Baby Bottle Tooth Decay refers to the decaying of baby teeth assumed to be caused due to careless and prolonged use of the baby feed bottle. It is also called early childhood caries (ECC).  ECC normally starts at the upper front teeth, but will not remain confined there, and can spread to other teeth as well. It is important therefore, to prevent baby bottle tooth decay, and if it does set in somehow, it must be treated immediately, because children need healthy teeth in order to eat, chew well and to speak properly. The argument that affected milk teeth are going to shed anyway and new permanent teeth will replace them in not correct.  There is a phase when children have a mixed dentition, and ECC can spread to neighboring permanent teeth also, causing a lifelong problem with teeth.

Baby bottle tooth decay is attributed to bottle remaining in the mouth of the baby for too long or too frequent feeds with the bottle. In either case cumulative exposure of teeth to sugars increases. Bacteria responsible for producing acid from food remnants are invariably acquired by infants from the kissing and handling of care givers. The bacteria use the sugars present in the milk to produce acids which makes the environment more acidic.

Tooth decay may also be caused more easily if the child does not get sufficient amount of fluoride. Baby bottle tooth decay can be prevented reducing the cumulative exposure of teeth to sugar in the milk. This can be done by avoiding the bottle as far as possible, not adding any extra sugars (e.g., to make milk attractive to the baby), following a strict feeding schedule, regular cleaning of the teeth if they have come, and not allowing the baby to retain the bottle once asleep. Some measure of safety may also be possible by taking care to prevent transfer of the bacteria from adults to the baby. At the same time, adequate intake of fluorides by the baby must be ensured.