Baby Bottle Tooth Decay (Early Childhood Caries) Fact Sheet

What is baby bottle tooth decay?

  • This is tooth decay that occurs in little children (infants and toddlers).
  • It is a preventable dental condition that causes rapid decay of many or all of the baby's teeth.

How does it happen?

  • Baby bottle tooth decay can happen when a child's bottled food containing sweetened liquids like formula, milk or fruit juice is left in the child's mouth for a long time.
  • It is also associated with infants and children who are breast-fed or given pacifiers dipped in honey, sugar or syrup for prolonged periods of time.
  • These sweetened foods cling to the infant's teeth, giving bacteria a chance to thrive in the mouth and produce acids that attack the teeth. 
when should a baby first visit the dentist

What are the signs of baby bottle tooth decay?

  • At first, white spots appear on the surface of the front teeth. If nothing is done to treat this, the white spots will rapidly develop into decay.
  • The affected teeth that have decay become darkened (black or brown).
  • There may be toothache and infection could follow.
  • As it progresses, the child could be irritable, come down with a fever, have gum swelling and a swollen face.

How is it treated?

  • The treatment depends on the severity of the decay.
  • It could involve basic steps such as the use of topical fluorides and fluoride supplements (effective when white spots are initially notices at the early stages), diet changes, use of tooth filling materials or crowns to restore teeth, or removal of affected teeth.
tooth decay: babies should not sleep with a sippy cup of milk or juice

How to prevent it?

  • A child’s first dental visit should be on or before the child's first birthday or within six months after the first tooth emerges).
  • Babies' teeth should be protected with fluoride. It can come in water, toothpaste and supplements. A dentist should be contacted to know the appropriate levels of fluoride needed.
  • Modifying baby’s diet by reducing the frequency of feeding with acidic foods like fruit juice. This should be done with advice from the paediatrician.
  • The gums should be cleaned with water and a clean soft cloth until teeth emerge in the mouth. Teeth should then be cleaned with a soft bristled brush.
  • Babies should not be given a bottle or sippy cup when about to sleep, or to fall asleep with. If this is the case already, they can be weaned from this habit by diluting the contents of the bottle with water. 
  • Sweeteners should not be used on pacifiers.


  • Premature or early loss of baby teeth can make a child have speech problems, disarranged teeth, have poor eating habits and can damaged adult teeth.
  • Having healthy baby teeth will bring about healthy permanent teeth.

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