Dr. Rob Mirabelli, Dr. Jen Mirabelli & Dr. Stefanie Hourani

4901 N. 44th Street #101 Phoenix, AZ  85018

Bottle Decay

Bottle Decay

What was previously known as “Nursing Bottle Decay” is now referred to as Early Childhood Caries (ECC for short) to reflect the new understanding that whether young children get cavities is influenced by much more than if they take a bottle to bed. Each child has both risk and preventative factors, which together determine their overall caries (cavity) risk. As pediatric dentists, it is important to assess each child’s personal risk and discuss a personalized home care plan that will decrease the chance that they develop cavities. Here are some of the things Dr. Rob or Dr. Stefanie might ask about:


  • ‍Establishing a dental home within 6 months of first  tooth erupting,  or by 1 year of age
  • Regular dental visits  (every 6 months for most kids)
  • Parental brushing before bed
  • Professional application of fluoride varnish
  • ‍Patient drinks optimally fluoridated water


  • ‍3 or more snacks between meals
  • Child is put to bed with a bottle containing natural  or added sugar
  • ‍Saliva sharing activity with individuals with active  cavities
  • ‍Medications that cause dry mouth
  • ‍Minimal spacing between teeth (↑ risk for cavities  between the teeth and ↑ need for flossing)

“Answering yes” to one of the habits listed under the increased risk category does not necessarily mean that your child will get cavities. These topics are just an outline that is helpful to determine a child’s overall risk and allows the dentist to make recommendations that are specific to your child’s needs.

ECC is the most common chronic disease of childhood; even more common than asthma. Dental caries is a chronic infectious transmissible disease resulting from bacteria sticking to the teeth, metabolizing a carbohydrate/sugar source. The breakdown of these carbs produces an acid that, over time, can demineralize tooth structure and cause a cavity.