Baby bottle tooth decay (BBTD), also known as “early childhood caries,” is one of the most serious forms of tooth decay. As the name implies, BBTD develops during infancy and early childhood as the result of extended exposure to sugary drinks. BBTD can cause serious pain and infection, and can seriously disfigure the child’s teeth. In the United States, the incidence of BBTD is significantly elevated in communities of color, including African American and Native American communities.

Although photographs of BBTD are often used to promote the need for fluoridating water, research has repeatedly shown that access to fluoridated water does not reduce the incidence of BBTD. The failure of fluoridation to prevent BBTD is consistent with the broader failure of fluoridation to prevent the “oral health crises” in low-income America. As is becoming increasingly evident, adding cheap industrial fluoride chemicals to the water supply is no substitute for providing genuine dental care services. While adding fluoride is cheap and convenient, it should not be confused as providing a meaningful solution to the oral health needs of low-income communities.

Excerpts from the Scientific Literature:

“Water fluoridation status of the children’s area of residence did not have a significant effect on Early Childhood Caries (ECC) at the 0.1 level of significance in the unadjusted logistic regression analysis, nor was it found to be a confounder of the effect of race/ethnicity on ECC prevalence in the multivariable model.”
SOURCE: Shiboski CH, et al. (2003). The association of early childhood caries and race/ethnicity among California preschool children. Journal of Public Health Dentistry63(1):38-46.

“Data from Head Start surveys show the prevalence of baby bottle tooth decay is about three times the national average among poor urban children, even in communities with a fluoridated water supply.”
SOURCE: Von Burg MM et al. (1995). Baby Bottle Tooth Decay: A Concern for All Mothers. Pediatric Nursing 21: 515-519.

“Children attending centers showed no significant differences (in baby bottle tooth decay) based on fluoride status for the total sample or other variables.”
SOURCE: Barnes GP, et al. (1992). Ethnicity, location, age, and fluoridation factors in baby bottle tooth decay and caries prevalence of head start children. Public Health Reports 107: 167-73.

“Regardless of water fluoridation, the prevalence of BBTD (baby bottle tooth decay) remained high at all of the sites surveyed. More research needs to be done on the relationship of fluoridated water and BBTD.
SOURCE: Kelly M, Bruerd B. (1987). The Prevalence of Baby Bottle Tooth Decay Among Two Native American Populations. Journal of Public Health Dentistry 47:94-97.

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