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Bottle rot and baby tooth decay: Everything parents should know

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Dr Teresa Li
July 18, 2023

We know that children’s tooth decay can impact your little one’s overall health, but what about bottle rot? Bottle rot, also known as milk rot or baby bottle tooth decay, is a common condition that can cause decay and damage to your child's primary teeth.

Babies and toddlers who fall asleep or go to bed with a bottle are particularly at risk of developing this particular type of tooth decay. 

While baby tooth decay may seem like less than a critical issue, bottle rot can lead to a myriad of oral health issues later on. Your child's baby teeth are important. They form the foundation of your child's mouth, holding the jaw in place for adult teeth.

Healthy teeth mean healthy eating practices, and setting up good habits early on will follow a child for the rest of their life.

Your baby's first dental check-up typically occurs at the one year milestone and this is one of the potential issues your dentist will look for.

Here, we look at what causes bottle rot teeth, the signs and symptoms to look out for, how to prevent bottle rot and bottle rot treatment.

Firstly, what is bottle rot?

Bottle rot is the most common term used to describe tooth decay or cavities in infants, babies, and toddlers. It most commonly occurs in the upper front teeth, because that’s where milk residue gathers when a baby falls asleep with a bottle. But the upper front teeth aren’t the only ones in the firing line. Bottle rot can impact other tiny teeth, too.

Baby teeth in general are more susceptible to tooth decay because the enamel is thinner than on adult teeth.

Bottle rot is the most common term used to describe tooth decay or cavities in infants, babies, and toddlers.
Bottle rot is a common condition that can cause decay and damage to your child's primary teeth. Babies and toddlers who fall asleep or go to bed with a bottle are perticularly at risk of developing this particular type of tooth decay

Wondering why it matters what happens to baby teeth when they fall out anyway?  Parents often ask us: Does bottle rot affect permanent teeth? And the answer is yes.

If left untreated, child tooth decay can lead to inflammation and infection in the gums which can cause partial eruption of adult teeth and misaligned adult teeth. 

What causes bottle rot?

While child’s tooth decay is most often caused by a number of dental hygiene issues, bottle rot is a specific kind of tooth decay caused by babies and toddlers falling asleep with bottles of milk or formula. This is because milk—or worse, juice—drunk from a bottle easily pools around the gums and teeth.

As the sugar in those drinks (yes, even breast milk!) maintains contact with the teeth during bottle feeding, it aids the growth of bacteria, which eats away at tooth enamel, eventually leading to cavities forming.

Signs and symptoms of bottle rot

The best way to treat bottle rot before it causes issues is to catch it early. So, what should parents look out for? The signs and symptoms of bottle rot can vary depending on the severity of the decay. We’ve included some of the most common signs for each stage below.

First phases of decay:

In the initial stages, bottle rot or baby tooth decay can present as white, yellow or brown spots on the teeth. You may also notice a visible biofilm (a thin, slimy substance) around their gums.

These signs may be difficult to spot on tiny teeth, which is why your little one’s first dentist visit should be no later than their first birthday.

Baby’s teeth show the beginning of tooth  decay.
Baby tooth decay can present as white, yellow or brown spots on the teeth. You may also notice a visible biofilm (a thin, slimy substance) around their gums

Major decay:

If the decay goes untreated and continues to progress, your little one may experience and show signs of tooth pain and tooth sensitivity.

While they may not have the words to tell you just yet, you’ll usually be able to spot this if they wince while eating or drinking certain foods and liquids.

Their gums may also appear red, swollen or tender. 

Severe decay:

In bottle rot’s most severe stages, it can cause bleeding gums, bad breath and black spots on their teeth.

At this stage, there is a high risk the decay will cause wider health issues so it is essential to have it treated as soon as possible.

If you notice any of these signs or symptoms in your little one, it is important to take them to your dentist right away. The earlier the treatment, the better chance you will have at preventing the decay from spreading and causing more serious problems.

Worried your little one might be developing bottle rot?

Book in for your baby’s first appointment now or download the Tiny Teeth Matter Guide to ensure you have all the information you need.

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How to avoid bottle rot

How can you maintain healthy baby teeth for your little one and prevent bottle rot? The easy answer is not allowing them to fall asleep with a bottle in their mouth. But like any sleep aid, falling asleep with a bottle at night can be a very hard habit to break!

It’s important to remember that, regardless of its contents, relying on a bottle to get to sleep can set your little one up for dental trouble in the future.

If your child has gotten used to falling asleep with the aid of a bottle, there are a few things you can try:

  • If your little one’s teeth haven’t come in yet, you can wipe their gums with a clean, damp gauze pad or washcloth after feedings —particularly if your child has an unresolved lip tie.
  • As soon as they do come in, brush the  baby teeth gently with a child-size toothbrush. Brush all sides of the teeth (or tooth) and gently massage the gums. 
  • If your child is over six months old, put water in their bottle. Water lacks any of the sugar that causes decay
  • For children under six months, or those who won't accept water, watch them as they drink, and remove the bottle as soon as you notice they have stopped sucking
  • If removing the bottle causes upset or distress, try replacing the bottle with a dummy while they’re almost asleep. Experts recommend eliminating pacifier use by four years of age, and ensuring they’re never dipped in sugary liquids.

Young child shows the dentist their teeth brushing technique at TL Dental.
Your little one's first dentist visit should be no later than their first birthday. It is important to start seeing the dentist early, which will establish good preventative care vital to their future dental health.

Any change in a bedtime routine is going to cause a small amount of distress and getting used to, but as with most changes, a gentle approach is best to help wean your little one off their nighttime bottles.

In addition to eliminating nighttime bottles, make sure you are taking proper care of your little one's teeth as soon as they begin to emerge. Start brushing early; good dental hygiene sets up your child to acquire and maintain good, healthy habits.

Good dental care at home is a cornerstone of your child’s health, but it’s also important to start seeing the dentist early, which will establish good preventative care vital to your little one's future dental health.

To quickly and easily schedule your little one’s first dental checkup, contact us today!

Bottle rot treatment

There are a number of ways your dentist can treat bottle rot in your little one, depending on how severe the tooth decay has become.

In mild cases, the dentist may be able to remove the decay with a simple cleaning fluoride treatment.

In more severe cases, the dentist may need to fill the cavities with a stainless steel crown or even remove the affected teeth via extraction.

If you suspect your little one is suffering from bottle rot, your dentist will be able to recommend the best treatment.

Child attends her regular dentist check-up at TL Dental.
There are a number of ways your dentist can treat bottle rot in your little one, depending on how severe the tooth decay has become

As parents, we want to provide the best care for our little one’s tiny teeth. If left untreated, bottle rot can have a significant impact on your child's oral health. But don’t fret!

By understanding the causes of bottle rot and taking preventative measures such as limiting sugary drinks, subbing bottles as a sleep aid and establishing good oral hygiene habits for babies, you can set your little one up for a healthy and beautiful smile for life.

At TL Dental, we’re committed to providing the highest quality care for our young patients. If your little one is ready for their first dental appointment, book a time to meet the team today.

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