Fact Checked

Bottle Rot: What Is It? And Can It Be Prevented?

Written by Fernanda Elizalde

December 27, 2022

Medically Reviewed

By Dr. James Younan, DDS

Having healthy baby teeth leads to having healthy permanent adult teeth. While adult teeth will ultimately replace them, baby teeth are still prone to decay and cavities, which can lead to oral health issues in the future. Baby bottle tooth decay, commonly known as early childhood caries or bottle rot, is one such issue.

This blog post will look at this problem and how to treat and prevent it so that your child can grow up having a bright, healthy smile.

baby bottle rot


Although baby teeth are not permanent, they are necessary for your child's health.

Your child's teeth are essential because they help your child:

  • Chew your food thoroughly.
  • Speak clearly and fluently.
  • Grow healthy permanent teeth.

A healthy child's mouth free of baby bottle tooth decay and good oral health also means a less stressful dental exam for you and your child.

Furthermore, a healthy child's oral health sets the tone for good oral health throughout your child's life.

Because cavities spread, decay can apply to adult teeth that have yet to erupt, leading to damaged adult teeth. As a result, 'Baby Bottle Tooth Decay' can harm your child's smile in the long run.

Do you want your child to live a life of tooth decay? And do you want to subject yourself to those costly dental visit appointments?

Now that you understand why baby teeth are important, let's look at what causes baby bottle tooth decay and how you can prevent it in your child.


Excessive time with a baby's bottle can lead to infant oral issues. Allowing a baby to go to bed with a bottle and the baby falling asleep with the bottle in their mouth may cause baby bottle tooth decay, also known as bottle rot. If the liquid in the bottle is baby formula which can be similar to sugar water or, even worse, adding soft drinks rich in sugar, the teeth will bathe in it, resulting in severe tooth decay.

The most common cause of bottle rot is drinking fruit juice, soft drinks, or even milk from a bottle for an extended time. The mouth's ecosystem changes when teeth are exposed to sugar for longer and more often. This causes dental plaque and bacteria that cause cavities to build up, leading to baby bottle tooth decay.

Frost oral care for kids


Look for signs of tooth decay on the gums of their front teeth, where you may notice white spots. However, the small size of your baby's teeth may make these signs challenging to detect without the proper equipment. That is why it is advised to take your baby to your family doctor or pediatric dentist when their teeth begin to erupt or grow in. That way, you'll have a clear plan for taking care of your baby's new teeth and preventing early baby bottle tooth decay.


Complications may arise if tooth decay affects your baby's teeth. Your baby having early tooth decay can lead to:

  • Discomfort and pain in the mouth
  • Potentially costly dental care or emergency care in the future
  • Permanent tooth damage or loss of space for them to grow in
  • Infections that may lead to other health problems

    While this may seem frightening, don't worry you can treat  Baby Bottle Tooth Decay effectively if done right.

    Let's take a closer look at some of the issues that can arise as a result of baby bottle tooth decay:

    Speech Development: Most of us have heard people speak when missing teeth, mainly front teeth. If you have, you understand how important teeth are for speaking clearly and adequately. This is because well-aligned teeth make communicating easier. This is also true for babies. Infants with healthy, strong, and mostly aligned teeth are likelier to form proper words and speak more clearly. Children who have unhealthy, poorly spaced, or misaligned teeth often have difficulty speaking properly, and the poor habits they develop at a young age can follow them throughout their lives.

    Tooth alignment and permanent tooth position: Baby teeth act as spacers and guides for adult teeth as the tooth erupts into place. If a baby's tooth falls out for any reason, nearby teeth may slide over or tilt into the space. When this occurs, a permanent tooth has less space to enter the smile and may even be prevented from an eruption.

    Baby teeth facilitate healthy chewing and eating: Chewing properly has benefits besides helping solid foods become swallowable and digestible. Tooth loss and poor alignment issues can strain the jaw and cause complications. Chewing issues can also impede the development of critical facial muscles. Chewing incorrectly might also result in inadequate nutrition!

