Also known as early childhood caries occur in children under the age of five and can be avoided through awareness and prevention. The earlier the problem is addressed, the less extensive and invasive the treatment will be. 


-Early signs of baby bottle decay usually appear as white spots on a tooth’s surface. At this stage, fluoride varnish can be used to remineralize the teeth and may reverse decay in its earliest stage, by helping to rebuild the surface enamel.  At this stage, you can also make changes to your baby’s diet to keep decay from progressing. These changes could include:

-limiting acidic foods

-limiting juices, especially citrus juices

-substituting water for juice, formula or milk in your child’s bottle

-avoid giving chewy vitamin C gummies

In later stages of decay, signs and symptoms could include:

-brown or black spots on teeth

-bleeding or swollen gums

-pain on chewing

-fever, swelling or irritability

Treatment for more serious decay in baby teeth may include:


-stainless steel crowns which are more durable and require less follow-up treatments

-pulpotomy (similar to root canal in adult teeth)


Reasons to be concerned about early loss of baby teeth

-If the baby teeth are lost prematurely, the spacing for the permanent teeth can be affected. This can lead to misaligned permanent teeth and bite issues that could require extensive orthodontic treatment. 

-diet and speech may also be affected due to loss of baby teeth too early. 

The best approach to baby bottle tooth decay is prevention. 

-try not to share saliva with your baby through common use of feeding spoons or licking pacifiers. After each feeding, wipe your child’s gums with a clean, damp gauze or washcloth. 

-when your child’s teeth come in, brush them with a child size toothbrush and a smear (or grain of rice sized amount) of children’s toothpaste until the age of 3

-brush the teeth with a pea-sized amount of fluoride toothpaste from the ages of 3 to 6. 

-Supervise brushing until your child can spit and not swallow toothpaste, usually not before 6 or 7yo. 

-Avoid filling the bottle with liquids such as juice or soft drinks. 

-Babies should finish their bedtime bottle before going to bed

-encourage healthy eating habits

If your child does experience early childhood dental caries, you and your child’s dentist can work together to determine the best treatment options.