Co-sleeping was associated with an approximately 2-fold increase in ECC risk and significantly higher dmft scores (7.14 vs 3.49), mediated by nocturnal feeding and insufficient oral hygiene practices.
Co-sleeping was reported in 18.7% of children in the study sample.
Co-sleeping children showed significantly higher mean dmft index scores than non-co-sleeping children.
Co-sleeping was associated with an approximately 2-fold increase in early childhood caries risk.
Co-sleeping was significantly associated with nighttime breastfeeding on demand, higher carbohydrate consumption, and inadequate oral hygiene practices.
The study design was retrospective and observational, and the authors note that prospective studies are warranted to confirm findings.
This research suggests that children who sleep in the same bed or room as their parents (co-sleeping) are at significantly higher risk of developing early childhood caries (ECC), commonly known as tooth decay in young children. In a study of 150 children aged 1 to 6 years, those who co-slept had average tooth decay scores roughly twice as high as children who did not co-sleep (7.14 vs 3.49 on a standard dental index). About one in five children in the study co-slept with a caregiver. The research found that the increased decay risk associated with co-sleeping appears to be linked to specific nighttime behaviors. Nearly 9 out of 10 co-sleeping children fell asleep with milk still in their mouth, which exposes teeth to sugar for extended periods overnight. Co-sleeping children were also more likely to be breastfed on demand at night, consume more carbohydrates, and have less consistent oral hygiene routines. These behaviors together create conditions that promote bacterial growth and acid production on tooth surfaces while children sleep. This research suggests that educating parents about nighttime feeding habits and oral care practices — such as cleaning a child's teeth before sleep and limiting on-demand nighttime feeding — could help reduce the risk of early tooth decay in young children. Because this was a retrospective study (looking back at existing records), the authors caution that future studies following children over time are needed to more firmly establish the causal relationship between co-sleeping and tooth decay.
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Upload Your LabsBayón-Hernández G, Solano-Mendoza P, Solano-Mendoza B, Gómez-Salgado J, Fagundo-Rivera J, El Khoury-Moreno L, et al.. (2026). Co-sleeping as a contributor to early childhood caries: Behavioral pathways and clinical outcomes.. Medicine. https://doi.org/10.1097/MD.0000000000048384