Somewhere between drinking from a bottle and drinking independently from a regular cup, a child is likely to use a sippy cup. There are all sorts of adorable options to choose from and you may make your decision purely off of how cute and convenient the cup is. However, while sippy cups sound harmless enough, cavities that are often associated with bottle feeding (baby bottle tooth decay) can also be caused by training cups.
This is because as soon as your baby’s teeth push their way through the gums, they are immediately vulnerable to anything they are exposed to. These brand new teeth are no match for attacks from the sugars in breast milk, formula, or fruit juices, and can easily develop issues with tooth decay from extended periods of exposure. Other issues with oral development can also arise from overuse of the wrong type of cup. Luckily, with a bit of care, you can keep your baby’s brand-new teeth perfectly healthy.
So, there are a few things to keep in mind in order to protect your child’s teeth when they begin using a sippy cup. Careful consideration should be given to exactly which type of cup is used, how often your kiddo drinks from one, and which fluids are put in it, in order to prevent harm to the teeth and mouth of your little one.
What type of cups should be used or avoided:
Skip the no-spill valve. First and foremost, the American Dental Association recommends avoiding a cup with a “no spill” valve. While convenient enough to prevent some of the numerous unwanted spills in any given household, the “no spill” cups also require the child to suck in order to get a sip, which is identical to the bottles they just left behind. These types of cups don’t actually teach the child to sip at all. And, as they suck, the front top teeth are soaked in whatever’s in the cup -- which is often milk, formula, or juice which all contain sugar and/or simple carbs.
Do note when shopping for your cup that the ADA is fine with cups with easy snap-on lids, self-righting weights, paper cups (with proper supervision), or more than one handle – just not the no spill valve (1). As your baby can learn to manage them, it is also fine to use regular, lid-free cups or straws.
How often to provide a sippy cup:
To keep your child’s teeth safe, allowing them to sip as they wish should only be done with fresh, pure water. Sippy cups containing anything other than water should not be given to children to freely sip as they wish. However popular and convenient this may be for busy parents it also increases the amount of time the child has sugary liquids washing over their highly susceptible teeth. This intermittent sipping ensures a nearly constant barrage of sugar against newly formed baby teeth, gradually increasing their likelihood of developing dental caries.
If anything other than fresh, pure water is given in the sippy cup, let it be during mealtimes or snack time only. This allows the saliva produced by the eating of the meal to offset sugars that might otherwise be harmful to the teeth (2).
When your child wants milk or juice instead of water between meals, ask them to simply drink half a glass of water first. Usually, once they’ve had a half glass of water, they’re not thirsty anymore and probably won’t want the sugary drink after all.
It is also important to note that the sippy cup is and should be regarded as a way for children to transition from the bottle to the regular, open cup. This means that they are not a long-term solution, but rather a helpful temporary step for all children.
What to put in the sippy cup:
Water is the best choice for sippy cups anytime. However, milk (either breast milk, formula, or other types of milk as your child is old enough), is fine at mealtimes or snack times as a solid second choice. While juice may be a favorite among the littles, it should be considered more of an occasional treat than a daily staple for them.
One reason for this is the fact that juice is described by the American Academy of Pediatrics as having “no nutritional value at all for children under 1 year old.” Even though children older than 1 year are fine to have some juice at mealtimes fresh, whole fruit and plain water are better choices overall (2, 3). If you do choose to offer juice to your toddler, please be sure that it is 100% juice, with no added sugar.
Problems that can develop from improper cup usage:
Weakened, de-mineralized tooth enamel – Too many simple carbs or sugars on the teeth provide plenty of food for bacteria, leading to weakened tooth enamel, de-mineralizing teeth, and kids and young people are the most susceptible to tooth decay because baby teeth have less tooth enamel than adult teeth. Children who have cavities in baby teeth are also more likely to develop cavities in permanent teeth.
Poor development of permanent teeth - Baby teeth are important for many reasons, including the fact that they hold the place for permanent teeth and help guide them into the correct position. If baby teeth need to be extracted, they cannot do this important job.
Lack of appetite - When babies are allowed to sip on their cups as much as they desire, they may not have much appetite left when it’s time for a meal. Since toddlers can be incredibly picky, a lack of appetite can allow them to be pickier than they would be if they felt hungry. This could lead to a lack of proper nutrition.
Oral motor skill development delays - Experts in mouth development and speech therapists note that long term use of sippy cups may prevent children from developing important skills such as the mature swallow pattern, which requires movements of the tongue for swallowing that certain sippy cups prevent. It can also lead to problems biting into food with the front teeth, breaking down food for proper digestion, and the eventual development of finicky eating habits.
Speech problems - Since the spout of the sippy cup presses down on a child’s tongue, speech issues like “lazy tongue” may arise with prolonged use. This occurs when children cannot say their ‘th’ or ‘st’ sounds.
Preventing tooth decay:
Here at Jungle Roots, we recommend that children see the dentist every six months from the day their first tooth erupts until they become an adult. This allows for a positive, comfortable relationship and a lifetime of dental health. We believe in a conservative approach, emphasizing education and prevention over treatment whenever possible. Early dental visits help us monitor the development and health of your child’s teeth and catch any warning signs that may eventually lead to tooth decay or other problems.
Meanwhile, before you bring your child in for their first dentist appointment, make sure to get them interested in dental care at home. After feedings, or at least once per day, wipe infant and toddler teeth with a damp cloth. You can also begin gently brushing your toddler’s teeth using a soft bristle toothbrush and fluoride-free toothpaste until they are old enough to spit it out. Let them take a turn as soon as they show interest!
Feel free to give us a call and/or make an appointment if you notice any areas of concern on your child’s teeth, or if you are having trouble with your child’s transition between bottle and cup. We’re always available to help out, answer questions, and give ideas when needed. We can’t wait to see you and your little one!
At Jungle Roots Children’s Dentistry & Orthodontics, we strive to provide the highest comprehensive pediatric and orthodontic dental care in a unique, fun-filled environment staffed by a team of caring, energetic professionals. We believe the establishment of a “dental home” at an early age is the key to a lifetime of positive visits to the dentist.
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From Baby Bottle to Cup - American Dental Association. https://www.mouthhealthy.org/~/media/ADA/Publications/Files/patient_36.ashx.
Colak, Hakan, et al. “Early Childhood Caries Update: A Review of Causes, Diagnoses, and Treatments.” Journal of Natural Science, Biology, and Medicine, Medknow Publications & Media Pvt Ltd, Jan. 2013, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3633299/.
Fruit Juice: Good or Bad for Kids? - Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/childrens-health/expert-answers/fruit-juice/faq-20058024.