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Bottles and Cavities: How are they Connected?

baby sleeping with bottle

Dental caries, or cavities, that occur in infants and very young children are usually known as early childhood caries, or bottle feeding syndrome, the later being the less common. The process is initiated when liquids rich in fermentable sugars, such as breast or formula milk and juices, are given to the child in a bottle. These sugars tend to attach to the surface of teeth, which are then broken down into simple sugars by caries- causing bacteria in the mouth. The result is an increase in oral acidity which then causes de-mineralization, and eventually caries in the teeth.

baby sleeping with bottle

How can Bottle Feeding Result in Cavities?

Children who sleep with a bottle of anything other than water in their mouth are at the highest risk of developing early childhood caries. This is because their teeth are constantly exposed to a high level of sugars present in the liquid. According to the American Academy of Pediatric Dentistry, bottle-feeding syndrome occurs because of a persistent interaction between the cariogenic bacteria and carbohydrates. The American Dental Association states that “what” you put in your child’s feeding bottle is less important. The more important thing, is “how frequently” you give it to your child, since repeated exposure to sugars is more dangerous than giving sugary drinks once or twice a day.

Similarly, some parents who dip their child’s pacifier into sugary syrups, or juices in an attempt to sooth their child. While this practice seems to be an effective way of calming the child down, it is highly detrimental to the teeth. For the whole duration the child keeps the pacifier in the mouth, the teeth are continuously exposed to sugars that can cause tooth decay.

What Are the Symptoms?

The teeth furthest in the back of the mouth, with more of a flat surface are most likely to become infected with caries. The upper anterior teeth are the most commonly affected with caries; however, the lower anterior and posterior teeth are just as vulnerable. The symptoms can vary depending on the severity and location. Some of these symptoms could include:


Tooth sensitivity

Mild to sharp pain when eating or drinking something sweet, hot or cold

Visible holes or pits in your teeth

Brown, black or white staining on any surface of a tooth

Pain when biting  down

As a parent, you may not be aware that your child is forming a cavity until it is already present, requiring a fill. This is why it is important to begin your child’s dental visits at age one. If any of these symptoms are present, it is best to see your child’s dentist.

How to Prevent It?

The first step in preventing the development of bottle feeding syndrome is to create feeding times for your child to have the bottle for a shorter amount of time, rather than an all-day snack so to speak. Also, purchase juices made for children with less sugar content, or water down the juice.  Additionally, parents must develop a habit of brushing their child’s teeth, starting from the time their first teeth appear. Your child’s teeth become vulnerable to dental caries as soon as they erupt, which usually occurs at the age of 6 months. Also, if your child is dependent on a bottle to sleep, replace the juice with water, and work to eventually wean from a bottle at night, altogether. Visit your child’s dentist once they observe the emergence of pearly white teeth in their mouth, usually by one year old. Regular visits to the dentist are recommended in order to prevent development of caries, which is most often not visible to the naked eye, unless it has progressed to an advanced stage.


The foremost principle in management is to immediately correct the dietary habits of the child. The milk teeth are ultimately replaced by the permanent teeth, and hence may not require restoration if the eruption of permanent teeth is expected in near future. It must be remembered that if primary teeth are lost at a very early age, there is a tendency for eruption of misaligned or crooked permanent teeth. Hence, taking care of your child’s milk teeth is very important, not only for the health of the adult teeth, but also for the practice of healthy oral habits.


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