Milk teeth are very important in children. They help them to look attractive, chewing food and in talking. The baby's first teeth appear usually by the age of 6 months. That is the age which the child depend mostly on the bottle milk and/or on honey dippers, so the child is more susceptible to the tooth decay. This condition is referred to as Baby Bottle Tooth Decay or Early Childhood Caries.

It is also called as Baby bottle syndrome which is caused by bacterial infection. This syndrome is characterized by severe decay in the teeth of young children with a greater chance of subsequent caries in primary and permanent teeth.

Early childhood caries  is also known as Nursing bottle caries. In some cases, severity of the tooth decay results in dental fillings or tooth extractions.


  1. Feeding milk containing sugar for infants using bottles, overnight bottle nursing have a risk of developing caries.
  2. Frequent consumption of liquids containing fermentable carbohydrates (e.g., juice, sugary drinks, milk, formula, soda) increases the risk of dental caries due to prolonged contact between sugars in the liquid and cariogenic bacteria on the teeth.
  3. Some children use honey dippers before sleeping.

Decay of teeth occurs when sweetened liquids are given for long periods. Sugars in the food lead to accumulation of bacteria like Streptococcus mutans and Lactobacillus in the mouth which produce acids. Enamel of the tooth gets damage, when it is exposed to those acid attacks for 20 minutes or longer eventually leading to tooth decay.

How to identify baby bottle caries?

- Tooth sensitivity bothers the child when they eat sweet or cold foods and liquids. It is one of the first signs of damaged tooth enamel.

 - There may be white, decalcified spots or streaks at the edge of the gum line which is the first indication that cavities are forming, and if not corrected, they will eventually turn brown and begin to chip off.

- Front teeth are the first teeth to appear and have the longest exposure time to the damaging bacteria and are more often affected. The tongue seems to protect the lower front teeth, but eventually they will show signs of damage because of the rapid progression of baby bottle caries.

- You may notice small holes or pitting in the enamel with possible areas of discoloration on the surface of the teeth if the damage has already begun. Clean the surface of the teeth daily as soon as they erupt with a cloth. This is also a good way to visually inspect them and prevent future tooth decay.

- Visit a dentist when the baby begins to have his/her first teeth or by first birthday. Bottle mouth syndrome is often undetected until a routine dental check-up.

 Preventive measures:-

It is important to keep the baby teeth or primary teeth in place until the permanent teeth come. Primary teeth help preventing crooked and overcrowded permanent teeth. The good news is that Baby bottle syndrome is preventable. Few small preventive measures help in developing healthy permanent dentition in future.

 1. Wipe the mouth of the infant or baby with a wet cloth or wet cotton every time after they drink milk.

2. Train the babies to brush their teeth without tooth paste when their milk teeth appear.

3. After proper training and confirming that they won’t swallow tooth paste, use peanut size of tooth paste and allow them to brush.

4. Parents should brush them or help them in brushing till the age of 6-7 years.

5. Mothers should maintain healthy and good oral hygiene because in many cases they share same utensils (spoons, plate) with the children. So there is chance of bacterial transmission.

6. Feed only milk with bottles. Don’t allow to drink juices, sugary water with bottles.

7. Feed milk before sleeping. Don’t make a habit of sleep with bottle in the mouth.

8. Encourage the child to drink with cups or mugs after 1 year of age.

    9. Give them healthy food containing less sugar substitutes. Prefer fruits than fruit juices.

    10. Visit the dentist when milk teeth appear. Regular dental check-up for every 6 months is necessary.