Understanding Tooth Decay Despite Good Oral Hygiene: Effective Strategies to Prevent Cavities

Many individuals wonder why they still get cavities despite brushing twice a day, flossing regularly, and using mouthwash. This article explores the underlying factors contributing to dental caries and offers practical solutions to enhance oral health.

Factors Contributing to Tooth Decay

Tooth decay is influenced by various factors that can undermine the effectiveness of good oral hygiene practices:

1. Tooth Formation

Some people are genetically predisposed to have weaker enamel due to illnesses or poor nutrition during tooth formation. Conditions like hypo-mineralisation can make teeth more susceptible to decay. Additionally, teeth with deep pits and grooves are more prone to accumulating bacteria and food particles, leading to cavities.

2. Diet

A diet high in refined carbohydrates, sugar, and acidic foods and drinks increases the risk of decay. Furthermore, choosing non-fluoridated toothpaste and drinking non-fluoridated water can weaken teeth, making them less resistant to tooth decay. Another critical factor is the timing of food intake, especially before bed.

3. Saliva

Saliva acts as a buffer to neutralise acids in the mouth and help prevent tooth erosion. People with dry mouth, often caused by medical treatments such as chemotherapy or illicit drug use, are more prone to decay. Artificial salivary substitutes, special toothpastes, and topical fluoride products can help prevent dental caries in such individuals.

4. Ineffective Oral Hygiene Techniques

Thoroughly cleaning all surfaces of the teeth and gum margins is crucial to remove debris and plaque. Inadequate techniques or improper timing of brushing can leave bacteria and food particles behind, leading to decay.

Strains of Streptococcus Mutans and Their Role in Tooth Decay

Streptococcus mutans, a bacterium responsible for tooth decay, has 39 different strains, some of which are more harmful than others. Changing the bacterial strain population can help prevent cavities. Current dental practices focus on removing decay and restoring teeth, but this may not be enough. Dentists often rely on Clinical Protocols for Caries Management by Risk Assessment (CAMBRA) for more effective strategies.

Practical Solutions to Prevent Tooth Decay

Here are some evidence-based strategies to reduce the risk of tooth decay:

1. Maintain Good Oral Hygiene

Continue to brush twice a day and floss regularly. However, these practices alone may not prevent cavities as they rely on mechanically removing bacteria, which is difficult to do completely.

2. Use Fluoride Efficiently

Fluoride treatments at the dentist can reduce cavities, but results are not always satisfying. Using fluoride varnish or a prescription mouth rinse like Peridex can be beneficial, but their effectiveness varies. Chlorine laundry bleach diluted in water has been shown to effectively control the most aggressive strains of Streptococcus mutans.

3. Use Xylitol

Chewing gum with xylitol sugar can help reduce the population of harmful bacteria. Start chewing gum three times a day, preferably after meals. Xylitol is a natural sugar substitute that is bactericidal.

4. Rinse with Bleach Solution

Create a 1:160 dilution of chlorine laundry bleach in water. Rinse with one ounce of this solution once a week for one minute. Use a WaterPik with a reservoir to simplify this process, but rinse the reservoir before use to avoid any residual bleach.

Remember, while these strategies can significantly reduce the risk of tooth decay, it is essential to maintain regular dental check-ups and consult your dentist for personalized advice.

Keywords: tooth decay, cavities prevention, Streptococcus mutans, dental caries