What Causes Tooth Decay in Babies

What are the common causes for tooth decay in babies and toddlers?

Although cleaning the teeth of a squirming infant or toddler isn’t always an easy task, cavities don’t generally pose a concern for most young children. In fact, it is unlikely that your child will develop significant cavity issues unless certain circumstances are present. Because most infants and toddlers have a diet that is lower in sugar than older children, teens, or adults, the risks of decay due to sugar content is low. In addition, babies and toddlers produce copious amounts of acid-neutralizing saliva ( due to teething) which further lowers their risk of decay. Since teeth are just newly erupting or have only been in the mouth exposed to sugars and bacteria for a few months to a couple of years, it is unlikely that dental decay will be an issue.

However, some factors do significantly increase an infant’s risk of caries or tooth decay. The most notorious culprits are sippy cups and bottles. Bottles and sippy cups filled with milk or juice allow a small child to continuously expose their new teeth to sugars and acids. Drinks given with meals or snacks are not the concern. The problem occurs when children are chronically sent to bed or laid down for a nap with their sippy cup or bottle. The occasional nighttime bottle is nothing to worry about. But babies or toddlers who have become used to taking a cup or bottle to bed are at a high risk for dental cavities. This problem is so significant that it is actually referred to as “baby bottle tooth decay”. Although breast milk also has sugars necessary for brain development, nursing infants and toddlers generally don’t see this same type of tooth decay.

In cases of baby bottle tooth decay, dentists often see cavities form on and in between front teeth. Cavities that form in back teeth are often caused by food stuck in teeth. However, decay on the front surface of anterior teeth are almost always due to chronic use of milk or juice filled sippies and bottles. Parents can best avoid this by reducing or eliminating the amount of times a child goes to bed with a bottle or sippy cup. If your child is already used to this habit, breaking it can be difficult. Try diluting the juice with water and increasing the amount of water vs. juice over time. Milk can be harder to dilute, but the lactose in milk is just as likely to cause cavities as the fructose in fruit juices.

If you are weaning your child off the bottle or cup at night, try removing the item once your child is asleep. If possible, wipe their teeth clean with a gentle cloth. Encourage the use of teething brushes as well. Early childhood decay is almost always caused by the sugars found in milk and juice. Eliminating the overnight bottle or sippy cup use is your best defense against infant and toddler tooth decay. If you notice any stains or pits in your child’s teeth, see your pediatrician or pediatric dentist as soon as possible. Children should have a “well dental” check up by the eruption of their first tooth, or their first birthday, whichever comes first.


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