Baby Bottle Tooth Decay: Why It Happens, Treatment, and Prevention

Clinical Content Reviewed by Dr. Jay Khorsandi, DDS
Last Modified:

Table of Contents

  1. What is Baby Bottle Tooth Decay?
  2. Causes
  3. Signs
  4. Prevention
  5. Treatment
  6. Do I need to Treat This?
  7. Frequently Asked Questions
  8. References

Dentists refer to Baby Bottle Decay as ECC — early childhood caries (cavities). Any tooth decay in a child younger than 6 years old qualifies at ECC.

ECC is the most common cause of lost teeth in children, and up to 23 percent of kids between 2 and 5 have at least one cavity in their primary teeth.

Too many bacteria and sugar are primary causes, along with poor dental care.

Symptoms include white spots or dark brown spots on teeth. Treatments include fillings and direct or indirect restorations as well as extraction in severe cases.

What Is Baby Bottle Tooth Decay

Dentists refer to Baby Bottle Tooth Decay as early childhood caries (ECC). The American Dental Association defines ECC as the evidence of decay in one or more teeth in a child below six years.

If your baby's teeth are missing because of cavities or have already been filled, it still fits the definition of Baby Bottle Tooth Decay.

Up to 23 percent of children between the ages of 2 and 5 have caries on their primary teeth, making ECC the most common cause of teeth loss in childhood.


Baby Bottle Tooth Decay stems from the interaction of bacteria and sugars on a vulnerable tooth surface. When a baby's teeth are exposed to sugar-rich foods like carbohydrates for a prolonged period, the risk of developing caries increases.

Because of this, dentists frown upon practices such as putting a baby to bed with a feeding bottle in the mouth. With no post-feeding rinse, lingering bacteria from the liquid nourishment promote the development of cavities. (Dentists instead recommend giving the child a sippy with water in it.)

Caregivers, typically mothers, can also transfer bacteria to children leading to initiation or worsening of caries. For instance, when you put the baby's feeding spoon in your mouth and back to the baby's, you pass cariogenic bacteria from your mouth to the baby. The bacteria ferment sugars in the mouth and cause demineralization loss of enamel.

Fluoride deficiency makes your child's teeth more prone to demineralization and consequent caries.

Poor oral hygiene with inappropriate brushing techniques also contributes to the development of early childhood caries.


Signs and symptoms of Baby Bottle Tooth Decay can vary from one child to another. Common features of ECC include:

  • White spots on the teeth surface that may be associated with early sensitivity

  • Brown cavities, which turn can turn dark with subsequent destruction of the tooth crown.

  • In severe cases, the child may complain of pain around the tooth and inability to eat

  • Sensitivity to particular foods like hot or cold drinks

ECC initially affects the incisors leaving kids with only root stumps on the front. The decay can spread to other teeth, including the molars.


Good oral care is the primary strategy of protecting your child against dental cavities. You can prevent Baby Bottle Tooth Decay by:

  • Visiting a dentist as soon your baby's first teeth erupt and attend other scheduled visits, which are usually after six months.

  • Brushing the child's teeth, tongue and gums with fluoride toothpaste for about two minutes twice a day.

  • Flossing twice a day, like brushing, for children older than 2

  • Monitoring your child's diet and feeding frequency. Limit snacks like candies, as they are rich in sugar

  • Not putting a baby to bed with a feeding bottle containing sugary liquids

  • Cleaning the pacifier with water and avoiding any other activity that can pass the bacteria to the baby.

  • Talking to your dentist about fluoride supplementation for your kids, especially if you live in fluoride-poor regions


Treatment options for early childhood caries vary. The right treatment depends on the child’s symptoms, age and overall health.

Treatment involves restorative dental procedures such as fillings, but extraction might be necessary in severe disease.

For mild and moderate cases, your doctor will remove the decayed part of the tooth and replace it with a synthetic material known as dental filling or restorations. Restorations are either direct or indirect:

  • Direct restorations are made of tooth-colored resin, silver, fine glass powder or acrylic acid. These direct fillings require only one visit.

  • Indirect restorations require at least two visits to fix, and they include crowns, bridges, onlays, inlays and veneers. They are usually made of ceramic, gold, composite, or base metal alloys.

Do I Need to Deal with Baby Bottle Tooth Decay?

Left untreated, Baby Bottle Tooth Decay interferes with your child's esthetics, speech and chewing, and is causes aberrant development of permanent teeth. Your baby might end up with teeth crowding during secondary dentition.

Parents and caregivers need to deal with the disorder promptly to prevent these adverse outcomes.

Frequently Asked Questions

If detected early, baby bottle tooth decay can be reversed by fluoride treatment and proper oral hygiene. However, tooth decay is irreversible in the late stages and might require tooth extraction.

Instead of filling the bottle with sugary liquids like juice or formula, fill the bottle with water especially if the child likes drinking. Also, avoid putting your baby to sleep with the bottle. Feeding should be completed before going to bed. Do not dip pacifiers in sugar or honey before giving them to the baby.

Disclaimer: This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to serve as dental or other professional health advice and is not intended to be used for diagnosis or treatment of any condition or symptom. You should consult a dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.