National Maternal and Child Oral Health Resource Center | Georgetown University
Module 2: Risk Factors for Tooth Decay
Boy drinking juice from a bottle

2.3 Other Factors

In addition to social and biological factors, the following other factors increase a child’s risk for tooth decay:

  • Having recently immigrated to the United States.
  • Consuming a special diet high in sugar, taking medications containing sugar, and/or having reduced saliva flow resulting from medication or irradiation.
  • Having poor oral hygiene.
  • Having inadequate fluoride exposure. (For a discussion of fluoride, see Module 3, section 3.2.)
  • Being put to sleep with a bottle or sippy cup or frequently drinking from a bottle or sippy cup containing a drink with added sugar (e.g., fruit drinks, soda), fruit juice, milk, or infant formula over the course of the day or night.
  • Frequently consuming foods containing sugar over the course of the day.
  • Sucking on a pacifier coated with sweeteners like sugar or honey.
  • Having a parent who has had tooth decay in the past 12 months.

Case Study  

father brushing toddler's teeth

The father of a 6-month-old tells you that he wants to help take care of his son's teeth but doesn't know how or when to start. What should you say?

Mariela Leyba, a dental hygienist with the New Mexico Department of Health, Office of Oral Health, shares this reply:

I’m pleased that you’re concerned about your son’s oral health! And that’s a great question. At about age 6 months, your son's first teeth are going to start coming in, and that’s when you need to start brushing with a tiny smear of fluoridated toothpaste. Here are a couple of options to try.

One way to brush your son’s teeth is to sit down and place him in your lap with his head against your stomach. Another way is to cradle him in the crook of your elbow. Then, how do you get his mouth open so you can brush those tiny teeth? You can tickle his lips with the toothbrush, and he’ll either open his mouth wide in awe or start sucking on the toothbrush. But you only need that moment to brush his teeth. Do you think you could try one or both of those methods?