Baby Bottle Tooth Decay: Causes & Prevention Guide for Parents

What is baby bottle tooth decay?

Baby bottle tooth decay, or bottle rot teeth, is a condition where your toddler teeth develop cavities or decay (caries), which can cause premature loss of baby teeth. This condition can occur in any of the teeth, but particularly in the upper and lower front teeth. These infant caries are most commonly caused by prolonged exposure to sugary liquids, such as breastmilk, formula milk, or juice. Especially if parents don't clean the infant's mouth after feeding, which can cause the remaining sugar in the mouth to promote bacterial growth.

What causes baby bottle tooth decay?

The primary cause of infant caries is the prolonged exposure of baby teeth to sugar for long periods. Several factors can contribute to this condition, including:

• Consumption of sugary liquids 

  • Giving the baby any sugary liquids other than plain water can leave residual sugar in the mouth, which causes harmful bacteria to flourish.

  • These bacteria then produce acids that erode tooth enamel, resulting in decay if proper cleaning is not performed. 

• Using baby bottle

  • When using a baby bottle, whether for feeding or as a pacifier, sometimes the baby can fall asleep. If the bottle contains sugary liquids, it can cause prolonged exposure of the baby’s teeth to sugar.

  • The risk of infant caries increases when the baby is sleeping because the production of saliva decreases, resulting in reduced natural protection for their teeth and gums.

• Lack of proper oral care

  • If infants don't get regular dental care after each feed, they have a higher risk of developing tooth decay as plaque and bacteria build up on the teeth.

  • Additionally, if the baby has already grown their baby teeth, a lack of brushing with a fluoridated toothpaste can also increase the risk for tooth decay.

• Cross-contamination

  • Tooth decay can also be caused by cavity-causing bacteria, which can be passed from the mother or primary carer to the infant.

  • Such bacteria are passed through saliva, such as when the mother tastes the baby's feeding spoon or cleans a pacifier using the mouth.

Baby bottle tooth decay symptoms

If your toddler is suffering from childhood caries, there are several symptoms that parents should watch for, including:

• Discolouration of teeth

  • When your infant has baby bottle tooth decay, the common symptom that is noticeable is the appearance of white spots or stains on the surface of the upper front teeth, which can progress to brown or black cavities. 

  • These spots indicate early enamel demineralisation and can progress to brown or black cavities if not treated.

• Visible cavities

  • As the decay worsens, there’ll be visible cavities, particularly on the upper front teeth. These cavities may appear as dark spots or holes in the enamel.

• Toothache

  • Infants may experience toothache that can cause significant discomfort, which can make sucking painful, causing them to drink less milk or refuse feedings altogether.

  • This pain can also make the baby cranky, leading to prolonged crying, difficulty soothing them, and making it harder for them to sleep through the night.

• Swelling or abscesses

  • In severe cases of tooth decay, infection can occur and lead to gum swelling or abscesses around the tooth.

• Fever 

  • A fever may develop as a result of gum or tooth infections, indicating that the body is responding to an infection.

Is your baby showing signs of bottle tooth decay? Don’t wait, early intervention is crucial to prevent further complications. Request an appointment with our paediatric dental specialists at Thomson Medical today for personalised care and guidance.

Treatment options

To treat this condition, it is advised that parents bring their child to paediatric dentists for a thorough examination of their dental health. Here are some treatments that can be done by the dentists to treat tooth decay:

• For mild conditions

  • If the condition is still mild and detected early, childhood caries can be treated with cleaning, dental fillings or fluoride treatments.

  • Additionally, the dentist may suggest changes to the baby's diet to help remineralise the teeth.

• For advanced conditions

  • In more severe cases, where cavities and decay have caused significant damage and reached the pulp chamber in the centre of the tooth, restorative treatments like crowns, root canals, or tooth extractions may be performed.

Thomson Dental Centre provides dental care services for children. Our paediatric dentists use equipment designed for children's dental needs. We aim to help children maintain good oral health.

How to prevent baby bottle tooth decay?

Your little one needs their strong and healthy baby teeth to chew their food, speak clearly, and ensure proper growth of their permanent teeth. Here are some preventive measures you can take to maintain your infant's dental health:

• Avoid bottle use at bedtime

  • Parents need to make sure that children are not falling asleep with a bottle containing milk, fruit juice, or other sweet liquids. If a bottle is necessary to soothe the child to sleep or is being used as a pacifier, fill the bottle with only plain water.

