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  • Writer's pictureChris Salierno, DDS

Why do I keep getting cavities?

Does it seem like you have a new cavity every time you get a check up at the dentist? You brush and floss and avoid too much candy but you keep getting the bad news that you need another filling. What’s the deal?

There ‘s definitely something wrong here and it has to do with your “caries risk,” which is a fancy way to say "your risk for getting tooth decay." If you frequently get new cavities, then your caries risk is probably high. There‘s three main influences on your caries risk: diet, hygiene, and genetics.


Sure, you probably know you should avoid too many sweets. Sugar is consumed by some of the bacteria that live in our mouths and then that bacteria excrete (poop) acid, which eats away at our teeth. So you probably know that more sugar means more likely to get cavities.

What you may not realize is how many foods and drinks have sugar in them. Are you drinking coffee with cream and sugar all day? Well, that adds up.

What also matters is the timing of the sugar intake. It’s actually better to eat your sugar all at once and get it over with than to space it out throughout the day. Exposing your mouth even to small amounts of sugar throughout the day will probably increase your caries risk.


You should brush your teeth, twice a day, and use some additional device to clean the stuff that brushing leaves behind. Let’s break that down. First, brush your teeth. That means with a toothpaste that has ingredients to help mechanically remove the bad stuff. If you have a higher risk for tooth decay then you should seriously consider getting a toothpaste with fluoride, which is clinically proven to fight tooth decay.

Next is the frequency: twice a day. In a perfect world you would brush after every meal and snack, but that isn't necessary in most cases. We like to brush in the morning so we have fresh breath, but the brushing before bed is arguably the most important. We need to get rid of all the the food debris from the day before we go to sleep. It is super important that you do not eat or drink anything except water after you brush your teeth at night. A warm glass of milk or quick bite of bread will bring sugars right back onto your teeth.

Finally, we need some device to clean away the stuff that brushing leaves behind. Traditionally that means dental floss to get between the teeth. I also recommend an oral irrigation device like a WaterPik. These devices gently blast water around the teeth and gums in areas that brushes and floss can't reach.


Your genes don't play as much of a role in your caries risk as you might think. This is good news because you can't control your genes but you can control your diet and hygiene. I sometimes hear people say they genetically have "soft teeth" as an explanation for why they are more susceptible to cavities. There are some rare conditions that can affect the strength of your teeth, but most people don't have that problem.

The more likely genetic issue is that the chemistry of your saliva isn't doing a good job of fighting tooth decay. Our spit contains minerals that can help remineralize tiny cavities. If your saliva has less minerals then you'll be more at risk for getting cavities. But please keep in mind that your diet and your hygiene are still far more likely to contribute to your caries risk then your genetics.


So there you have it. If you seem to keep getting cavities then your caries risk is probably high. By improving your diet and your hygiene you should hopefully be able to lower your risk to more normal levels and get a better report card from your dentist.


Disclaimer: ToothQuest is for informational purposes only and is not to be taken as dental, medical, or legal advice.  Please consult with your dentist or other appropriate healthcare professional before making any decisions that would affect your health.

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