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HomeAnswersPediatric Dentistryearly childhood cariesWhy are my son's upper four teeth look rough and crumbling?

My 14 months old son's top four teeth look rough and are crumbling. Why?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At July 4, 2017
Reviewed AtJuly 11, 2023

Patient's Query

Hello doctor,

I am a very concerned father of a 14 months old boy. His first six teeth came in, but the top four teeth look quite rough and are crumbling. His bottom two teeth seem fine. He is still almost exclusively breastfed, as he does not like to eat food, and seldom opens his mouth. I believe his teeth cause him a lot of pain. I have included some pictures. He has no other health issues that we know of. He has not had antibiotics and his mother is in decent health although, she eats a lot of sugar and carbohydrates. This is causing us great anxiety, as we need to get him to start eating, and I believe it is delaying his speech because he keeps his mouth closed. Please, help us.

Answered by Dr. Naveen Thomas


Welcome to icliniq.com.

I have seen the attached photos (attachment removed to protect patient identity).

  • The upper front teeth show early childhood caries lesion resulting in decay. You need start giving him other semi-solid food and reduce exclusive breastfeeding.
  • After every breastfeeding, please make sure you get his upper and lower teeth cleaned by using a wet cotton or a finger brush, which you can wear on your finger and make him brush.
  • The continuous sticking of breastmilk overnight is causing this decay, and it needs to be stopped soon. Or else, it may get painful.
  • Use a pediatric toothpaste with fluoride to prevent caries. If possible, go to a dentist and get a fluoride application over the teeth. It is very important that you start other semi-solid food and reduce overnight breastfeeding. Clean his teeth using wet cotton after feeding.

Thank you.

For more information consult a pedodontist online --> https://www.icliniq.com/ask-a-doctor-online/pedodontist

Patient's Query

Thank you doctor,

Can caries be there right at the edge of the teeth? My wife said that as soon as she saw his budding teeth, they looked jagged and malformed. They are chipping easily now.

Answered by Dr. Naveen Thomas


Welcome back to icliniq.com.

  • The problem is it started as soon as the teeth came out. The bacterial load inside the mouth and the sticky content of breastmilk contributed to the early childhood caries condition.
  • This type of caries is very fast due to the soft nature of milk tooth, so it does not take much time. Start using a feeding bottle with plain water. Just drinking some water after feeding helps in preventing such caries.
  • Usually, after 6 months of age, it is necessary to start bottle feeding of plain water to help cleanse the mouth and teeth. This reduces the acidity, which builds up inside mouth due to bacterial load.

Thank you.

For further queries consult a pedodontist online --> https://www.icliniq.com/ask-a-doctor-online/pedodontist

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Naveen Thomas
Dr. Naveen Thomas


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