Bottle Rot: What Is It? And How Can I Prevent It??

Your nearly toothless baby can get cavities—it’s called bottle rot. Read on to learn what causes this surprisingly common condition, plus how to prevent it.

Did you know that your little almost-toothless baby is capable of getting cavities? It's a condition called bottle rot. And you may be surprised to find what the most common culprit is. Read on to learn about bottle rot, what causes it, and how you can prevent it.

When cavities occur in babies and toddlers (yes, cavities can strike even if your baby only has a couple teeth!), they give it a special name: bottle rot. But before you go running towards your child with a toothbrush and a magnifying glass to check for rotting teeth, let’s break it all down, including:

  • What bottle rot is
  • What causes bottle rot
  • Plus, how to prevent bottle rot in the first place

What is Bottle Rot?

Bottle rot is tooth decay or cavities in infants, babies, and toddlers. It most commonly occurs in the upper front teeth, but other teeth can be affected.

What Causes Bottle Rot?

Bottle rot is associated with prolonged exposure to drinks that contain sugar—even milk. 

Don’t let that scare you though. Most babies won’t get bottle rot simply from breastfeeding or formula. Babies are more likely to get bottle rot, because of three scenarios:

Falling asleep with a bottle

When baby falls asleep with a bottle, the liquid is more likely to pool in their mouths. When this happens, baby’s teeth are directly exposed to the natural sugar (called lactose) in milk for hours at a time. Over time, this can lead to tooth decay.

Lip tie

An uncorrected lip tie can also cause significant bottle rot—particularly in a baby’s upper front teeth—because residual milk gets trapped between the upper lip and the gum. Over time, this can also lead to tooth decay.

Tongue tie

An uncorrected tongue tie is less likely to cause bottle rot, but it is possible. If baby doesn’t have enough tongue mobility to sweep their mouth clean, milk can puddle underneath the tongue. Over time, this can lead to tooth decay—particularly in molars.

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Signs of Bottle Rot

You may suspect your baby or toddler has tooth decay if you notice the following signs:

  • White, yellow, or brown spots on the teeth
  • Visible biofilm (a thin, slimy substance) around the gums
  • Tooth pain that doesn’t appear to be due to eruption or teething
  • Gum pain that doesn’t appear to be due to eruption or teething

Uh Oh! I Think My Baby Has Bottle Rot…

A holistic dentist can formulate a treatment plan to manage any existing bottle rot and develop a plan of action for better oral hygiene to prevent further tooth decay. (Find a holistic pediatric dentist in your area.)

In mild cases…

Your child’s dentist may suggest a change in diet to prevent further decay. (More on this below!)

If decay is significant…

Your child’s dentist may suggest treatment. Treatment for bottle rot is very similar to treatment for tooth decay in adults—the dentist will use a drill to remove the decay, then cap the tooth with a porcelain filling or crown. Depending on your child’s age and maturity, this may require a numbing agent or anesthesia.

If decay is severe…

In very severe cases, extraction may be necessary—but don’t worry, mama, this is not common.

How to Prevent Bottle Rot

Luckily, bottle rot is a condition that’s almost entirely preventable. Here are some best practices to prevent bottle rot:

