I brush and floss, but still get cavities. Why?

Are you devoted to your dental hygiene regimen, following all the recommendations, but still getting cavities?  Brushing and flossing are essential to good oral health, but there are other factors that may be contributing to your high cavity rate.

But first let’s reviews what causes cavities to form:

What causes cavities?

 Your teeth are covered by a sticky film of bacteria, which is called plaque. After a meal or snack, the bacteria turn the sugars in foods and drinks into acid. The acid demineralizes the enamel on teeth. Once the demineralization progresses through the entire enamel layer the bacteria reach the dentin. Bacteria can digest the dentin so once the bacteria reach the dentin the tooth must be drilled to remove the infected tooth structure.

But I brushed and flossed!

Yes, brushing and flossing regularly is an essential key to maintaining oral health. But there are other factors that might be contributing to your high cavity count:


You know those chewy gummy bears you can’t get enough of? Noshing sugary snacks and guzzling sugary drinks throughout the day increases your chance of tooth decay! Every time you have food with sugar, the plaque becomes acidic for a couple of hours accelerating demineralization. Saliva neutralized the acid but needs time so frequent snacking doesn’t give your saliva time to do its job.

Choice of toothpaste

Make sure your toothpaste has the ADA seal of approval. To get that seal, manufacturers demonstrate the efficacy of their fluoride which hardens enamel, making it more resistant to acid demineralization. Fluoride can also reverse tooth damage by aiding in enamel remineralization.

Your tooth anatomy

If you have crowded teeth, it’s harder to access some of the areas where plaque and bacteria are lurking. Back molars and premolars, in particular, contain crannies and grooves that trap food and are difficult to clean.

“Consider Invisalign or some other orthodontic treatment to better align your teeth which reduces plaque accumulation and gives you better access to the surfaces that retain plaque,” suggests our own Dr. Rebecca Koenigsberg.

Dry mouth

Saliva is the mouth’s natural first line of defense, washing away plaque and bacteria and re-mineralizing enamel. It also neutralizes the acids that can attack your teeth. Many medications reduce saliva resulting in dry mouth. This could make your mouth vulnerable to decay.

Chewing sugarless gum or sucking on a sugarless hard candy can increase saliva flow and help rinse away sugars. Dr. Andrew Koenigsberg, of Gallery57Dental suggests choosing something not only sugarless but neutral and not acidic like a lemon or orange. There are products with xylitol which may have additional anti-cavity properties.

Brushing and flossing incorrectly

It’s all about removing as much of the plaque as you can so being effective is more important than an arbitrary amount of time. Review the basics with your hygienist to help your toothbrush and floss do the work required to keep you cavity-free.

“It is recommended to floss first and then brush. The rationale is that you loosen any plaque between the teeth with floss, then you brush it all away with thorough brushing and , of course, a good rinse,” asserts Dr. Robert Rawdin of Gallery57Dental.

“Also, the use of a mouth wash that has fluoride in it can help significantly. This is very helpful for those who have a high decay rate.”


Some people have a more acid saliva. While you  can not change this you need to be extra meticulous in plaque removal if you have a more acidic oral cavity.

Maintaining good oral hygiene with regular brushing and flossing is essential.   But being aware the various factors that might sabotage your efforts is equally important. By following all the dental health recommendations and working together with your dentist, we can prevent cavities before they start! To schedule a visit, call us today at 212.246.8700. Follow Gallery57Dental on Facebook here!

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156 W. 56th Street, Suite 903
New York, N.Y. 10019

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