Baby teeth are important. If baby teeth are lost too early, the teeth that are left may move and not leave any room for the adult teeth to come in. Also, if tooth decay is not prevented it can be costly to treat, cause pain, and lead to life-threatening infections.
Tooth decay (called early childhood caries) is the most common chronic infectious disease of childhood. Tooth decay may also be called nursing caries or baby bottle tooth decay.
Healthy dental habits should begin early on because tooth decay can develop as soon as the first tooth comes in. The following is information from the American Academy of Pediatrics (AAP) can help parents and other caregivers understand the causes of tooth decay, signs of tooth decay, and how to prevent tooth decay.
Causes of Tooth Decay in Babies
Tooth decay develops when a baby's mouth is infected by acid-producing bacteria. Parents and caregivers can pass bacteria to babies through saliva. For example, bacteria is spread by sharing saliva on spoons or cups, testing foods before feeding them to babies, and cleaning off a pacifier in the parent's or caregiver's mouth.
Tooth decay also develops when the child's teeth and gums are exposed to any liquids or foods other than water for long periods. The natural or added sugars in the liquids or foods are changed to acid by bacteria in the mouth. This acid then dissolves the outer part of the teeth, causing them to decay.
The most common way this happens is when parents put their children to bed with a bottle of formula, milk, juice (even diluted), soft drinks (soda, pop), sugar water, or sugared drinks. It can also occur when children are allowed to drink from a sippy cup, suck on a bottle, or breastfeed for long periods frequently during the day or night.
Signs of Tooth Decay in Babies
Tooth decay might first appear as white spots at the gum line on the upper front teeth. These spots are hard to see at first—even for a child's doctor or dentist—without proper equipment. A child with tooth decay needs to be examined and treated early to stop the decay from spreading and to prevent further damage.
How to Prevent Tooth Decay in Babies
Take the following steps to prevent tooth decay:
- Take good care of your own oral health even before your baby is born.
- Take good care of your baby's teeth.
- Birth to 12 months: Keep your baby's mouth clean by gently wiping the gums with a clean baby washcloth. Once you see the first teeth, gently brush using a soft baby toothbrush and a smear (grain of rice) of fluoride toothpaste.
- 12 to 36 months: Brush your child's teeth at least 2 times per day. Use a smear of fluoride toothpaste until your child is 3 years of age. The best times to brush are after breakfast and before bed.
- Never put your child to bed with a bottle or food. Not only does this expose your child's teeth to sugars, it can also put your child at risk for ear infections and choking.
- Do not use a bottle or sippy cup as a pacifier or let your child walk around with or drink from one for long periods.
- Check to see if your water is fluoridated. Your child will benefit from drinking water with fluoride in it. If your tap water comes from a well, your child's doctor or dentist may want to have a water sample tested for natural fluoride content. If your tap water does not have enough fluoride, your child's doctor or dentist may prescribe a fluoride supplement. He or she also may apply fluoride varnish to your child's teeth to protect them from decay.
- Teach your child to drink from a regular cup as soon as possible, preferably by 12 to 15 months of age. Drinking from a cup is less likely to cause the liquid to collect around the teeth. Also, a cup cannot be taken to bed.
- If your child must have a bottle or sippy cup for long periods, fill it with water only. During car rides, offer only water if your child is thirsty.
- Limit the amount of sweet or sticky foods your child eats, such as candy, gummies, cookies, Fruit Roll-Ups, or cookies. There is sugar in foods like crackers and chips too. These foods are especially bad if your child snacks on them a lot. They should only be eaten at mealtime. Teach your child to use his or her tongue to clean food immediately off the teeth.
- Serve juice only during meals. The AAP does not recommend juice for babies younger than 6 months. Juice for babies between 6 months to 12 months should limited to 4 ounces per day and it should be diluted with water (half water, half juice). Juice for children 1 to 6 years should be limited to 4 to 6 ounces per day.
- Make an appointment to have your child see the dentist before the age of 1. If you have concerns, the dentist can see your child sooner. Find a pediatric dentist in your area on the American Academy of Pediatric Dentistry Web site at www.aapd.org.
Tooth decay can be prevented. Talk with your child's doctor or dentist if you see any signs of decay in your child's teeth or if you have any questions about your child's teeth. With the right care, your child can grow up to have healthy teeth for a lifetime of smiles.
The AAP recommends that:
- All infants receive oral health risk assessments during well-child visits starting at 6 months of age.
- All children should be referred to a dentist as early as 6 months of age in order to establish a dental home.
- All children in their early toddler years should have a thorough initial dental examination and regular dental care whenever possible.