Why Do I Keep Getting Cavities Even With Good Oral Hygiene?

You’re diligent about brushing your teeth twice a day, and you even floss regularly. Mouthwash is your friend (hello, fresh breath), and your dental cleanings are scheduled twice a year without fail.

Yet, somehow, despite your good oral hygiene, you keep getting cavities. What’s going on?

The fact is, many other factors go into play under the surface of your enamel. Even the best-scrubbed teeth can develop cavities if these other elements aren’t addressed.

So, what could be causing your cavities, and how can you prevent them? This article explains how cavities develop and why they need to be addressed at the (ahem) root of the problem.

Common Causes of Recurring Cavities

The fact is that almost all of us will develop a cavity at some point in our lives. The Centers for Disease Control and Prevention’s (CDC’s) 2024 reports indicate that 1 in 5 adults aged 20-64 had one or more untreated cavities (also known as caries).

Millions more had tooth decay that was treated by a dental professional. So while you don’t want to ignore yours, it’s also not something to be surprised about.

What’s going on that makes cavities so prevalent? Well, it’s not a new thing. Tooth decay has been a part of humanity for thousands of years, with the first recorded evidence of a filling made from beeswax dating back 6,500 years ago!

Still, certain factors make a person more or less likely to develop cavities, over and above their oral hygiene.

Dental Details That Increase Cavity Risk

Whether inherited or environmental, these four oral health factors make a person at higher risk for dental caries:

• Enamel strength: Your enamel is the strong outer tooth layer that protects the interior layers of your tooth from decay. Weakened or eroded enamel (as is often seen with teeth grinding) leaves the dentin exposed, increasing the likelihood of bacteria causing decay and leading to cavities.
• Saliva quality and production: Saliva flow is the body’s natural defense against cavities because it washes away food particles and neutralizes acids in your mouth. If your salivary glands aren’t producing enough moisture (either from genetic reasons or insufficient water intake), bacteria and acid attack the enamel and gums, and your cavity risk increases.
• Oral pH: To maintain optimal enamel health, the pH levels in your mouth should be neutral or higher. Low pH levels are acidic, which can increase the risk of cavities through demineralization and enamel erosion.
• Previous dental work: If you’ve had dental work before, the same treatment that fixed a problem can put you at risk for cavities. Restorations create edges that are prone to plaque and tartar buildup.

Lifestyle Traits That Increase Cavity Risk

Having a strong oral health routine is a crucial part of your lifestyle, but recurring cavities could also be a result of other factors within your control.

How’s your diet? If you eat and drink a lot of acidic or sugary foods and beverages (including fruit and starches), you’re skyrocketing your risk of cavities, even with brushing and flossing. For the best dental health help, add the following to your diet:

• Vitamin A
• Vitamin D
• Calcium
• Phosphorus
• Magnesium

Wash these essential nutrients down with plenty of water. Dehydration — another significant healthcare issue — causes dry mouth (xerostomia), which contributes to the development of cavities.

Speaking of your diet … if it consists of alcohol, tobacco, or drugs, those extra lifestyle “enhancements” are putting you more at risk of developing cavities because they reduce saliva production and promote bacterial growth.

When you’re ready to tackle your cavities, start by reeling in your diet and eliminating extras that damage your teeth.

How to Identify High-Risk Areas in Your Mouth

Short of an entire lifestyle and nutritional overhaul, how can you get a handle on the high-risk cavity areas in your mouth before a toothache warns you there’s a problem?

One way is to look at the tools used by professionals.

Dentists often utilize CAMBRA, or Caries Management by Risk Assessment, to identify patients at high risk for caries. This simple tool determines a person’s risk factors and then assigns a treatment recommendation. You can use the same strategy to find the high-risk areas in your mouth.

How can you use CAMBRA before you go to the dentist with a cavity?

Let’s break it down into risk levels first: low, moderate, high, and extreme. You’re placed into one of these categories using the following risk factors:

• Protective factors: The patient has good oral hygiene, uses fluoride toothpaste or fluoridated drinking water, and has adequate saliva production.
• Diet: They don’t snack often on fermentable carbohydrates like juice and sticky fruits, and they eat a balanced diet.
• Saliva production: They don’t use medications or drugs that cause dry mouth, including tobacco and alcohol.
• Presence of cavities or plaque: No evidence exists of bruxism or weakened tooth enamel, and they don’t already have cavities, previous dental issues, or heavy plaque on the teeth.

Are you at a moderate or higher risk for cavities? Protective factors like good oral hygiene buffer the other negative factors a bit.

But if you have any existing signs of tooth decay (including plaque), are a heavy snacker, take anything that leads to dry mouth, or have a history of dental issues, you’re at moderate or extreme risk.

The more of these factors that apply, the higher your risk.

Lifestyle and Diet Adjustments to Reduce Cavity Risk

Now that you know your risk level, what happens next?

