Early Childhood Caries

ExitCare ImageEarly childhood caries is tooth decay in the baby teeth of children aged from birth to 71 months. 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.


The process of decay begins when bacteria and foods (particularly sugars and starches) combine in your child's mouth to produce plaque. Plaque is a substance that sticks to the hard, outer surface of a tooth (enamel). The bacteria in plaque produce acids that attack enamel and cause tooth decay.


Consuming sugary foods or liquids puts your child at risk for caries. Sipping on sugary liquids (such as milk, breast milk, formula, fruit juices, and soda) frequently or for long periods of time makes dental caries more likely to develop.


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

  • Dark-colored areas on the teeth.  

  • Pain.  


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


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

  • Avoid sharing saliva with your child. Do not share a feeding spoon with your child or lick your child's pacifiers before giving them to your child. The bacteria that causes dental caries is passed on through saliva.  

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

  • Do not put a child to bed with a bottle. Infants should finish bedtime and naptime bottles before going to bed.

  • Children should be weaned from the bottle between ages 12 and 18 months.  

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

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

  • Begin brushing your child's teeth with a soft toothbrush when your child's first tooth appears. Do not use toothpaste until your child is able to spit. If your child is at moderate to high risk for caries, talk to your dentist about the amount of toothpaste to use before the age of 2 years. From ages 2 to 5 years, use a pea-sized amount of toothpaste.  

  • Schedule your child's first dental visit when his or her first tooth appears or, at latest, by the age of 1 year.  

  • Give fluoride supplements as directed by your child's health care provider or dentist.  

  • Allow fluoride varnish applications to your child's teeth as directed by your child's health care provider or dentist.


  • There are white spots or lines near the gums.  

  • There are dark-colored areas on the teeth.  

  • Your child feels pain around a tooth.


  • There is swelling of your child's face, neck, or jaw.  

  • There is swelling around any tooth.  

  • Your child feels severe pain that is not controlled by pain-relieving medicine.  


  • Understand these instructions.

  • Will watch your child's condition.

  • Will get help right away if your child is not doing well or gets worse.