Early Childhood Caries

Early childhood caries is tooth decay in baby teeth of young children. It is also known as baby bottle tooth decay. Tooth decay can begin as soon as teeth appear in a child's mouth. Teeth usually appear by 6 months of age. Decay often occurs in the upper front teeth first. If it is not treated, the decay can spread quickly to other teeth. It is caused by germs (bacteria) in your child's mouth exposed to sugary liquids such as milk, breast milk, formula, fruit juices, and soda for long periods of time. These bacteria produce acids which attack the child's teeth to form decay. However, this type of tooth decay can be prevented.


Signs and symptoms include:

  • The appearance of white spots or lines near the gums.

  • Dark colored areas on the teeth.

These signs and symptoms may occur with or without pain.


A dentist will examine your child's teeth to evaluate the amount of decay.


  • Inspect your child's mouth on a regular basis.

  • Avoid sharing saliva with your child through common use of feeding spoons or licking pacifiers and giving them to your child. Children are not born with bacteria. It is passed on through their mother or primary caregiver's saliva, which contains the cavity causing bacteria.

  • Place only milk, formula, or breast milk in your child's bottles.

  • Infants should finish bedtime and naptime bottles before going to bed. Never put a child to bed with a bottle.

  • Wipe off your child's teeth and gums with a damp wash cloth two times daily and when your child has finished feeding or nursing.

  • Never dip your child's pacifier in honey, syrup, or sugar.

  • Begin brushing with a soft toothbrush when your child's first tooth appears. Do not use toothpaste until your child is able to spit.

  • Schedule your child's first dentist visit when his or her first tooth appears or at least by age 1 year.


Any signs or symptoms listed previously are present.


  • Any of the signs and symptoms above are present along with:

  • A fever over 102° F (38.9° C).

  • Swelling of your child's face, neck, or jaw.

  • Swelling around any tooth.

  • Severe pain not controlled by pain medicine.