Baby bottle tooth decay

Alternative names
Bottle mouth (Bottle carries)


Baby bottle Tooth decay is a dental condition characterized by significant decay (dental caries or cavities) of the infants teeth, particularly the upper and lower incisors.

The decay is caused by frequent and prolonged exposure to liquids containing sugars. The worst offenders are juices, punches, soft drinks, gelatin, sugar water or other sweetened liquids. Milk and formula can also contribute to decay.

Bacteria on the teeth uses these sugars as an energy source to form acids which attack tooth enamel. An almost continuous supply of sugar (meaning an infant with a bottle of juice in his mouth most of the day) means that decay takes place on a continuous basis rather than just at the times of feeding.

Tooth decay may also occur when breast-fed infants are on the breast for prolonged periods of time; for example, if the mother falls asleep while the baby is nursing.


  • DO NOT put your child to bed with a bottle.  
  • Avoid prolonged use of pacifiers and DO NOT dip the pacifier in honey, sugar or syrup.  
  • After each feeding, gently wipe your child’s teeth and gums with a clean washcloth or gauze to remove plaque.  
  • Begin toothbrushing by the time your child is 2 years old. Brush your teeth together at least at bedtime. Have your son or daughter use a toothbrush with soft, nylon bristles. You will need to supervise and assist. Use a very small amount of toothpaste (no more than the size of a pea.)  
  • Begin flossing teeth of children when all of the primary (baby) teeth have erupted (usually around age 2 1/2).  
  • DO NOT fill your child’s bottle with fluids that are primarily sugar such as punch, gelatin, or soft drinks.  
  • If you do not have fluoridated water, then make sure your child gets fluoride in some form. Talk to your doctor about the advisability of fluoride drops or tablets.  
  • Inspect your child’s teeth regularly and begin dental visits when all of the baby teet have erupted or at age 3 - whichever comes first.

Johns Hopkins patient information

Last revised: December 4, 2012
by Janet G. Derge, M.D.

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