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In addition to BBTD, the review yielded studies that demonstrate additional pediatric morbidities associated with prolonged bottle use.
In particular, Beaulieu and DuFour (2000) point out that evidence suggestive of BBTD is the presence of a dull, white band of demineralized enamel along the gingival margin, usually found on the central incisors.
Therefore, a breastfed baby is much less likely to get BBTD. However, a baby who nurses frequently throughout the night can have the liquid pooling effect in the mouth, which might cause the same problem.
The irony of this disease is that by the time children are routinely seen in dental offices, usually at the age of 2 years, BBTD is likely to have caused its greatest damage.
Diagnosis of the earliest stages of BBTD simply requires lifting the child's lip and examining the maxillary anterior teeth for signs of decalcification (etching of the enamel).
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