Baby Bottle Tooth Decay

Babies are at risk for tooth decay as soon as the first 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” no later than age 1. 

What is baby bottle tooth decay?

Baby Bottle Tooth Decay most frequently occurs on the upper front teeth but can occur on other teeth in infants and toddlers.  The upper teeth are primarily effected due to frequent exposure of the top front teeth to liquids with sugar from a bottle or from nursing.

If baby bottle tooth decay becomes severe, the pediatric dentist may be unable to save the affected teeth.  In such cases, the damaged teeth may need to be removed to prevent infection, which causes pain and damage to the developing permanent teeth.  Note: the top front teeth are not replaced by permanent teeth until the child is 7 or 8 years old. 

How does baby bottle tooth decay start?

Tooth decay is caused by bacteria.  Initially, these bacteria may be transmitted from mother or father to the 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 drinks with carbohydrates (sugar).  These liquids include breast milk, baby formula, milk, juice, and sweetened water. Note: frequent breastfeeding especially through the night can lead to extensive tooth decay.

When these liquids are used as a nap time or bedtime drink, the risk of decay is increased 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 decay.

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

Baby bottle tooth decay is preventable!  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.
  • Do not allow the child to take a bottle to bed or nurse through the night.  If the child insists, fill the bottle with water as opposed to a sugary alternative. 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.  Fluoride-free toothpaste is recommended for children under the age of two.
  • Children don't need juice.  Do not place sugary drinks in baby bottles or sippy cups.  Only fill these containers with water, breast milk, or formula.  Encourage the child to use a regular cup (rather than a sippy cup) when the child reaches 1 year of age.
  • Do not dip pacifiers in sweet liquids (honey, etc.).
  • Have your child see a dentist by age 1 and at least every 6 months for regular checkups.

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


Our Irvine, CA Pediatric Dentists and Orthodontists at Irvine Children's Dentistry are dental professionals dedicated to excellence in pediatric dentistry and orthodontics (braces) for children and teens. Available treatments include dental cleanings, comprehensive exams, digital x-rays, sealants, fluoride treatments, white fillings, crowns, root canal treatments, extractions, emergency care, laser dentistry, gum surgery, cosmetic dentistry, orthodontics, Invisalign, braces and more.

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Irvine, CA, 92612
(949) 786-0800
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