Description and epidemiology of nursing caries.

Nursing caries is a virulent form of tooth decay that affects the primary dentition of infants and preschool children. The purpose of this paper is to review the scientific literature to describe the clinical characteristics of this disease and to report on its prevalence in various locations and populations around the world. A Medline search was completed using the key words below. All English-language articles that reported on the prevalence of caries involving the primary maxillary incisors in preschool children in association with feeding habits were included in the review. Nursing caries is associated with ad libitum bottle feeding, particularly at naptime or nighttime, and has been reported in children who engage in demand breastfeeding. A substantial body of literature from numerous countries now exists that documents the prevalence of nursing caries. In developed countries the prevalence is reported to vary between 1 percent and 12 percent. However, in developing countries and within disadvantaged populations in developed countries, the prevalence has been reported to be as high as 70 percent in the preschool population. A universally accepted definition for nursing caries does not exist and methods used to define the condition, establish study populations, and collect prevalence data vary widely among studies. This review provides a detailed clinical description of nursing caries, reviews the characteristics of children who may be at risk for nursing caries, and reviews the prevalence data for nursing caries for countries that have reported it, and suggests directions for research into nursing caries etiology and prevalence.