ECC (Baby Bottle Tooth Decay)

Early Childhood Caries (ECC): What Every Parent Should Know

At Descanso Smiles: Pediatric Dentistry & Orthodontics, we believe that caring for baby teeth is essential—not optional. Though baby teeth eventually fall out, they play a critical role in your child’s development, including speech, chewing, facial growth, and creating space for future permanent teeth.

When baby teeth are lost too early due to decay or trauma, nearby teeth can shift, leading to impacted adult teeth, misalignment, and lengthy orthodontic treatment down the road.

What Is Early Childhood Caries (ECC)?

ECC, often called “baby bottle tooth decay,” is the presence of cavities in infants and toddlers. While all teeth can be affected, it’s most common in the upper front teeth.

Baby teeth are vulnerable to decay as soon as they erupt—usually around 6 months of age. That’s why the American Academy of Pediatric Dentistry (AAPD) recommends a child’s first dental visit by age 1, or within 6 months of the first tooth.

How Does Baby Bottle Tooth Decay Happen?

ECC is caused by acid-producing bacteria that feed on sugars left in the mouth. These bacteria often come from:

Sharing utensils or cleaning pacifiers with your mouth
Putting sugary drinks in bottles or sippy cups
Letting your child fall asleep with a bottle (especially one with milk, juice, or sweetened liquids)

When these sugars stay on the teeth—particularly during sleep—they feed bacteria that produce acid. This acid attacks tooth enamel, leading to painful cavities and possible tooth loss.

Risk Factors for ECC Include:

Frequent snacking or sipping on sweetened drinks
Nighttime bottle use
Low fluoride exposure
Poor oral hygiene
Parent-to-child transmission of bacteria

Why Baby Teeth Matter

Even though baby teeth are temporary, they:

Help your child speak and chew properly
Maintain proper space for adult teeth
Support healthy jaw and facial development
Prevent the tongue from posturing abnormally, which may impact breathing and speech
Premature tooth loss can lead to orthodontic issues, spacing problems, and long-term bite concerns.

Preventing Early Childhood Cavities at Home

A few simple habits can keep your child’s smile healthy from the start:

Keep it Clean

Wipe baby’s gums with a soft, damp cloth after each feeding
Begin brushing with a soft toothbrush and fluoride-free toothpaste as soon as the first tooth appears
Once your child can spit reliably (usually by age 3), switch to a pea-sized amount of fluoride toothpaste

Be Smart with Bottles & Cups

Avoid putting juice, sweetened water, or milk in bottles at bedtime
Never dip pacifiers in honey or sweet liquids
Transition from bottle to cup by age 12 months
Only fill bottles or sippy cups with water, formula, or breast milk

Limit Bacteria Transmission

Don’t share spoons or clean pacifiers with your mouth
Rinse toys and pacifiers with clean water, not your saliva

Promote Healthy Habits

Offer nutritious snacks and limit sugary foods and drinks
Help your child brush until age 7, when they have the coordination to clean thoroughly
Ask your pediatric dentist about your child’s fluoride exposure and whether supplements are needed

When ECC Is Severe

If decay becomes advanced, we may need to remove the affected tooth and place a space maintainer to prevent crowding and misalignment of future teeth. But with early care and regular checkups, ECC is almost entirely preventable.

Start Early, Stay Healthy

Your child’s first dental visit sets the tone for lifelong oral health. At Descanso Smiles, we’re here to guide your family every step of the way—from that first baby tooth to a confident, cavity-free smile.

Schedule your baby’s first visit or ask us about cavity prevention at 818-790-5959.
Together, we’ll build healthy habits that last a lifetime.

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