Baby Bottle Tooth Decay (Infant Caries)

Written by Jacquelyn Cafasso and Kristeen Cherney | Published on August 24, 2015
Medically Reviewed by The Healthline Medical Review Team on August 24, 2015


Baby bottle tooth decay is the term that describes tooth decay in infants and young children. It may also be called:

  • infant caries
  • early childhood caries (ECC)
  • bottle mouth

Baby bottle tooth decay usually occurs on the front teeth, or ‘incisors’. Cavities, or “caries,” are caused by too much sugar on the teeth. The sugar is found in milk or formula, as well as other artificially sweetened juice and snacks.

As a parent, you hold the keys needed to help prevent infant caries. Proper dental hygiene and cleanings are essential. Learn how to keep your baby’s teeth clean and free of cavities in their early years, as well as how to teach self-care techniques as your child grows older.

What Causes Baby Bottle Tooth Decay?

Bottle tooth decay develops when baby teeth come into frequent contact with too much sugar. Bacteria in the mouth feed on the sugar, multiply, and produce acid as a waste product. The acid attacks the teeth and tooth enamel, resulting in tooth decay.

Sugar is found in:

  • milk
  • infant formula
  • juice
  • snacks

When an infant falls asleep with a bottle, or uses a bottle or sippy cup for extended periods of time, the sugar can coat the teeth. This causes the teeth to decay more quickly in such children.

What Are the Signs of Baby Bottle Tooth Decay?

The caries caused by decay can occur in any of the teeth. However, they most often occur on the upper front teeth (called ‘upper incisors’). Caries can appear as dark or brown spots on the teeth. As the decay worsens, children might experience pain and swelling around the teeth.

Potential Complications of Baby Bottle Tooth Decay

Infant caries can be a serious problem. A child needs their teeth to chew, speak, and smile. Baby teeth also hold the space for adult teeth. Pain and infection will likely result if a tooth is lost too early or if tooth decay is left untreated.

In addition, if the baby teeth don’t develop properly, your baby may develop poor eating habits or have speech problems. Adult teeth may grow in crookedly or cause crowding.

Widespread or severe tooth decay can cause further complications, including:

  • chronic pain
  • crooked adult teeth
  • pain or difficulty chewing
  • serious infections

How Can Baby Bottle Tooth Decay Be Prevented?

It’s possible to prevent infant caries by being conscious of your child’s bottle-feeding habits and properly cleaning your child’s teeth.

Bottle Feeding Tips

  • Don’t put your child to sleep with a bottle of juice or milk. The sugar in the liquid will remain on your infant’s teeth for hours.
  • If you must give your child a bottle, fill it with water. Some pediatricians recommend against giving a bottle in the crib at all, while others say that children must first be able to sit up on their own.
  • Don’t let your child walk around with a bottle of juice or milk dangling from the mouth.
  • Avoid filling bottles with sugar water, soft drinks, or juices.
  • Teach your child how to drink from a cup around 6 months of age. The American Dental Association (ADA) recommends switching to a cup by your child’s first birthday.
  • Avoid prolonged pacifier use. Never dip a pacifier in honey or syrup. Never give honey to a baby under 12 months of age for any reason.
  • Limit the amount of juice you give your child. The American Academy of Pediatrics recommends no more than 6 ounces per day for young children. Babies under 6 months should not drink juice at all.
  • Encourage healthy eating habits, and limit sweets in general.
  • Wipe your infant’s gums after a feeding. Use a cloth to remove food bits or plaque.
  • Begin brushing your child’s teeth as soon as they grow in.
  • Have the whole family brush teeth together at bedtime.
  • When your child is old enough not to swallow it, use fluoridated toothpaste. Fluoride helps the teeth resist acid. Note: Fluoride can be dangerous if swallowed, so monitor your child until they get the hang of it.
  • Floss your child’s teeth after all of them have grown in.
  • Have a dentist inspect your child’s teeth regularly.

Cleaning Tips

Refrain from sharing utensils and other items that come in contact with your child’s teeth to avoid passing your saliva to your baby’s mouth. Such habits can promote bacterial transmission.

Outlook: How a Pediatric Dentist Can Help

Oral health habits are first started at home. As your infant grows, it’s time to consider other preventive measures with the help of a pediatric dentist. Your child’s first dentist’s visit should occur within six months after the first tooth appears. In fact, the ADA recommends that children should see a dentist before their first birthday.

A pediatric dentist can detect potential problems with your child’s teeth, including caries. This is why regular appointments are a must. Always call your child’s dentist if you have any specific concerns.

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