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"I brush my teeth--Why do I still have cavities?"

Guest author: Eugene D. Tunick, D.D.S.

Dental caries (decay) has multiple causes. You need to understand the whole picture to avoid the damage, discomfort and unnecessary expense involved. There are at least six factors which operate (positively or negatively) in the development of decay. When all the above factors operate positively, there is no decay. In many people, only one or two factors are needed to prevent decay, in others everything has to be "just right".


The most significant factor of all. Some people are "health conscious" and have grown up in families where emphasis was placed on a healthy lifestyle. They aren't neurotic about healthy living, but do believe in prevention. Other people neglect themselves and wonder why they aren't as healthy as they should be. (Example: smoking) Low self-esteem and apathy can play a dramatic role in some people's attitudes toward dental health. Tobacco, alcohol and drugs drain off funds which could be used for health care.

Lifestyle factors influencing dental health are:

Excessive sweets and snacks?? Frequent snacking? Any baked goods can cause decay if not brushed away quickly.
Oral hygiene
Brushing: Frequency, timing, duration, technique. Floss is essential. Gum stimulators and water irrigators help.
A balanced diet is as necessary for dental health as it for the rest of the body.

Professional Dental Care

Regular cleanings and checkups can maintain a basically healthy mouth at reasonable cost, but 5O% of Americans don't go to the dentist regularly.

Many people always demand the cheapest possible treatment. That's exactly what they get. It takes its toll after a while.


No subject has ever been researched as thoroughly as fluoride. Every responsible organization involved with dental health supports the use of fluorides. There is no controversy on this subject among dental health experts. Fluorides, in various dosage forms, applied at home on a regular basis, drastically reduce decay at negligible cost.

General Health and Medication

Systemic diseases can promote decay directly or indirectly, e.g., dry mouth caused by diuretics (drugs which are used to control high blood pressure), promotes decay and gum disease.

Occlusion (Bite)

Missing, uneven, and/or crowded teeth can contribute to decay by making oral hygiene difficult.


"Bad teeth run in my family, no wonder I have so many cavities".

Most of the time, it's bad habits and not bad genes that are the problem. However, it's possible to overcome the handicap of truly "bad" teeth completely. Heredity is usually the least important factor in dental decay.


A thorough medical history, dental and oral exam, x-rays (and frequently other exams or tests) are needed to make it possible for the dentist to evaluate all the factors involved, and to formulate an effective treatment and prevention program. Finally, keep in mind that you are responsible for your dental health. The dentist must be capable. He must give you adequate information. You must make the decisions. Demand care of the highest quality and maintain it well. You will enjoy the wonderful feeling of well- being that comes from knowing that you have a healthy mouth and an attractive smile.

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