Early Dental Care
Baby Bottle Tooth Decay

Maintaining the health of primary (baby) teeth is exceptionally important.  Although baby teeth will eventually be replaced, they fulfill several crucial functions in the meantime.

Baby teeth aid with speech production, help a child chew food correctly, maintain space for adult teeth, and prevent the tongue from posturing abnormally in the mouth.  When baby teeth are lost too soon, adjacent teeth may shift to fill the gap, causing impacted adult teeth and the potential need for orthodontic treatment.  This phenomenon can lead to impacted adult teeth, years of orthodontic treatment, and a poor aesthetic result.

Babies are at risk for tooth decay as soon as the first primary tooth emerges – usually around the age of six months.  For this reason, the American Academy of Pediatric Dentistry (AAPD) recommends a “well-baby check up” with a dentist around the age of twelve months.

What is baby bottle tooth decay?

The term “baby bottle tooth decay” refers to early childhood caries (cavities), which occur in infants and toddlers.  Baby bottle tooth decay may affect any or all of the teeth, but is most prevalent in the front teeth in the upper jaw.  Babies must not be allowed to sleep with a bottle of formula or breast milk.  Even nursing your baby at night and not cleaning the teeth afterward, may lead to "baby bottle tooth decay".  Milk, formula, and even breast milk is basically sugar water and care must be taken to clean the teeth after your baby "eats".  At the very least, follow a milk bottle with water bottle to dilute the milk present in their mouth.  

If baby bottle tooth decay becomes too severe, the dentist may be unable to save the affected tooth.  In such cases, the damaged tooth is removed.  Treating an infant with baby bottle tooth decay is usually not possible without using a General Anesthesia (similar to what would be used to place tubes in the ears or to perform a tonsillectomy).  Please refer our section on General Anesthesia for more information.

Scheduling regular checkups with a dentist and implementing a good homecare routine can completely prevent baby bottle tooth decay.

How does baby bottle tooth decay start?

Acid-producing bacteria in the oral cavity cause tooth decay.  Initially, these bacteria may be transmitted from mother or father to baby through saliva.  Every time parents share a spoon with the baby or attempt to clean a pacifier with their mouths, the parental bacteria invade the baby’s mouth.

The most prominent cause of baby bottle tooth decay however, is frequent exposure to sweetened liquids.  These liquids include breast milk, baby formula, juice, and sweetened water – almost any fluid a parent might fill a baby bottle with besides water.

When sweetened liquids are used as a naptime or bedtime drink, they are a heightened risk because they remain in the mouth for an extended period of time.  Oral bacteria feed on the sugar around teeth and emit harmful acids.  These acids wear away tooth enamel, resulting in painful cavities and pediatric tooth decay.

Infants who are not receiving an appropriate amount of fluoride are at increased risk for tooth decay.  Fluoride works to protect tooth enamel, simultaneously reducing mineral loss and promoting mineral reuptake.  Currently the city of Stockton does not add fluoride to the water supply so toothpastes with fluoride are recommended.  A remineralizing mouth wash like ACT can be brushed on after brushing and flossing at night.

What can I do at home to prevent baby bottle tooth decay?

Baby bottle tooth decay can be completely prevented by a committed parent.  Making regular dental appointments and following the guidelines below will keep each child’s smile bright, beautiful, and free of decay:

  • Try not to transmit bacteria to your child via saliva exchange.  Rinse pacifiers and toys in clean water, and use a clean spoon for each person eating.
  • Clean gums after every feeding with a clean washcloth.
  • Use an appropriate toothbrush along with an ADA-approved toothpaste to brush when teeth begin to emerge. 
  • Do not place sugary drinks in baby bottles or sippy cups.  Only fill these containers with water, breast milk, or formula and follow with brushing at night.  Encourage the child to use a regular cup (rather than a sippy cup) when the child reaches twelve months old.
  • Do not dip pacifiers in sweet liquids (honey, etc.).
  • Review your child’s eating habits.  Eliminate sugar-filled snacks and encourage a healthy, nutritious diet.
  • Do not allow the child to take a liquid-filled bottle to bed.  If the child insists, fill the bottle with water as opposed to a sugary alternative.
  • Clean your child’s teeth until he or she reaches the age of seven.  Before this time, children are often unable to reach certain places in the mouth.

If you have questions or concerns about baby bottle tooth decay, please contact our office.



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