    What Factors Influence Bottle Rot?

    Bottle rot is linked to extended exposure to sugary liquids, including milk.

    But don't let it scare you. Most babies will not acquire bottle rot from nursing or formula alone. Babies are more prone to bottle rot due to three scenarios:


    When a baby sleeps with a bottle in their mouth, the formula or other fluid is more likely to pool up in their mouths. After this happens, the milk's lactose is directly exposed to the baby's teeth for several hours at a time. This can eventually lead to more tooth decay.


    Because remaining milk becomes trapped between the upper lip and the gum, an untreated lip tie can cause substantial bottle rot, especially in a baby's upper front teeth. This can eventually lead to severe tooth decay.


    It is less likely that an untreated tongue tie can develop bottle rot, although it is conceivable. Milk can pool behind the tongue if the infant does not have adequate tongue movement to keep their mouth clean. This can eventually lead to tooth decay, especially in the molars.


    Fortunately, bottle rot is a problem that is nearly avoidable. The following are some best techniques for preventing bottle rot:

    • Wipe your child's gums with a clean, wet cloth after feedings, especially if they have a  lip tie.

    • Brush your teeth carefully with a child's toothbrush as soon as they get their first teeth. Brush every side of the teeth, front, back, and top, and massage gums softly. 

    • You should not put the baby to bed with a bottle.

    • Fill bottles only with milk and avoid filling up bottles with other drinks such as fruit juice.

    • Do not share kids feeding spoons. Not only between other children but also between you and your children as well. Sharing utensils might transfer germs that can cause tooth decay from you to your baby's mouth.

    • Wash bottles thoroughly between uses to keep germs at bay. 

    • Encourage them to drink from a cup before they turn one.

    • Limit refined sugars, juices (particularly citrus), acidic meals, and snacks to promote healthy eating habits. The fewer sugar contacts their teeth have, the less chance of cavities. (Remember that sugar may be found in meals other than sweets, such as crackers!)

    • Consider taking an oral probiotic.

    • Increase fat-soluble vitamin intake, including A, K, and D, which help to strengthen your teeth and prevent decay. Cod liver oil is an excellent source of all three vitamins.

    • Add calcium-rich foods to the baby's diet (if they're eating solids), such as salmon, yogurt, leafy greens, kefir, and lentils. Get enough vitamin D through sunlight, vitamin D pills, or vitamin D-rich foods such as fatty fish like salmon and mackerel,  free range eggs, grass-fed meats, and egg yolks.

    • Give your child a daily dosage of citrus or other foods containing vitamin C, as vitamin C promotes healthy gums.

    • Consult your dentist about xylitol treats. Xylitol creates an alkaline environment in the mouth, which aids in the prevention of tooth decay.

    • Consult with a holistic dentist. The American Academy of Pediatric Dentistry and American Dental Association recommends that your kid see a dentist as soon as their first tooth shows and before their first birthday.


    Healthy infant teeth lead to healthy adult teeth. Baby bottle tooth rot can harm adult teeth in two ways:


    When a primary tooth is under the gums, it cannot infect a permanent (adult) tooth.

    The teeth are in a sterile environment when they are hidden behind the gums. On the other hand, adult teeth might develop cavities if partially erupted through the gums.


    When a primary tooth is removed owing to severe decay, permanent teeth grow into the open area, resulting in an improper bite and crowded teeth.

    Once all permanent teeth have grown in, children will likely require orthodontic treatment, such as braces or clear aligners. If primary teeth are lost too soon, space maintainers can be used to keep permanent teeth in place as they grow.


    If your kid has Baby Bottle Tooth Decay, excellent therapy is available. According to the Institute of Dental and Craniofacial Research, baby bottle tooth decay can be reversed and enamel repaired, most notably with fluoride. The first step, however, is to consult with your doctor or pediatric dentist. They will assist you in developing a treatment plan based on your child's age and the severity of the ailment.

