Baby bottle tooth decay is decay caused by milk, formula or sugary drinks left on a baby’s teeth. Prevent it by keeping bottles out of bed, brushing from the first tooth and seeing a dentist by age one. Redondo Beach Dental Group is a short drive from Torrance.
Dentists also call it early childhood caries. Baby teeth matter even though they fall out: they help your child eat and speak and hold space for the adult teeth. The CDC reports that more than half of children aged 6 to 8 have had a cavity in at least one baby tooth, and the habits that lower that risk start in infancy.
What Causes Baby Bottle Tooth Decay
Decay starts when bacteria in plaque feed on sugar and make acid that wears away enamel. In babies, the sugar usually comes from drinks. Juice and sweetened drinks are the obvious ones, but milk, formula and breast milk contain natural sugars too. They are normal feeds; the problem is how long they sit on the teeth. The American Dental Association (ADA) points to frequent, prolonged contact with sugary drinks, especially when a baby is put to bed with a bottle or given one to settle. A bottle or sippy cup carried around and sipped all day does the same. Saliva flow slows during sleep, so the teeth have less natural protection at night.
Three other things add to the risk:
- Shared saliva. The ADA explains that cavity-causing bacteria can pass from a parent or caregiver to a baby through saliva, for example when a spoon or pacifier is cleaned in the adult’s mouth.
- Too little fluoride. The ADA notes that infants and toddlers who do not get an adequate amount of fluoride have a higher risk of decay.
- Frequent sugar in any form. The American Academy of Pediatric Dentistry (AAPD) advises against frequent sugary drinks and snacks, and against added sugars for children under 2.
Early Signs of Bottle Rot
Baby bottle tooth decay most often shows up on the upper front teeth, though other teeth can be affected. The first sign can be a white or chalky band along the gumline, which may later turn brown. Pain and swelling usually come later, once decay has spread, so a tooth can have a problem before your child complains. A spot that looks different from the rest of the tooth is worth a call, and a swollen face or gum needs a call the same day.
How to Prevent It, Step by Step
Before the first tooth
Wipe your baby’s gums with a clean, damp washcloth or gauze pad after feedings. The full routine, including teething, is laid out in the guide to infant oral care.
When the first tooth comes in
Brush twice a day with a soft, child-size toothbrush. The ADA and the AAPD advise a smear of fluoride toothpaste, about the size of a grain of rice, from the first tooth until age 3, then a pea-sized amount from 3 to 6. An adult should do or supervise the brushing.
Bottles, cups and drinks
- Let your baby finish the bottle before bed rather than fall asleep with it. If your child needs a bottle to settle, fill it with plain water.
- Fill bottles with formula, milk or breast milk, not juice, sugar water or soft drinks, as the ADA advises.
- Offer a bottle or sippy cup at feeds, then put it away instead of letting your child sip all day.
- Offer a regular cup by the first birthday.
- Skip juice in the first year, as the AAPD advises, and keep 100% juice to no more than 4 ounces a day for ages 1 to 3. Water is the best drink between meals.
- Never dip a pacifier in honey, sugar or any sweet liquid, and rinse a dropped pacifier with water instead of your mouth.
The AAPD also advises avoiding on-demand or nighttime bottle-feeding, and notes that frequent or nighttime breastfeeding beyond the first year is linked to early childhood caries. Every family’s situation is different, so talk with your pediatrician and dentist about a plan that fits your child.
Professional care
The AAPD recommends a dental home, with a cavity-risk check and advice for parents, when the first tooth comes in and no later than the first birthday, and the CDC advises a visit by the first birthday. You can read what to expect at your child’s first dental visit. The AAPD also recommends professional fluoride varnish for young children at risk of decay, the usual form of fluoride treatment for kids.
If Decay Has Already Started
Decay in a baby tooth is worth treating because it can spread and cause pain and infection. What your dentist recommends depends on your child’s age and how far the decay has gone, and it may be dental fillings for children or, for a badly damaged tooth, pediatric dental crowns. Changing the feeding habit matters as much as the repair, because whatever caused the first cavity can cause the next one.
Cost and Insurance
The cost of a visit for a young child depends on what is done and on your plan, so ask us for an estimate when you call. We accept PPO plans, and you can ask us how your plan applies to your child’s care. For anything your plan does not cover, we offer payment plans through Cherry, CareCredit and LendingClub, and an in-office plan for patients without insurance.
About the Practice
Redondo Beach Dental Group is a family practice that provides dental care for children alongside adult care, so parents and children can be patients at the same office. Dr. Moshe Eizdi leads the practice. He earned his Doctor of Dental Surgery degree at the University of Southern California, where he graduated with honors.
Frequently Asked Questions
Can bottle feeding cause tooth decay?
Bottle feeding can cause tooth decay when milk, formula, juice or other sugary drinks stay on the teeth for long periods, especially when a baby falls asleep with a bottle or sips from one all day. Keeping bottles to feeding times and cleaning the teeth keeps the risk down.
What are the early signs of bottle rot on a baby’s teeth?
The early signs of bottle rot are white or chalky marks along the gumline, most often on the upper front teeth, which may turn brown as the decay grows. Early decay may not hurt and can be hard to see at home, so ask a dentist to look at any spot that seems different from the rest of the tooth.
Can you fix baby bottle tooth decay?
Baby bottle tooth decay can be treated, and the earlier it is found, the simpler the treatment tends to be. A dentist may watch a very early white spot while you change feeding habits, repair a cavity with a filling, or cover a badly damaged tooth with a crown. A repair does not remove the cause, so the bottle and drink habits still need to change.
How do you prevent baby bottle tooth decay?
Baby bottle tooth decay is prevented by limiting how long sugary liquids touch the teeth and by cleaning the teeth. Keep bottles out of bed or fill them with water only, wipe the gums after feeds, brush from the first tooth with a smear of fluoride toothpaste, move to a cup by the first birthday, and book the first dental visit when the first tooth comes in and no later than the first birthday.
Can breastfed babies get baby bottle tooth decay?
Breastfed babies can get early childhood caries, because breast milk contains natural sugar. The AAPD notes that frequent, on-demand or nighttime breastfeeding beyond the first year of life is linked to early childhood caries, so talk with your pediatrician and dentist about what works for your family.
When should a baby stop using a bottle?
A baby should be offered a regular cup by the first birthday, according to the ADA, and the AAPD advises avoiding on-demand or nighttime bottle-feeding. Move away from the bottle gradually, keep it to feeding times, and ask your dentist or pediatrician for tips if your child resists.
Is it okay to give a baby juice in a bottle?
Juice is not a good choice for a bottle, because the ADA advises filling bottles only with formula, milk or breast milk. The AAPD also advises no juice before the first birthday and no more than 4 ounces of 100% juice a day for ages 1 to 3.
Book a Visit for Your Child in Redondo Beach
Redondo Beach Dental Group is at 2511 Artesia Blvd, Redondo Beach, CA 90278. We are open Monday 7:30 a.m. to 5:30 p.m., Tuesday 8:30 a.m. to 5:30 p.m., and Wednesday through Friday 7:30 a.m. to 5:30 p.m. Call (310) 542-6988 or request an appointment online to ask about your child’s teeth or a bottle habit you are worried about.