dietary habits, it is important to know which foods are being eaten, how frequently they are consumed, and in what combination. A combination of carbohydrates with protein or fat is preferable.

	Almost no saliva flows during sleep, so it is important that parents understand that when sleeping or taking a nap, a baby should have only water in his or her bottle after the eruption of the first tooth. Fruit juices, soft drinks, sweet teas, formula, or milk should not be put in a baby’s bottle or sippy cup during bedtime or nap time. If a bottle is given at nap time or bedtime, parents should use a cloth to wipe the baby’s mouth prior to lying the infant down. Due to the decreased salivary flow, any food or drink that is in the baby’s mouth during sleeping periods stays there for many hours and promotes the caries process.

	Because there is an increased risk for the development of caries for children who sleep with bottles containing liquid with natural or added sugars, and because children who drink bottles while lying down may be more prone to getting ear infections, the AAP suggests that children not be put to bed with bottles.

	Parents should also be reminded that pacifiers should not be dipped in sweet liquids. In addition, because bacteria are transmitted through the saliva, pre-tasting, pre-chewing, and sharing of utensils should be avoided.