Date: May 21, 2019

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Childhood Tooth Decay

This page was reviewed or revised on Thursday, March 8, 2018 2:33 PM

Childhood Tooth Decay

Taking care of your children's teeth is one of the most essential parts of raising a healthy family. This section has information on early childhood tooth decay and maintaining a healthy smile.

Early Childhood Tooth Decay (ECTD)

ECTD is a type of cavity that affects the primary ("baby") teeth of infants and young children. Once a child has teeth, they are at risk.

What causes ECTD?

The main cause of ECTD is frequent consumption of liquids containing natural and unnatural sugars. The longer the liquid is in contact with the teeth, the greater the chance of the teeth being "attacked" by the sugars, causing decay.

The following are examples of what makes a child more prone to ECTD:

  • The child's teeth are not cleaned properly.
  • The baby/child is put to bed with a bottle or "sippy cup" containing anything but water (including: breast milk and formula which have hidden sugars that can "attack" the teeth).
  • The child is allowed to walk around with a bottle or cup taking frequent drinks of anything other than water.
  • A bottle or sippy cup is given to the child to soothe or pacify them.

What does ECTD look like?

ECTD will start as a crescent shaped white mark along the gum line of the teeth (especially the top front teeth). If not noticed, it will quickly progress into a brown spot, which may lead to open holes, and possibly broken teeth that look like stumps.

How does ECTD affect a child?

ECTD is not only an infection that can be painful but it can affect speech, eating, learning, playing, and sleeping. If severe, it can affect growth and development. This in turn can affect the quality of life of the child, and can crossover into adulthood.

How can you prevent ECTD?

It is important to clean your child's teeth and gums at least 2 times a day for 2 minutes each time. If your child does not have teeth, the gums should be cleaned using a wet washcloth. It is also very important that your child see a dentist at least once a year. You should not allow your child to continually snack and drink throughout the day. There should be designated meal and snack times, and water should be the only drink offered between meals. Finally, you should never put your mouth on anything that goes into your baby's mouth (i.e. soother, bottle nipple, spoon, etc.), as this will allow bacteria from your mouth to be passed to your child.

Pacifiers & Thumb Sucking *

With infants and young children, sucking is a natural impulse that helps them self-soothe and feel comforted. Usually the urge to suck decreases, or stops, when the child is between 2 and 4 years of age. Thumb sucking does NOT put the child at risk for cavities.

Pacifiers (soothers) are safe to use in place of a thumb. In fact, using a soother is better than thumb sucking because it is easier to control or stop the use. NEVER dip the soother in honey, sugar, or anything sweet because this could cause cavities.

It is best to discontinue a sucking habit before the permanent ("adult") teeth come in, around the age of 5. If thumb sucking or the use of a pacifier continues after the child's permanent teeth come in, the position of the child's teeth and jaw could be altered. If you are concerned your child's adult teeth may be affected by thumb sucking or pacifier use, seek advice from a dental professional.


* We recommend that you do not use bottles, pacifiers, and nipple shields while your baby is learning to breastfeed. They can make it more difficult for your baby to learn to breastfeed well and for you to produce a good milk supply.