Cavities, also known as dental caries, are structural damage in teeth caused by tooth decay. They arise when plaque—a sticky substance made of bacteria—hardens, turning into tartar.
This damages and breaks down the tooth enamel (the hard outer case of the teeth). Cavities can cause pain, tooth sensitivity, and other symptoms and are a leading cause of tooth loss.
Plaque and tartar buildup is mainly caused by poor oral hygiene. Preventing cavities involves developing habits that keep the teeth and mouth cleaner and reduce the chances of tartar developing.
The key to preventing cavities is taking steps to promote good oral hygiene and health. In addition to changing lifestyle habits, consistent dental cleaning practices and regular checkups are important. Dental procedures to protect the teeth can also help.
Regular Dentist Visits
Regular dental checkups and cleanings are cornerstones of cavity prevention. The only way to remove plaque and tartar buildup is with professional cleaning. Dentists can also screen for other risk factors, like gum disease. As with other health issues, the sooner your dentist detects tooth decay or cavities, the better the outcome.
You should have dental cleanings at least twice a year. At these appointments, the dentist performs scaling (using tools to scrape off plaque and tartar), takes dental X-rays, and performs a physical evaluation to look for oral issues that can lead to cavities.
Lifestyle Habits
Alongside regular dental care, healthy oral hygiene practices and lifestyle habits play a central role in preventing cavities. These include:
- Brush your teeth thoroughly at least twice a day, aiming for a minimum of two minutes total: 30 seconds each for the inside lower, outside lower, inside upper, and inside lower teeth
- Floss at least once a day
- Use fluoride toothpaste
- Stay hydrated and boost your fluid intake to reduce dry mouth
- Avoid sugary, starchy foods, such as hard candies, other types of candy, cookies, and sodas
- Limit snacking between meals, including foods that get stuck in teeth, like popcorn
- Limit fruit juice, which is especially important for infants or toddlers
- Quit or avoid smoking
- Change toothbrushes or toothbrush heads every three months
Complementary Methods
In addition to other methods of cavity prevention, oil pulling may help support dental health. This involves swishing coconut, sesame, or sunflower oil (about a tablespoon for adults) for 15-20 minutes and then spitting everything out.
Many people claim oil pulling fights off gum disease and tartar, but the evidence for this method is mixed. However, one review found daily oil pulling reduced bacteria levels in saliva. Effects on gum health and plaque buildup were inconclusive.
Dental Procedures
If cavities are severe or maintaining oral hygiene is difficult, dental sealants are another option for prevention, especially in children and adolescents. Dentists apply a special plastic coating to the chewing surfaces of teeth—typically molars and back teeth.
When applied to newly formed back teeth (which form at about age 6 and 12), sealants can prevent up to 80% of cavities for two years. Children ages 6-11 without sealants are nearly three times as likely to develop dental caries.
All people can develop cavities, and they’re very common. Researchers estimate that almost all adults develop at least one in their lifetimes. That said, certain populations are at increased risk:
- Younger children: Because their teeth are still forming, younger children are at increased risk for cavities. Some have weaker enamel, making them more susceptible. This population may also eat diets high in enamel-damaging foods and drinks and may not be able to care for their teeth very well.
- Older adults: Researchers estimate that about 96.4% of adults aged 65-74 have had tooth decay, cavities, tooth loss, and other cavity-related issues. This increased risk is primarily due to gum recession—a natural consequence of aging—and xerostomia (dry mouth). Dry mouth increases with age and can be a side effect of some medications. Without enough saliva in the mouth, the teeth are more vulnerable to bacteria and tooth decay.
- People with lower socioeconomic status: A large study found that people with lower incomes and levels of education were more likely to develop cavities. This effect was more pronounced in high-income, developed countries. People with lower socioeconomic status tend to have less access to necessary dental products and dental cleanings, raising their risk. This population is also at higher risk for behaviors harmful to teeth, like smoking or alcohol use.
- People with disability: Physical or mental disability can raise your cavity risk. Physical disabilities or conditions like arthritis (joint pain) can make brushing and flossing difficult and painful, leading to poorer dental health. This is also the case with neurological diseases like cerebral palsy or conditions impacting cognitive (thinking, reasoning, and planning) function, such as dementia. The latter are also less likely to seek regular dental care.
Factors that raise your risk for cavities may be in or out of your control. In addition to your age, health, and economic status, your diet, habits, and body weight may affect your risk.
- Certain eating patterns: Simple carbohydrates, such as those in starchy or sugar-rich foods and drinks, feed the plaque-forming bacteria in your mouth. Frequently consuming sodas, juices, cookies, cakes, candy, gum, or other sugary foods increases your risk of developing cavities. This is especially true if you don’t get enough fresh fruit, vegetables, and whole grains in your diet.
- Not enough fluoride: Fluoride is a mineral that supports the health of tooth enamel, making it stronger and more resistant to plaque. It’s found in many toothpastes, and most water systems in the United States also add it to drinking water. People who don’t use fluoride toothpaste or live in places with untreated water have an increased risk of cavities.
- Smoking status: Another habit that significantly raises your risk of cavities is smoking. Among other health effects, tobacco smoke causes dry mouth, which allows bacteria to develop and do damage. Smoking can also affect necessary immune function in the mouth, allowing plaque to harden into tartar and cause tooth decay.
- Too much or not enough weight: Research has found that weight status can influence dental health. People who have excess weight or are obese—defined as a body mass index (BMI) above 30—are at increased risk for cavities. Researchers looking at tooth decay in children up to age 18 also found being underweight can increase your risk.
Genetics play a significant role in dental health. If you have a family history of cavities and tooth loss, your own risk is higher. In one study, monozygotic (identical) twins—with the same genes—had very similar rates of cavities. There were some differences among dizygotic (fraternal) twins—who share some but not all DNA—and even more among non-twin siblings.
Researchers have traced this connection to mutations in three sets of genes passed down from parents. One set causes lower saliva production, increasing susceptibility to gum disease, tartar, and cavities. Mutations in another group of genes cause weaker tooth enamel, raising the risk of decay. Another set of genes can affect the activity of the immune system in the mouth.
If you have or think you have a cavity, it’s important to know when to call your dentist. Signs you need dental help include:
- Pain when eating, applying pressure, brushing, flossing, or without a recognizable cause
- Sensitivity in your teeth to hot, cold, or wind
- Red, swollen, or bleeding gums
- Chronic bad breath
- Loose or drifting teeth or changes in your bite
- Blood in the gums after brushing
When seeing your dentist for a cavity or oral symptoms, it’s important to discuss preventative care. If you’re diagnosed with gingivitis (gum inflammation) or periodontitis (gum disease and infection)—risk factors for cavities—you may need a dedicated treatment called root scaling, as well as more frequent checkups and cleanings.
In addition to treating any cavities, dentists and oral hygienists can deep clean your teeth and remove plaque and tartar. These treatments also treat gum disease, protecting the teeth from tooth decay.
Cavities are holes in teeth caused by tooth decay. Eating a diet high in sugars and starches, smoking, and being older or younger are among the risk factors for this condition.
Cavity prevention primarily involves maintaining good oral hygiene habits, such as brushing and flossing twice daily. Avoiding manageable risk factors, like smoking and sweet foods or drinks, can also help.
It’s also critical to have regular dental checkups and cleanings.
