A: Bonnie, there is a very good chance that your grandson won’t drink fluid milk because his teeth are temperature sensitive, and milk is generally served cold. You are doing the right thing by offering him dairy alternatives, but he really needs to be seen by a pediatric dentist to assess the full extent of the tooth damage. This condition is generally know as “bottle mouth” and is caused by long-term use of bottles containing sugar-containing beverages, especially at bedtime. The sugars stay in the mouth and cause decay while the child sleeps.

Unfortunately, often the damage is worse than what you can see, extending to the permanent tooth buds developing under the gum line. All babies, including those who are breast-feeding, should have their gums wiped clean with water at least once each day, and toddlers should be shown how to brush and floss to minimize this kind of damage. Please encourage your grandson’s parents to get him to a dentist as soon as possible.