    Specific therapies will be determined by the severity of your child's situation. Fluoride treatments such as fluoride toothpaste for children, in-office treatments that may include SDF, or silver diamine fluoride, which remineralizes the enamel and dentin, or even mouth rinses may be recommended by your dentist.

    In more challenging situations, pit-and-fissure sealants are often required to help prevent and manage cavities. Finally, your dentist may advise you to give your child low- or non-cariogenic snacks such as cheeses, crunchy fresh vegetables, and things like peanut butter, to drink fluoridated water, and to limit sugary foods and drinks.


    Perhaps fluoride is not enough for your child. In that case, your pediatric dentist may recommend a more severe approach to treat a child or toddler with tooth decay.

    According to the American Academy of Pediatric Dentistry, stainless steel crowns can be used with large cavities and do not require maintenance. In extreme circumstances, teeth may need to be pulled. This is more likely if the tooth is infected or has decayed so severely that it cannot be restored.


    The permanent adult teeth, which will last your child until adulthood, are always present in the jawbone from infancy. The baby teeth serve as a placeholder for permanent teeth. They can affect the spacing of permanent teeth if they are lost prematurely. Premature tooth loss can result in misaligned adult teeth and other issues that may necessitate orthodontic treatment.

    The best way to ensure your child's long-term dental health is to instill good oral hygiene in them from the start. For babies, this means cleaning your baby's mouth after each feeding with a damp washcloth or gauze. Supervise children while they brush their teeth. Make sure they use a pea-sized amount of fluoride toothpaste and that you are assisting them in developing healthy and nutritious dietary habits.


    If a child exhibits any of the above symptoms, he or she will most likely require a dental restoration to treat the infected tooth. A pediatric dentist may recommend a stainless steel crown or tooth extraction depending on the severity of the decay:


    SSCs (stainless steel crowns) repair decayed, damaged, or fractured baby teeth. SSCs help prevents further damage to a baby's tooth if it has tooth decay, but it is not severe.

    These crowns are strong and long-lasting and rarely need to be replaced.


    When a baby's tooth becomes severely decayed, surgical tooth removal (extraction) is required.

    Untreated tooth decay can eventually lead to more serious oral conditions. For example, bacteria from a decaying baby tooth can spread to the jaw, airway, bloodstream, or brain.

    Baby bottle decay affects front teeth more than molars. Front teeth, on the other hand, are easier to extract because they have a single root rather than multiple roots.


    Sealants can be applied after your child's baby teeth have fallen out and the adult teeth have fully grown in.

    Tooth sealants are typically applied to adult teeth that are free of cavities. The coating protects newly erupted teeth from acid, food particles, and cavity-causing bacteria.


    There are so many details to consider regarding your baby's health that it may be daunting. Fortunately, education and prevention are the greatest strategies for preventing infant bottle teeth rot. Begin creating appropriate oral health care practices for your infant soon after birth. See your doctor or pediatric dentist when they are six months old or when their first tooth shows. That way, you'll have the finest information to keep your baby's dental health in tip-top shape, which may mean a healthy, confident grin in adulthood—something they'll undoubtedly appreciate!



    Bottle rot and nursing decays are decay and cavities caused in infants by bacteria buildup from sugary liquids. When natural sugars from milk, formula, or fruit juice cling to an infant's teeth, bacteria can grow and produce acid, which attacks the enamel.


    Baby bottle tooth decay can be reversed with fluoride treatments to remineralize the teeth if detected early (at the appearance of white spots). Restorative dental care may be used to treat cavities if the decay has progressed further.


    Although any child can develop caries at any age, children who drink from bottles are especially vulnerable, beginning as early as six months.


    One of the most common types of early childhood caries is "baby bottle tooth decay," which is caused by exposing a baby's teeth to sugary drinks on a regular and prolonged basis. Baby bottle tooth decay primarily affects the upper front teeth but can also affect other teeth.

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