I have always had mums talk about baby bottle tooth decay or caries and wondering if they are revisable and what really causes them and treatment options.
It’s often a cause for concern even though it’s a well-known issue. With this article, I’m trying to answer all the questions you probably have and reassure you!
Being a mum myself, I have had to teach myself the benefit of keeping baby teeth clean free from any kind of tooth decay.
I rely on my knowledge as a radiographer, and I also consulted a dentist specialist and research on the subject matter.
Happy reading!😀 and feel free to ask questions in the comments or share your own experience.🙏
Last updated: October, 2025. Written by Juliet S, a diagnostic radiographer.
▶️Baby tooth:
Baby teeth start to develop in utero and the primary dentition initiates formation at approximately 6 weeks to 8 weeks of gestation and dentition begins to calcify by the end of the first trimester.
Most of the permanent dentition begins to form at approximately 5 months of gestation, calcifying after birth.
Even though the primary teeth begin to form in utero, most infants do not have erupted teeth present at birth.
Brecher,2018
Even though baby teeth are temporary, they are important for chewing, speaking and act as placeholders for the permanent teeth.
▶️What are baby bottle caries?
Baby bottle caries, also known as early childhood caries, are cavities that develop when a baby’s teeth are frequently exposed to sugary liquids for a long period of time.
Early childhood caries is defined as the presence of one or more decayed, missing or filled tooth surface in any primary tooth of children aged under 71 months (Avila,2015)
Image of a baby tooth decay.
▶️What causes baby bottle caries?
Analysing one of the first research published on dental caries in babies which was first perfumed in 1927.
When doctors noticed that many babies had extensive caries in tooth surfaces although there was no research into the role of breastfeeding and bottle feeding being the cause.
Over the years more studies since then have revealed ambiguous results with respect to feeding habits and dental caries in babies.
The number of studies published each year on this baby tooth decay or caries is referenced in these medical studies search engine.
And here are some of the causes of baby bottle tooth decay.
🟠Sugars and Bacteria:
When you feed your baby with liquids such as milk, normally the sugars in the liquid left in the mouth make it easy for bacteria in the mouth to feed on these sugars causing tooth decay.
🟠Acid production:
As these bacteria break down the sugar, they normally produce acid that attacks and weakens the tooth enamel.
🟠Reduced saliva flow especially at night when sleeping
When your baby is sleeping the flow of saliva which helps neutralize acids and wash away food particles slows down which leaves your baby’s teeth exposed to sugar and acid for a prolonged period leading to decay.
🟠Developmental Enamel Defects such as enamel hypoplasia, have been recognized as a significant risk factor for developing early childhood caries.
🟠Systemic diseases and certain medications:
Children with juvenile diabetes mellitus due to high blood sugars or children with special needs who may have to cope with reduced oral hygiene are more susceptible to caries.
Tungare,2023
▶️I do hear mothers wonder about the factors that increase the risk of baby caries or decay.
Baby-bottle tooth decay risk factors have been critically assessed in research studies.
According to (smith et al 1998) here are some of the factors that were identified:
Inappropriate feeding practices such as:
➡️Non-nutritive sucking.
➡️ Prolonged bottle and breast feeding
➡️Nap time feeding.
A retrospective cohort study on early childhood caries and associated risk factors was performed among mothers with 25- to 30-month-old infants from a community where prolonged breastfeeding was common practice (Tungare,2023)
➡️This was the conclusion:
Children that consumed sugary food or rice that was pre-chewed by the mother and fell asleep with the breast nipple in the mouth were found to have early childhood caries.
➡️However, children who were breastfed beyond the age of twelve months without those habits did not have early childhood caries.
The issue of whether bottle feeding is more cariogenic than breastfeeding remains unresolved even today.
Some authors have not found an association between breastfeeding and dental caries (Roberts ,1994) while other study have reported the existence of such an association (Corrêa-Faria,2023)
However, the association of baby bottle tooth decay may be a consequence of the poor socio-economic status conditions is stronger and more consistent (Smith,1998)
This could lead to prenatal deficiencies of calcium and vitamin D when feeding babies. In turn it affects the enamel defects leading predisposed teeth to caries.
▶️What are the early signs of baby bottle tooth decay?
Here are some of the signs you will be looking for in your baby’s tooth.
🔴Dull, white spots on the surface of the teeth especially the upper front teeth can be a sign of demineralisation.
🔴As decay worsens, the spots can turn yellow, brown or black
🔴Visible cavities or holes in the teeth.
🔴In severe cases, a child may experience pain, swelling around the gum.
🔴Un pleasant taste or bad breath sometimes.
🔴Sometimes fever if an infection develops.
▶️How can you prevent or treat baby bottle caries or decay?
It may be easy to disregard oral health in infancy because most infants are not born with teeth and only a few teeth erupt during the first year of life.
However, at this stage of Infancy, it is a critical time for formation of positive habits that will prevent baby tooth decay.
| To close this gap and prevent baby tooth decay, it is important to provide education directed at changing the postnatal feeding practices even though teeth begin formation in utero |
Here are some habits that can help prevent baby tooth decay
⚫Clean after feeding: Wipe your baby’s gums with a clean, damp cloth or gauze after each feeding, starting at birth.
