Tooth decay - early childhood


Tooth decay in early childhood occurs most often in the upper and lower front teeth (incisors) and can be a serious problem.

Alternative Names

Bottle mouth; Bottle carries; Baby bottle tooth decay; Early childhood caries (ECC)


Your child needs strong, healthy baby teeth. These teeth help your child chew food, speak, and have enough space in his or her jaw for the adult teeth to grow in straight.

Tooth decay can happen when your child's teeth come in contact with too much sugar. This sugar helps bacteria grow. Acids that the bacteria make cause the teeth to decay.

Many of the liquids that your child drinks contain sugar, including milk, formula, and fruit juices. Eating snacks with sugar also places more sugar on your child's teeth.

How often your child drinks liquids containing sugar, and how long the sugar stays in the mouth are also important. When children sleep or walk around with a bottle or sippy cup in their mouth, sugar coats their teeth for longer periods of time, causing teeth to decay more quickly.

Breast milk by itself is the healthiest food for babies’ teeth. It tends to slow bacterial growth and acid production. However, when breast milk is alternated with sugary foods or drinks, the rate of tooth decay can be faster than with sugar alone.


Feeding tips to prevent tooth decay:

Tips for caring for your child's teeth:


Douglass JM, Douglass AB, Silk HJ. A practical guide to infant oral health. Am Fam Physician. 2004;70:2113-2120.

Dental caries. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 304.

Ribeiro NM, Ribeiro MA. Breastfeeding and early childhood caries: a critical review. J Pediatr (Rio J). 2004;80:S199-S210.

Sexton S, Natale R. Risks and benefits of pacifiers. Am Fam Physician. 2009;79:681-685.

Touger-Decker RJ. Position of the American Dietetic Association: oral health and nutrition. J Am Diet Assoc. 2007;107:1418-1428.

Review Date: 8/2/2011
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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