  • Wipe your child’s gums with a clean, damp gauze pad or washcloth after feedings before teeth come in—particularly if your child has an unresolved lip tie.
  • Brush teeth gently with a child-size toothbrush as soon as teeth come in. Brush all sides of the teeth (or tooth) and gently massage the gums. Check out this post for a step-by-step guide to brushing teeth.
  • Don’t put baby to bed with a bottle.
  • Only put milk in bottles, and avoid filling bottles with liquids such as juice.
  • Don’t share feeding spoons. Not just between kids, but between you and your baby. Sounds cold and sterile, right? Maybe, but sharing utensils can transfer bacteria that causes tooth decay from your mouth to your baby’s mouth.
  • Wash bottles well between uses to limit the spread of bacteria. Learn how to sterilize bottles here in this post.
  • Encourage your child to drink from a cup by his/her first birthday.
  • Promote healthy eating habits by limiting refined sugars, juices (especially citrus), acidic foods, and snacking. The less contact their teeth have with sugar, the less opportunity for cavities. (Don’t forget: Sugar lurks in foods like crackers—not just sweets!)
  • Consider an oral probiotic….
  • Boost fat soluble vitamins like A, D, and K, which strengthen teeth and reduce decay. Cod liver oil is a wonderful food that contains all three vitamins.
  • Add calcium-rich foods, like salmon, leafy greens, yogurt, kefir, and beans—to baby’s diet (if they’re eating solids)
  • Get plenty of vitamin D, whether in the form of sunshine, vitamin D supplements, or vitamin D-rich foods like fatty fish (salmon and mackerel), eggs, grass-fed beef, and egg yolks.
  • Give your child a daily dose of food-based vitamin C from camu camu powder or other foods, as vitamin C supports healthy gums.
  • Ask dentist about xylitol mints or lollipops. Xylitol bathes the mouth in an alkaline solution, helping to fight tooth decay.
  • Look into dental decay protocols, like Cure Tooth Decay or Kiss Your Dentist Goodbye.
  • Visit a holistic dentist. According to the American Academy of Pediatric Dentistry (AAPD), your child should see a dentist shortly after their first tooth appears, and no later than their first birthday.

But Baby’s Teeth Are Only Temporary…

You may be asking yourself why you should be so concerned about bottle rot if baby teeth are only temporary? Turns out, baby teeth are actually a lot more important than you think. Think of baby teeth as the groundwork for the permanent teeth.

  • Baby teeth play a vital role in the development of proper eating, speaking, and breathing.
  • Tooth decay can cause pain that interferes with eating or normal function of the mouth.
  • Healthy baby teeth ensure adult teeth are healthy and come in properly.
  • The mouth microbiome affects the health of the entire body, from the gastrointestinal system, to the nervous system, to the immune system. (source)


If you spot signs of bottle rot or tooth decay, try not to freak out. Babies are very resilient and your child’s holistic dentist can work with you to come up with a safe, gentle plan of action that doesn’t have to include 10-minute long brushing sessions—just a little TLC.

How About You?

Has your child had any tooth decay? Share your stories below—you could help other natural mamas!

Genevieve Howland

About the Author

Genevieve Howland is a childbirth educator and breastfeeding advocate. She is the bestselling author of The Mama Natural Week-by-Week Guide to Pregnancy and Childbirth and creator of the Mama Natural Birth Course. A mother of three, graduate of the University of Colorado, and YouTuber with over 130,000,000 views, she helps mothers and moms-to-be lead healthier and more natural lives.


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  2. We’ve been struggling with my daughters’ mouth. She’s going to need multiple extractions. What I keep telling myself is that it’s not my fault, because it’s not. I have always done the best I possibly could with what I knew at that moment. Don’t feel like you have to stop breastfeeding of you don’t truly want to. This is not your fault. Some things are outside of our control.

  3. Great post! Anyone interested in improving their oral health should definitely look into prodentim. Its a natural candy supplement that contains healthy bacteria that most people are missing out on from things like bad diet, smoking, not brushing enough etc. Heres a great review of prodentim:

    Keep up the great content! Thanks!

  4. Great post! Anyone interested in improving their oral health should definitely look into prodentim. Its a natural candy supplement that contains healthy bacteria that most people are missing out on from things like bad diet, smoking, not brushing enough etc. Heres a great review:


  5. Thanks for this. Both of my boys dealt with this. The oldest needed ozone treatments and fillings. My second had to get extractions and fillings. Now my daughter is showing signs. All were/is exclusively breastfed, no bottles. With the youngest we’ve wiped her mouth and used a toothbrush (no toothpaste) since teeth appeared around 4/5months. She’s 1 now. Also we’re vegan. I’m extremely frustrated and feel pressured to stop nursing even though the research says breastmilk doesn’t cause decay but sugar mixed with breastmilk is worst than sugar alone. I’m feeling stuck, guilty, and ugh. Suggestions welcome.

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