Since you’ve already had cavities, we know it’s not “low,” but you take care of your teeth (good oral hygiene), so you’re not in the extreme level, either.

Falling in between, a few simple lifestyle and diet adjustments may be all you need to reduce your cavity risk!

Enamel Strengthening

Picture your enamel like a piece of strong wood, and everything you put in your mouth is a sander. Over time, the wood gets thinner.

That’s what happens to your enamel if you don’t take care of it. The more damaging factors your teeth are exposed to — such as acidic and sugary drinks or teeth grinding — the faster the enamel wears down.

Like that piece of wood, once those enamel layers are gone, they’re gone.

But you can strengthen them through remineralization with these easy additions to your already great oral hygiene routine:

• Brush twice a day using a soft-bristled toothbrush and fluoride toothpaste. (Don’t forget the chewing surfaces.)
• Follow up brushing with flossing and an antibacterial mouthwash.
• Get regular dental checkups and professional cleanings.
• Reduce your sugar and acid intake, and increase your vitamin-rich leafy greens, fish, and dairy products. (Take supplements if your diet doesn’t give you enough of these vitamins and minerals.)
• Switch to enamel-strengthening toothpaste and mouthwash.

Wear a custom-fit night guard to prevent enamel erosion from teeth grinding while you sleep. Our JS Dental Lab products are high-quality, affordable, and quick and easy to order!

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Saliva and pH Tips

Dehydration is detrimental to both your oral health and the rest of your body. But it doesn’t have to be hard to drink water and improve your saliva production.

Keep in mind that by skipping the dehydrating drinks, like alcohol, caffeine, and sugary beverages, you’re already making steps towards a balanced pH and better saliva output.

Drinking water is essential to prevent dehydration, though. You can’t just cut back on your tea, coffee, and soda. How much water should you drink? Well, that depends on things like your activity level, weight, gender, and more.

If you find it difficult to make it through a 64 oz. thermos, start smaller. Try to drink an inch or two of water per hour, then work your way up.

Other things you can do include:

• Switch to alkaline snacks like nuts and veggies.
• Chew sugar-free gum to amp up your saliva production.
• Rinse your mouth after meals to prevent acid buildup.

Professional Treatments and Preventive Options

Once you have any restorations like dental fillings and crowns, you need to take care of them to prevent bacterial buildup. These fixes don’t mean you can’t get more dentistry issues.

Going for regular dental visits keeps problems from getting worse fast. Your dentist may suggest dental sealants to protect small holes from turning into deep cavities, or fluoride treatments to strengthen enamel. For more serious problems, you may need a root canal to prevent total tooth loss.

Tips For Improving Oral Hygiene Effectiveness

How can you elevate your oral hygiene routine to the next level? Here are a few tips to improve what you’re already doing and give your teeth and gums some cavity-fighting TLC:

• Brush up on your brushing techniques. Did you know that most people don’t brush their teeth correctly? Angle matters. Hold your brush at a 45-degree angle towards the gum line and use small, gentle circles to clean all the tooth surfaces.
• Set a timer when brushing your teeth so you brush for the full two minutes recommended by the ADA.
• Use a soft-bristled toothbrush and don’t overscrub. Vigorous, aggressive brushing and harder bristles can cause enamel erosion.
• Floss once a day. As a popular dentist’s office sign says, “You don’t have to floss all your teeth. Just the ones you want to keep.” Seriously, though — flossing can be the difference between developing gum disease and keeping your teeth healthy.
• Use an anti-bacterial mouthwash and fluoride toothpaste to give your teeth and gums a little extra help.

Your oral health routine takes less than three minutes, but caring for your teeth is an all-day job. As we mentioned earlier, avoid sugary and acidic foods and beverages, as well as snacking on carbs, to maintain optimal saliva production and oral health pH levels.

Get regular dental care and — since you know you’re prone to cavities — address any signs of tooth decay immediately.

One more pro tip: Wear your custom-made night guard regularly. Humans grind their teeth at a whopping 250 pounds per square inch (psi). Without the little barrier of a night guard protecting your permanent teeth, your enamel will weaken quickly, leading to cracks, chips, cavities, and damaged dental restorations. No level of oral health magic can keep your teeth safe if they’re exposed to unprotected jaw clenching and teeth grinding every night!

Read on: 7 Unpleasant Side Effects of Grinding Your Teeth

Conclusion

You know how important it is to brush and floss your teeth, and your oral health routine is on point. Yet, it seems like you can’t leave the dentist’s office for preventive care without hearing the dreaded word “cavity.”

The problem might not be in your brushing. (Although boosting your routine with the above tips can help.) It could be genetic, dehydration, your diet, or teeth grinding.

If you think bruxism is the reason for your cavities, don’t wait! Check out our custom-made night guards at JS Dental Lab. You’ll get professional, high-quality oral appliances without the hefty dentist’s office price tag. The solution to your cavity problem will be delivered right to your door!

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