Bottle cavities

Babies are prone to cavities immediately after the eruption of the first temporary tooth in the oral cavity, i.e. around 5-6 months of age.

The first signs of bacterial contamination appear early, shortly after tooth eruption.

If the factors that lead to the appearance of carious processes are not suppressed so early, the pathology progresses, affecting the dental units as they erupt and affecting the dental surfaces both in extent and depth, often with an asymptomatic course.

Baby bottle tooth decay occurs, as the name suggests, due to this feeding habit.

The fact that these carious lesions do not occur in all children, even though each of them bottle-feeds for a certain period of their lives, suggests that there are other local factors that lead to the development of caries of this type.

Baby bottle tooth decay is defined by the early appearance of carious lesions on the smooth surfaces of temporary teeth.

The newborn baby has a sterile, bacteria-free oral cavity. However, some factors can lead to infection.


Saliva of the mother and surrounding people – this comes into contact with the oral mucosa through a passive mechanism. From the first days of life, micro-organisms begin to colonize the oral mucosa.

Food consumed – breast milk, water or other liquids consumed may contain micro-organisms that affect the oral soft tissues or may simply be a vehicle for bacterial transport.

If in the first months of life a limited number of micro-organisms are present, with the appearance of permanent dental units, around 5-6 months of age, the oral bacterial flora diversifies and those micro-organisms adhering to the hard dental surfaces appear.

The baby’s basic food is breast milk.

This breaks down lactose and then glucans, which can lower the local pH and help bacterial adhesion.

These two mechanisms favor the development of carious processes. On the other hand, breast milk also contains elements with a protective role against caries such as proteins, calcium, casein and phosphates. Overall, breast milk does not cause caries in the absence of local pathogenic factors.


Among the precautions and prevention methods that parents should consider, the following are crucial to decrease the incidence of baby bottle tooth decay:

Bottle-feeding with sweet liquids before bedtime should be avoided because the liquids will stagnate in the oral cavity, representing a reservoir of nutrients for micro-organisms.

Feeding of carbohydrates through a pacifier should be avoided because direct contact with the dental units increases the risk of caries, especially in the front, upper and lower teeth.

Parents should be educated as early as possible, as they most often go to the dentist or paediatrician when dental lesions are advanced and the teeth have reached the stage of root remnants.

The child should be taught to consume liquids from the cup as soon as possible after the first teeth erupt.

Oral hygiene should not be neglected, and check-ups with the dentist can be carried out as soon as the first teeth appear.

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