8 Reasons You're Still Getting Cavities Even Though You Brush and Floss

When it comes to dental hygiene, you always bring your A-game: You're a flawless flosser and a brilliant brusher. Which is why you're also probably stumped, because you keep getting cavities. So what gives?

Hate to break it to you, but brushing and flossing are only part of the cavity-fighting battle. Yep, even with a solid oral health regimen, it's still possible to develop dental issues like tooth decay.

Before you throw up your hands and toss your toothbrush in the trash, let's be clear: Proper oral hygiene habits are essential for healthy teeth and gums. And they're especially important for people who are prone to cavities. So, continue brushing twice daily and flossing regularly.

With that in mind, we spoke with dentist David Mitola, DDS, New York State Dental Association spokesperson, to understand why cavities can happen even when you take good care of your teeth, and what you can do to reduce your risk.

If cavities run in the family, you might wonder whether your DNA has something to do with your dental problems. So, can you be born with bad teeth‌?‌ The answer is ‌yes, to a degree.‌

While things like your oral hygiene and diet (more on this later) can significantly contribute to (or curb) cavities, "research shows that genetics can also play a role in your risk for developing tooth decay," Dr. Mitola says.

For example, "Genes associated with cavities are most commonly involved with enamel formation, saliva production or immune response," Dr. Mitola says. Genetics may also, in part, determine the type of bacteria that live in your mouth, which can make you (more or less) susceptible to cavities and gum disease, he adds.

That said, "The role of genetics in dental disease is not completely understood and further research will allow for better predictability in prevention and treatment," Dr. Mitola says.

Have you noticed your gum line getting lower lately? You likely have gum recession, a condition that occurs when your gums recede below the enamel layer and expose the root surface of the teeth, Dr. Mitola says.

Gum recession can spell trouble for your dental health. That's because your teeth's root surface is thinner and contains less mineral content than enamel, making it more vulnerable to the formation of cavities, Dr. Mitola explains.

Factors like periodontal disease, ill-fitting dentures and tobacco use, among others, can increase your chances of gum recession, he says.

Teeth grinding, also known as bruxism, is a common habit that can hamper your oral health.

"The pressure applied to teeth when grinding can cause fractures in existing fillings and in the teeth themselves, making them more susceptible to cavity formation," Dr. Mitola says.

Grinding also causes gum recession, which, as we already know, can raise your risk of developing dental decay.

"Night guards — that are worn while sleeping — can be an effective way to minimize the negative effects of teeth grinding," Dr. Mitola says.

"Despite good oral health habits like brushing and flossing regularly, a poor diet will often lead to the development of dental decay," Dr. Mitola says.

You probably already know that sugary foods like juices, sports drinks, soda, candy and cereals can contribute to cavities. But Dr. Mitola says there are other types of foods that are bad for your teeth because they may increase your chances of developing tooth decay too, including:

• ‌Highly acidic foods:‌ When you have them often, foods with a high acid content (think: carbonated drinks like soda or seltzer, and tomato sauce) can cause tooth erosion, triggering the breakdown of enamel.
• ‌Sticky foods:‌ From peanut butter to dried fruit, sticky foods can get, well, ‌stuck‌ in the chewing surface of your teeth, which increases exposure time and the likelihood of developing cavities.
• ‌Starchy foods:‌ Refined carbohydrates like pasta, white bread and potatoes break down into sugar when exposed to the bacteria in your mouth.

"People with chronic dry mouth may be at a higher risk for tooth decay because they do not produce enough saliva, which naturally rinses off teeth," Dr. Mitola says.

Because dry mouth is often the side effect of another health-related issue, it's important to speak with your doctor or dentist who can help you identify the underlying cause.

To ease the discomfort of dry mouth in the meantime, you can use alcohol-free mouthwashes and lozenges that help keep the mouth moist, Dr. Mitola says.

Although rare, it's possible you're prone to cavities if you have tongue-tie. This (possibly hereditary) condition occurs when you're born with an uncommonly short, thick or tight band of tissue (called the lingual frenulum), which remains attached to the bottom of the tongue, according to the Mayo Clinic.

Because this condition restricts the tongue's range of motion, people with tongue-tie might struggle to clear away food debris from their teeth, per the Mayo Clinic. Consequently, this can contribute to the creation of cavities and gingivitis (inflammation of the gums).

If tongue-tie is causing severe problems that interfere with your ability to eat or speak, your doctor may recommend a surgical procedure to resolve the issue.

Acid reflux is a condition where your stomach acid flows backwards into your mouth, according to the Mayo Clinic. And this acid can break down your tooth enamel and cause damage, like cavities or decay.

Per the Mayo Clinic, other symptoms of acid reflux include:

• Heartburn
• Regurgitation of food or sour liquid
• Upper abdominal or chest pain
• Trouble swallowing
• Feeling of a lump in your throat

If you experience these symptoms alongside cavities, visit your doctor to see if reflux is the cause (and, if so, get treatment).

Vitamin D is an important nutrient for your oral health, as it supports tooth mineralization and strength, according to May 2020 research in ‌Nutrients.‌

But if you have a vitamin D deficiency, your teeth aren't getting the nutrients they need to stay strong and healthy. This can result in poor mineralization, enamel defects and, consequently, tooth damage, decay or cavities.

Visit your doctor to determine if a vitamin D deficiency is to blame for your cavities, and, if so, how best to treat it.

Beyond good oral hygiene habits like daily brushing and flossing, there are other preventative measures you can take to decrease development of tooth decay. Here, Dr. Mitola shares a few:

The best way to curb cavities is to have a discussion with your dentist. Together, you can review your risk factors and come up with a customized oral hygiene plan, Dr. Mitola says.

And of course, see your dentist regularly (every six months) to head off possible dental problems.

If you have a history of root cavities and gum recession, your dentist may prescribe a highly concentrated fluoride toothpaste to strengthen the exposed tooth below the enamel layer, Dr. Mitola says.

Topical fluoride varnishes also help reinforce the root surface of your teeth and can be applied by your dentist, he adds.

"It's good practice not to eat a snack after brushing at night," Dr. Mitola says. "Food that stays in the grooves of the teeth is more likely to cause cavities."

Especially steer clear of sugary, sticky, starchy and highly acidic foods before bed.

Staying hydrated can be a big help. Not only does drinking water wash away food particles, but it also helps dilute acids.

"Each time you eat or drink, the acidity level in your mouth rises," Dr. Mitola says. Remember, acid can erode your tooth enamel and increase the likelihood of tooth decay.

Sipping H2O with fluoride also strengthens your teeth and keeps your mouth moist, minimizing cavity-causing bacteria, according to the American Dental Association (ADA).

OK, so this technically counts as oral hygiene. Still, while you may be a frequent flosser, water flossing can take your gum-health game up a notch and help protect your teeth from cavities.

Water-powered flossers can be effective for people who often get food debris impacted between their teeth, Dr. Mitola says.

Because water flossers help with removing plaque, they may — in conjunction with twice-daily brushing — decrease your risk for cavities and gum disease, according to the ADA.

Water flossers can be an especially helpful option for people who find regular flossing difficult, including those with braces or bridgework, per the ADA.