Tooth Decay in Baby Teeth

Did you know that tooth decay is the most common long-term childhood disease? Children of any age can get tooth decay, even babies and toddlers. And tooth decay is five times more common than asthma. The good news is that tooth decay can be prevented!

What causes tooth decay?

Bacteria in the mouth change the sugar in foods and drinks into acid that attacks the teeth. Each time you eat or drink, that acid can attack the teeth for 20 minutes or longer. Over time tooth decay can develop and a cavity can form.

How does tooth decay affect baby teeth?

Tooth decay in the primary (baby) teeth of young children is also called early childhood caries. Caries is another word for a cavity. It happens when the child's teeth come into contact with sugary foods and drinks often and for long periods of time. These drinks include fruit juices, soda and other drinks with sugar.

Parents are often surprised to learn that tooth decay can begin as soon as a baby's teeth come in, usually by age six months. Decay in baby teeth can cause pain, and the infection can spread. If decay is not treated, it can destroy the baby teeth.

Tooth decay can also have an effect on a child's general health. If a child has tooth pain, she may have trouble eating. The child may not get enough vitamins and minerals to grow up healthy.

Decay in Baby Teeth

Healthy baby teeth

Healthy baby teeth

Moderate to severe decay baby teeth

Moderate to severe decay

Moderate to severe decay baby teeth

Moderate to severe decay

severe decay baby teeth

Severe decay

Why are baby teeth important?

Baby teeth hold space in the jaw for the adult teeth. If a baby tooth is lost too early, the teeth beside it may drift into the empty space. When it's time for the adult teeth to come in, there may not be enough room for them. This may cause adult teeth to be crowded and crooked. Crooked teeth may be hard to keep clean.

adult teeth crowded

If a baby tooth is lost too early, the teeth beside it may drift into the empty space.

If a child's baby teeth are healthy, it is more likely his adult teeth will be healthy too. Children who have decay in their baby teeth are more likely to have decay in their adult teeth.

Decayed and crooked teeth also can affect your child's self-esteem. Tooth decay is not only unhealthy, it also looks bad. If your child has tooth decay he may feel bad about his smile. On the other hand, a nice-looking smile can give your child confidence at school.

How to keep your child’s teeth healthy

Children learn healthy habits from their parents and caregivers. You can start good habits if you clean your child's teeth every day, feed your child a healthy diet and take her to the dentist regularly.

Clean your child's teeth at home

  • Wipe the baby’s gums with a clean, wet gauze pad or washcloth after each feeding, before sleep. This removes bits of food that can harm teeth that are starting to come in. It also helps the child get used to having his mouth cleaned.
  • As soon as the first tooth appears, start brushing your baby’s teeth twice a day (morning and night). Use a soft-bristled, child-sized toothbrush and a fluoride toothpaste. Until the child is three years old, use no more than a smear or grain-of-rice-sized amount of fluoride toothpaste. For children three to six years old, use no more than a pea-sized amount of fluoride toothpaste.
  • The American Dental Association recommends that you brush your child’s teeth until she is at least six years old. When your child is old enough to do the brushing, watch to make sure she is not “rushing the brushing”. Children should be taught to spit out toothpaste, not swallow it.

toothpaste for children under three years old

For children under three years old

toothpaste for children three to six years old

For children three to six years old

Bottles, pacifiers and breastfeeding

  • Infants should finish their bedtime or naptime bottle before going to bed.
  • After your child’s first tooth comes in, he should not be allowed to breastfeed constantly or fall asleep while breastfeeding.
  • Infants should not be put to bed or allowed to fall asleep with a bottle that contains milk, formula, fruit juices, or any liquids with sugar. Even watered-down drinks can damage teeth.
  • If your child uses a pacifier, don’t dip it in sugar or honey. Also, do not put it in your mouth before giving it to the child. Decay-causing bacteria in your mouth can be passed to your baby.
  • A bottle should not be used as a pacifier. Frequent sips of sugary liquids can cause tooth decay.

Training ("sippy") cups

  • To lower the risk of tooth decay, try to get your child to drink from a cup by her first birthday.
  • Do not let your baby constantly sip on liquids with sugar (including juice drinks). Offer these liquids only at mealtimes. Keep the cup out of reach while the child is in a car or stroller. If your child is thirsty between snacks or meals, offer water in the cup.
  • Training cups should be used for only a short time. Once your child has learned how to sip, the training cup is no longer needed and should be set aside.

A healthy diet builds strong teeth

  • Limit between-meal snacks.
  • Avoid using sweet foods and drinks to reward your child.
  • If your child eats sweets, make sure it is with a meal.
  • Infants and young children should have a healthy diet. Information can be found at www.choosemyplate.gov

First Dental Visit

  • Talk to your dentist about planning the child’s first dental visit. It’s helpful to have the first visit after the baby’s first tooth appears but no later than the first birthday. This first visit is a “well-baby checkup” for your child’s teeth.
  • At this visit, the dentist can check for decay and other problems. He or she can show you how to properly clean your child’s teeth.
  • Also, the dentist may offer advice on your child’s diet, pacifier use, and oral care products for your family. He or she can tell you how to prevent injuries to your child’s teeth and mouth and what to do in case of a dental emergency.
  • Children should get the ideal level of fluoride to help prevent tooth decay. Ask your child’s dentist about how your child can get the right amount of fluoride.


American Dental Association
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