Dental Health Tips

Dental Health Tips

Baby-Bottle Caries

How early can a person have tooth decay? The answer is, as soon as a person has teeth erupted.


This means an infant under the age of 1 can start having tooth decay. Tooth decay that happens in infants is called Early Childhood Caries. ECC is a severe problem that causes debilitating tooth destruction in infants and young children.

The prevalence of ECC is estimated to be as high as 90 percent in some Head Start populations. However, by following the guidelines developed by the American Academy of Pediatric Dentistry and by visiting a dentist for the first check-up by the child's first birthday, ECC can easily be prevented.

ECC is a specific form of severe decay found in the teeth of infants and toddlers who fall asleep with bottles of milk, juice or any sweetened liquid in their mouths. ECC is also known as baby-bottle tooth decay, nursing-bottle caries and milk-bottle syndrome. It is the only severe dental disease common in children under 3 years of age.

Bacteria, which are found in the mouth, convert sugar into acids. These acids destroy the enamel and dentin of the tooth. The flow of saliva in the mouth helps to wash acids from the tooth surface during the daytime. However, when an infant is asleep, the flow of saliva is significantly reduced, and this allows acids to pool on the tooth. This, coupled with the sugars found in juices, milk or other soft drinks, will lead to early cavities.

The top four front teeth are most affected by ECC, which appears as white chalky marks on the teeth due to decalcification by the acids. If these teeth are left untreated, unsightly and often painful cavities will develop.

Baby teeth are important to a child for chewing and biting food, making a good smile, and speaking. However, the most important function of baby teeth is that they are holding space in the mouth for upcoming permanent teeth.

The first baby tooth erupts around 6 to 8 months of age, and usually all 20 baby teeth are erupted by the age of 2 or 2-and-a-half. Early loss of baby teeth can cause blocked eruption, drifting, crooking and crowding of the permanent teeth.

A child who prematurely loses baby teeth will have a very high chance of needing braces in the future. If an abscess or infection occurs around baby teeth with ECC, it may affect the development of the underlying permanent teeth.

The best treatment for ECC is prevention. But teeth affected by ECC can still be treated if intervention is early and the underlying causes are stopped.

The following are guidelines, developed by the American Academy of Pediatric Dentistry, for preventing baby-bottle tooth decay:

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Don't allow a child to fall asleep with a bottle containing milk, formula, fruit juices or other sweet liquids.
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Comfort a child who wants a bottle between regular feedings or during naps with a bottle filled with cool water.
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Always make sure a child's pacifier is clean, and never dip a pacifier in a sweet liquid.
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Introduce children to a cup as they approach 1 year of age. Children should stop drinking from bottles soon after their first birthdays.
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See the dentist if any unusual red or swollen areas appear in a child's mouth, or any dark spot on a child's tooth.

Healthy adult teeth begin with healthy baby teeth. Knowing and following the AAPD guidelines, and visiting a dentist for the first check-up around the age of 1, are very important for preventing young children from getting ECC.