Read on and we’ll explain exactly what causes toddler tooth decay and, more importantly, how you can prevent or treat tooth decay in your little one. After all, you'll want your toddler's smile to remain as adorable as ever, and beautiful teeth are healthy teeth!

What Causes Tooth Decay in Toddlers

Toddler tooth decay (aka cavities or dental caries) occurs when bacteria within the mouth build up and produce acid, which eats away at the baby tooth enamel. There are a number of common – but very preventable – things that can cause this to happen in toddlers:

Sleeping with a bottle. There's even an unofficial term for this: baby bottle tooth decay, officially known as early childhood caries (ECC). The cause of this condition is giving your toddler a bottle filled with milk or juice at nap time or bedtime. The bottle's sugar-laden liquid can remain in your tot's mouth all night, creating an ideal breeding ground for bacteria to flourish and tooth-eroding acids to form.

Unhealthy eating and drinking habits. If you give a toddler a bottle or sippy cup with milk or juice to carry around, that too breeds bacteria. As does letting your child suck on candy for prolonged periods or eat a lot of sugary foods.

Insufficient dental care. Not regularly brushing your toddler's teeth or taking your youngster to a dentist regularly can lead to tooth decay.

Sharing saliva. Cleaning off pacifiers by putting them in your mouth, eating from the same utensils as your child, giving your child slobbery kisses on the lips - all are no-nos in toddler oral care. You can actually pass along any cavity-causing bacteria from your mouth to your child's mouth.

Prevention: How to Cavity-Proof Your Toddler's Teeth

To prevent tooth decay in your toddler's mouth, the secret is to reduce the amount of time their teeth are exposed to decay-causing, acid-forming sugars. Here are some actions you can take.

Give sleepy-heads water only. If you give your child a bottle or drink before bedtime or naptime, always choose water – never milk or juice.

Save milk and juice for mealtimes. Of course, you want to provide your growing child with the nutrients in milk and juices. But it's best you only serve those liquids during mealtimes when your child will drink them within a limited time, rather than sip them all day from a bottle or sippy cup.

Serve more healthy foods and fewer sugary treats. By adding foods chock-full of vitamins and minerals to mealtimes and snack times, you'll significantly and positively impact your child's oral health.

Keep sugary or acidic foods and drinks to a minimum. Limit candy, other sweet foods, and carbohydrates to special times when your toddler can enjoy them right away – not suck or chew them for long stretches of time. And avoid acid- and sugar-filled sodas!

Establish an oral health care routine. Make sure you take care of their teeth daily. Here's a great routine you can make loads of fun with songs and games:

  • Brush your toddler's teeth at least twice daily. 
  • Use a brush with extra soft bristles that fits a toddler's mouth.
    • Use mild-flavored fluoridated toothpaste without artificial colors, preservatives, or sodium lauryl sulfate.
    • Use the right amount of toothpaste. tiny amount of toothpaste: For  children under two, use a sliver the size of a rice grain. From two onwards, use a pea-sized amount and encourage them to spit after brushing.
  • Introduce flossing. Clean gently between your tot's teeth when two of them start touching, usually around the age of 2 or 3. Waxed floss, floss picks, or interdental cleaners work best for a toddler's mouth.

Schedule regular dental appointments. Your toddler should visit the dentist before you plan a first birthday party. The American Dental Association provides these tips for your little one's first visit:

  • Schedule a morning visit when toddlers are usually on their best behavior.
  • Accentuate the positive to make the visit anxiety-free.
  • Talk to your child about what to expect (again, in an upbeat way) during the dental visit.

During the visit, your dental professionals will:

  • Clean your toddler's teeth professionally to ensure all plaque is removed.
  • Catch and treat any dental issues sooner than later.
  • Listen to you as you tell them about your toddler's oral routine, habits, and concerns.
  • Advise you on additional oral care practices, teething issues, and preventive measures such as sealants and fluoride treatments.
  • Recommend ways to stop toddler habits, such as thumb-sucking and depending on pacifiers.

Treatment for Toddler Tooth Decay

We know you don't want your toddler having to undergo treatment for dental decay. But, unfortunately, depending on the extent of the decay and the damage it's done, toddlers might need these treatments:

  • Fillings to treat smaller cavities with minimal decay
  • Crown insertions to prevent bacteria from spreading if the decay is extensive
  • Root canal to treat a tooth in which the decay is close to the nerve
  • Tooth extraction to remove a severely decayed tooth.

But why work on baby teeth that will fall out eventually? There are a couple of important reasons:

  • Untreated decay can cause discomfort and pain, and the decay might spread to nearby teeth.
  • Badly decayed baby teeth might make it hard for your child to eat and speak properly.
  • Severely decayed baby teeth might fall out too soon, causing spacing problems with your child's adult teeth that might require braces to correct.

By starting good oral habits early in your child's life, you're not only protecting your child's baby teeth but their adult teeth, too. Plus, you're laying the groundwork for your child's oral hygiene. Starting healthy oral care habits with toddlers = preventing dental issues throughout your child's lifetime!

Frequently Asked Questions About Toddler Tooth Decay

What causes tooth decay in toddlers?

Toddler tooth decay is caused by a build-up of plaque and bacteria. Acid produced by the bacteria eats away at the hard enamel of the tooth, leading to decay and cavities (holes) in the teeth. 

How can I prevent tooth decay in my toddler?

You can prevent toddler cavities and tooth decay by following a thorough daily oral hygiene routine, limiting sugary and acidic foods, and attending regular dental visits. It’s especially important to avoid giving your toddler bottles or sippy cups containing milk, juice, or other non-water liquids for extended periods of time, as this can lead to “baby bottle” tooth decay. Give them only water to sip on throughout the day, during naps, and at bedtime, and save the juice and milk for mealtimes. 

Are there any signs of tooth decay I should watch for in my toddler?

White, chalky spots on the teeth are the earliest visible signs of tooth decay. At this stage, decay can still be reversed, so take your child for a dental visit as soon as possible. Signs of more advanced decay might include brown marks on the teeth, visible holes, toothache, and difficulty eating or drinking. 

How can I encourage my toddler to practice good oral hygiene habits?

We know it can be hard to get toddlers on board with oral hygiene! You can help by starting an oral hygiene routine from birth to get them used to oral care. When they’re toddlers, it helps to turn toothbrushing into a game or fun activity, and let them have a little involvement in the process. For example, you can let them choose a toothbrush with their favorite character, or take a turn at brushing. 

What should I do if my toddler develops tooth decay?

Schedule a visit to your dental professional right away. They can help you to stop toddler tooth decay in its tracks and treat any teeth that have been damaged. They’ll also help you to develop a great oral hygiene routine and offer you dietary advice to help get your toddler’s oral health back on track and prevent future problems.

Oral Care Center articles are reviewed by an oral health medical professional. This information is for educational purposes only. This content is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your dentist, physician or other qualified healthcare provider. 


What's behind your smile?

Take our Oral Health assessment to get the most from your oral care routine


2.3 billion

people worldwide suffer from tooth decay


What's behind your smile?

Take our Oral Health assessment to get the most from your oral care routine


2.3 billion

people worldwide suffer from tooth decay