• Do routine cleaning

  • To make sure there’s no left-over food residue in their mouth, it’s recommended for you to clean your infant's teeth after each feed. You can do this by gently wiping their gums with a clean, wet soft cloth, a damp gauze, or baby toothbrush.

  • If the infant has already begun to develop their baby teeth, parents can also use a small amount of fluoride toothpaste during this cleaning routine.

• Using a cup

  • Transition your child from a bottle to a sippy cup or regular cup as soon as the child is 6 to 12 months of age to reduce dependency on baby bottles. Additionally, the baby will also have an easier time transitioning and completely weaning off the bottle. 

• Limit sugary drinks

  • To prevent tooth decay, parents should reduce the amount of sugary drinks given to the baby. This sweet drink should be in limited amounts and only given at mealtime (such as breastfeeding or formula milk), not throughout the day.

  • Parents also shouldn’t let the baby carry around a bottle of juice or milk. Because this can create a bad habit of the baby constantly sucking on the bottle and coating their teeth with sugar.

• Using fluoridated toothpaste

  • For children under 3 years old: Use a smear (grain of rice-sized amount) of fluoride toothpaste as soon as their first teeth appear.

  • For children aged 3 to 6 years old: Use a pea-sized amount of fluoride toothpaste.

• Regular dental visits

  • Within 6 months of their first tooth coming up or at their first birthday, parents should schedule a dental visit to monitor their child's oral health. This allows the dentist to create a plan for caring for the baby's new teeth and preventing early decay.

• Proper nutrition

  • A healthy diet that is low in sugar and rich in nutrients can help protect teeth from decay.

  • Parents also should never dip a pacifier in honey for babies under 1 year old. Because there could be spores of the bacterium Clostridium botulinum in the honey that could cause infant botulism in babies. 

Complications that may happen

When tooth decay occurs in infants and is left untreated, it can lead to serious complications. Here are some complications that might happen to this condition:

• A severe toothache that causes chewing difficulty.

• Their adult teeth may grow improperly, causing them to be misaligned and crowded.

• Improper permanent teeth growth could also lead to deficient eating habits or speech problems. 

• Infections on the decayed tooth and surrounding gums.

FAQ

Can you fix baby bottle tooth decay?

Yes, baby bottle tooth decay can be treated, with tailored treatment plans to suit the child's age and degree of decay. For mild cases, dentists can perform cleaning, dental fillings or fluoride treatments. In more advanced cases where decay has reached the tooth's pulp chamber, treatments may include crowns, root canals, or tooth extractions.

Can bottle feeding cause tooth decay?

Yes, bottle feeding can lead to tooth decay when babies are exposed to sugary liquids like breastmilk, formula milk, or juice. Without proper cleaning after feeding sessions, the sugar from these liquids remains on the teeth, and bacteria in the mouth can feed on these sugars.

These bacteria produce acids that can erode tooth enamel, especially when the baby is sleeping, when there's less saliva production to naturally protect the teeth.

How to prevent milk bottle caries?

To prevent early tooth decay in your little one, there are several steps you can take, including:

• Never let your baby fall asleep with a bottle containing milk or sweet drinks.

• Clean your baby's gums and teeth after each feed with a soft, damp cloth or gauze.

• Transition to a cup between 6 and 12 months of age.

• Only give sugary drinks at mealtimes, not throughout the day.

• Use fluoridated toothpaste once baby teeth have emerged.

• Schedule regular dental checkups.

• Maintain proper nutrition with a low-sugar diet.

What do bottle rot teeth look like?

Here are the signs of bottle rot teeth, such as:

• White spots or stains on the upper front teeth at the early stage.

• Dark spots on the teeth.

• Visible cavities or holes in the tooth enamel.

• Possible swelling or abscess around affected teeth in severe cases.

Will a decayed baby tooth eventually fall out?

While baby teeth naturally fall out, waiting for a decayed tooth to fall out on its own is not recommended because:

• Untreated decay can cause severe pain and infections.

• It may affect the proper growth of permanent teeth.

• It can lead to eating and speech difficulties.

• It may cause misalignment of permanent teeth in the future.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice, parents can consult a paediatric dentist at Thomson Medical.