⚫Avoid bedtime bottles: Do not put your child to bed with a bottle containing anything but water. If a bottle is needed for comfort, use water.
⚫Avoid negative habits such as bottle propping and frequent juice consumption, use a cup from their first birthday.
According to the (Policy on Dietary Recommendations for Infants2017)
Fruit juice should be avoided in children younger than 12 months of age, limiting it to 120 ml up to 3 years of age and 120 to 180 ml in 4- to 6-year-olds.
⚫Emphasize behaviours that affect oral health such as promoting caries.
⚫Brush regularly: Begin brushing as soon as the first tooth appears
⚫Limit sugar: Restrict the frequency of sugary snacks and drinks. Offer water between meals.
⚫Always see your dentist when your baby’s first tooth appears.
Brecher,2018
▶️Is baby bottle tooth syndrome or caries reversible?
Yes, early-stage baby bottle tooth decay or caries can be reversible, but later stages are not and require professional dental treatment.
When you notice early decay in your child’ s tooth, always seek dental advice to help you stop decay and manage enamel repair.
However, when a cavity (hole) forms in the decay, it can be irreversible and must be treated by a dentist.
Here are some reversible early stages
1️⃣Demineralization: When decay begins, it can manifest as white or brown spots on the teeth.
2️⃣Remineralization: At this point, the enamel can repair itself using minerals from saliva and fluoride from toothpaste or other sources.
3️⃣Dental professional treatment: A dentist can help reverse early decay with treatments
Ten Cate,1991
▶️How to treat baby bottle caries?
Treatment for your baby bottle tooth decay will depend on the severity of the decay, the age and related complications.
Here are some of the early-stage treatments your dentist may recommend:
⚫Fluoride treatment: for very early decay, a dentist can apply a fluoride gel, varnish, or paste to strengthen enamel and help reverse the decay.
⚫Dietary and hygiene changes
⚫Fillings if cavities have progressed beyond the initial white spot stage.
⚫Stainless steel crowns may be used for larger cavities to protect the tooth.
⚫Pulp therapy if the decay is deep and has reached the tooth. Nerve.
⚫Extraction in severe cases where the tooth is too decayed to restore.
| Summary:Appropriate breast- and bottle-feeding practices must be emphasized:Avoiding regular sipping of sweet drinks, putting the child to sleep with a bottle of formula, or falling asleep with the breast nipple in their mouth at night.As a parent, you should be able to brush your child’s teeth immediately after taking any sugar containing oral medication medications or any sweet fluids. |
This will help you prevent baby tooth decay.
We have come to the end of this article; any questions let’s meet in the comments section below. Wishing your baby a quick recovery!🙋
Here are other articles you may be interested in
⚫Can a tooth abscess go away on its own?
⚫How long will the pain last after a root canal?
📚Sources:
Avila WM, Pordeus IA, Paiva SM, Martins CC. Breast and Bottle Feeding as Risk Factors for Dental Caries: A Systematic Review and Meta-Analysis. PLoS One. 2015 Nov 18;10(11):e0142922. doi: 10.1371/journal.pone.0142922. PMID: 26579710; PMCID: PMC4651315.
Dental caries in babies.Lancet. 1927;209(5401):502–503. Available at:https://www.sciencedirect.com/science/article/abs/pii/S0140673600733307
Corrêa-Faria P, Martins-Júnior PA, Vieira-Andrade RG, Marques LS, Ramos-Jorge ML. Factors associated with the development of early childhood caries among Brazilian preschoolers. Braz Oral Res. 2013 Jul-Aug;27(4):356-62. doi: 10.1590/S1806-83242013005000021. PMID: 23780495.
Roberts GJ, Cleaton-Jones PE, Fatti LP, Richardson BD, Sinwel RE, Hargreaves JA, Williams S, Lucas VS. Patterns of breast and bottle feeding and their association with dental caries in 1- to 4-year-old South African children. 2. A case control study of children with nursing caries. Community Dent Health. 1994 Mar;11(1):38-41. PMID: 8193983.
Smith PJ, Moffatt ME. Baby-bottle tooth decay: are we on the right track? Int J Circumpolar Health. 1998;57 Suppl 1:155-62. PMID: 10093266.
Brecher EA, Lewis CW. Infant Oral Health. Pediatr Clin North Am. 2018 Oct;65(5):909-921. doi: 10.1016/j.pcl.2018.05.016. PMID: 30213353.
Dayo AF, Wolff MS, Syed AZ, Mupparapu M. Radiology of Dental Caries. Dent Clin North Am. 2021 Jul;65(3):427-445. doi: 10.1016/j.cden.2021.02.002. Epub 2021 May 3. PMID: 34051924.
Tungare S, Paranjpe AG. Early Childhood Caries. 2023 Aug 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 30570970.
ten Cate JM, Featherstone JD. Mechanistic aspects of the interactions between fluoride and dental enamel. Crit Rev Oral Biol Med. 1991;2(3):283-96. doi: 10.1177/10454411910020030101. PMID: 1892991.
Policy on Dietary Recommendations for Infants, Children, and Adolescents. Pediatr Dent. 2017 Sep 15;39(6):64-66. PMID: 29179323.