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Early Childhood Caries / Baby Bottle Tooth Decay

Early childhood caries (also called nursing/bottle decay, bottle caries, or nursing mouth) is an infectious disease. It is hard to see as it begins along the gum-line behind the upper front teeth. It then spreads to the front of the teeth.

Early childhood caries can cause painful toothaches, which can make your child sick. Decayed teeth can become infected and may need to be removed.
Early childhood caries can develop when a child’s teeth are in contact with sweet liquids like milk, formula and juice for long periods of time when nursing or using a bottle. When this happens, the bacteria that cause tooth decay (Streptococcus mutans and Lactobacilli) mix with the sugar and produce an acid which attacks the surface of the tooth.
Early treatment can prevent early childhood caries from staining or pitting permanent teeth.


Tips to prevent early childhood caries:

  • Clean your child’s mouth daily with a clean washcloth, even before teeth appear.
  • When teeth appear, brush at least twice a day using a small, soft-bristled toothbrush and water.
  • Don’t share spoons, cups, food, or toothbrushes. At any time in your saliva there may be many viruses and bacteria. Like the spreading the cold virus (for example) the bacteria that cause cavities can also be passed to baby from your mouth.
  • Break the habit of prolonged nursing at bedtime. If you nurse your baby in bed, make sure you unlatch and let him/her swallow before you both go back to sleep.
  • Do not put your baby to bed with a bottle. If your baby does go to sleep with a bottle, use only water.
  • Hold baby’s bottle for him/her while feeding.
  • Encourage drinking in a cup from around one year of age.
  • Save milk and juice for snack and meal times, and offer water in a sippy cup the rest of the time. Avoid apple juice in a bottle and pop (even diet pop) as the acid causes wear and decay.
  • Give children healthy snacks and avoid sweet and sticky foods.
  • Start flossing and do not use toothpaste with fluoride until you child is able to spit out, usually around age three.
  • When a child can spit out properly, use a pea size amount of toothpaste on the toothbrush.
Bring your child to visit a dental health professional by age one. Your doctor and dentist should examine your baby’s mouth to check for normal growth, development and provide advice. Click here for Northwestern Health Unit Dental Health programs.