Baby teeth are temporary, but they can still get cavities. Tooth decay in infants and toddlers is often called baby bottle tooth decay or early childhood caries. The American Dental Association (ADA) notes baby teeth help children chew, speak and smile, and help make sure adult teeth come in correctly. The good news, the ADA says, is that this decay is preventable.
What causes it
- Frequent, prolonged exposure to sugary drinks. The ADA says this is a common cause, for example when a baby is put to bed with a bottle or a bottle is used as a pacifier.
- Bacteria passed through saliva. Decay can begin with cavity-causing bacteria passed from a parent or caregiver, such as by putting the baby’s spoon in your mouth or cleaning a pacifier in your mouth.
- Not enough fluoride, which the ADA says can raise the risk.
The ADA says it most often affects the upper front teeth, though others can be affected. The National Institute of Dental and Craniofacial Research (NIDCR) describes it as severe decay that starts in the front teeth and spreads to the back teeth.
How decay develops
The NIDCR explains that bacteria in the mouth turn sugars and starches from food and drink into acid. That acid pulls minerals out of tooth enamel. With repeated exposure, such as frequent sips of a sugary drink, the enamel keeps losing minerals.
- White spots. A white spot where minerals were lost is a sign of early decay. The NIDCR says decay can be stopped or reversed at this stage. Saliva and fluoride from toothpaste or a dental treatment help enamel repair itself.
- Cavity. If more minerals are lost than restored, the enamel breaks down and forms a hole.
- Pain or infection. Advanced decay can cause toothache or sensitivity. An infected tooth can form an abscess, with pain, facial swelling and fever.
Signs to look for
The NIDCR says early decay usually has no symptoms. It lists white, brown or black staining on teeth as signs of decay. Ask a dentist about any spots you see.
How to prevent it
Bottles, cups and pacifiers
- Put only formula, milk or breast milk in bottles. Avoid sugar water, juice and soft drinks.
- Have your baby finish bedtime and nap-time bottles before going to bed.
- Offer a clean pacifier. Don’t dip it in sugar or honey, and don’t clean it in your mouth.
- Encourage drinking from a cup by the first birthday.
Cleaning
- After each feeding, wipe your baby’s gums with a clean, damp gauze pad or washcloth.
- When teeth come in, brush gently with a child-size toothbrush and a smear (rice-grain amount) of fluoride toothpaste until age 3. Use a pea-sized amount from ages 3 to 6.
- Supervise brushing until your child reliably spits rather than swallows. The ADA says that is usually not before age 6 or 7. Using the right amount also helps prevent dental fluorosis.
What a dentist can do
The NIDCR says a dentist can apply fluoride to reverse early decay before a hole forms. Cavities are usually treated by removing the decay and filling the tooth.
Dental visits
The ADA advises talking to your dentist about the first visit when your child’s first tooth appears. See your child’s first dental visit and pediatric vs general dentists.
Frequently asked questions
Is milk in a bedtime bottle a problem?
The ADA advises letting infants finish bedtime and nap-time bottles before going to bed rather than falling asleep with one.
Do cavities in baby teeth matter if they fall out?
Yes. The ADA says baby teeth are needed for chewing and speaking and help adult teeth come in correctly.
When should my baby first see a dentist?
The ADA suggests talking to your dentist about scheduling a visit when the first tooth appears.
Can early decay be reversed?
The NIDCR says it can, at the white-spot stage before a cavity forms, with fluoride.
Sources
By the Dentist Review Editorial Team.
This article is for general information only and is not medical advice. Talk to a licensed dentist about your own situation. See our disclaimer.
Featured image: “Silicone Baby Bottles” by TheUnaverageJoe, via Wikimedia Commons, licensed CC BY-SA 4.0. Resized and compressed for the web.
Our guides are written and reviewed by the Dentist Review editorial team. We research each topic using public, authoritative sources such as the CDC, the National Institutes of Health (NIH/NIDCR), the American Dental Association (ADA) and CMS, and we update guides when guidance changes. Guides are for general information only and are not dental or medical advice; please read our disclaimer and learn more about us.