Step #1: Evaluate what you are eating and drinking.
There are a lot of different factors that go into whether you develop cavities. These
include your eating habits, brushing and flossing, genetics, and medications you are
taking. Out of all of these, none is so important as your diet. If you starve the bacteria
that cause cavities then you won’t develop them.
The rule of thumb is that anything that contains sugar (or breaks down in sugars) or
anything acidic will cause cavities. Let’s take a look at some of the most common culprits.
Cavity Causing Foods:
• Anything with sugar
• Breakfast cereals
• Sauces and syrups such as tomato based pasta sauce and ketchup
• Fresh fruits, especially citrus
• Dried fruits
Not to be outdone, here are some of the most common drinks that cause cavities.
Cavity Causing Drinks:
• Regular Sodas (highly acidic and massive amounts of sugar)
• Diet Sodas (highly acidic)
• Juice (acidic and lots of sugar)
• Sweetened Iced Teas (sugar)
• Coffee With Sweeteners (sugar)
Now you may be thinking, “If I cut all of those out of my diet, I won’t have anything to eat
or drink!”. No worries! I’m not going to ask you to do that, which brings us to Step #2…
Step #2: How Often You Consume These Foods Is More Important Than How Much
So here is the good news. You don’t have to stop eating all of those foods I just
mentioned. You just have to watch how often you consume them. Every time you eat or
drink something that causes cavities it puts your mouth into a cavity promoting state.
This state lasts for 20-30 minutes after you’ve had something to eat or drink. If you are
snacking or sipping on these products all day long then your teeth never get a chance to
An easy lifestyle change to make is to only eat at specific times during the day. I
personally recommend that you stick with three main meals and two quick snack times
during the day. You can eat or drink anything you want at these times but when you’re
done, no going back for more later!
This especially applies to sugary drinks. When I see a patient who has a lot of large
cavities, I can almost guarantee that they have been sipping on soda or fruit juice all day
long. I’d estimate that 95% of people I see who have 10+ cavities have a major soda habit.
If you’re one of those people who carry a screw top bottle of soda, fruit juice, or iced tea
around with them all day, the best thing you can do is stop that habit immediately!
If you stick to a healthy pattern of eating and drinking your mouth has far more time to
spend in a cavity prevention state than in a cavity promoting state.
Step #3: Cleaning Your Teeth Effectively
I see a lot of people with cavities who say, “But I brush and floss my teeth all the time!”. If
you are one of these people, go back to steps #1 and #2 and make sure you doing those right first. If you brush and floss well but have poor eating habits, you’ll still develop cavities.
Once you’ve got your diet under control, it is time to make sure you’re cleaning those
teeth well. The point of keeping your teeth clean is so the bacteria that cause cavities and
gum disease can’t get out of control. Brushing and flossing disrupts the bacteria and
make it so that they have to start all over again.
There are a couple of easy steps to make sure you’re getting a good clean…
• Floss (or use an interproximal brush or Waterpik) before you brush. You’ll floss
more often if you do it this way and it allows your toothpaste to get into those
areas between the teeth when you do brush.
• Brush for two minutes, once in the morning and once right before bed.
• Consider getting an electric toothbrush. They work much better than a regular
Step #4: Chewing Gum
For most (but not all) people following steps 1-3 is enough to ensure a cavity free life. Steps 4-7 are all
about the extra things you can do to decrease your risk of cavities even further.
The first of these is to start chewing gum (sugar free) throughout the day. Chewing gum
has a lot of benefits for your teeth including…
• Chewing gum increases your saliva flow. The biggest benefit to come of this is an
increased buffering capacity of your mouth. What this means is that your mouth
can bring it’s pH back to a normal level much more quickly after eating or drinking
something acidic. This is especially important if you drink soda, fruit juice, or
sports drinks on a regular basis as all of these tend to be quite acidic.
• Chewing gum reduces cavities. Most of this is a result of the increased saliva flow
and buffering capacity that we talked about before. There are huge decreases in
cavity development with consistent chewing of gum, especially after meals.
• Chewing gum reduces plaque on your teeth. This is a result of the increased saliva
flow as well as the mechanical action of the gum on your teeth. It’s estimated that
people only clean 35-40% of the plaque off their teeth when brushing. Gum can
definitely help improve this for you. Reduced plaque will help keep your gums
• Chewing gum reduces bad breath. This effect comes from the increased saliva flow
as well as the flavorings in the chewing gum. This effect tends to be temporary as
researchers found that the odor returned to regular levels within three hours of
stopping chewing the gum.
• Chewing gum with baking soda as an ingredient can reduce stains. Arm and
Hammer makes a couple of gum products containing this. The effect can be seen
after about 4 weeks of chewing with it.
• Chewing gum helps with dry mouth. As long as your salivary glands haven’t been
destroyed by radiation or other rare medical conditions, chewing gum with
increase your saliva flow helping your mouth feel dry. People with dry mouth tend
to develop cavities much more quickly so chewing gum can be an easy solution to
significantly reduce that risk.
Step #5: Xylitol
Xylitol is a sugar substitute. The really interesting thing about xylitol is that it actually
protects your teeth your against cavities. The bacteria that cause cavities can’t feed on
xylitol and actually struggle to grow in its presence.
For the full effect of xylitol it is recommended that you consume approximately 6 grams
a day. This comes out to about 6-12 pieces of xylitol sweetened gum, mints, or candy. I’ve
found that chewing gum sweetened with xylitol is the easiest way to do this and you’re
knocking out two of these steps in one.
Some of the major companies that sell these products include Dr. John’s Candies, XLear,
Epic Dental, and Xyloburst. I’ve tried all of these different products and like them all.
Step #6: Fluoride
Every time your mouth goes into a cavity promoting state, it starts to pull some of the
minerals out of the outer enamel layer of your teeth. This is known as demineralization
and it is the first step in the process of developing a cavity. When you’ve lost enough of
these minerals the enamel actually starts to break apart and you’ve got a full blown
cavity on your hands. In the early stages of the process, this damage can actually be
reversed. Fluoride is one of the major ways we do this.
Enamel is made primarily of crystals of hydroxyapatite. When fluoride is present, these
crystals take it up and create a new type of crystal known as fluoroapatite. These
fluoroapatite crystals are more resistant to breakdown.
The easiest way to get fluoride is to brush with a fluoride containing toothpaste every
Step #7: Professional Treatments
If you’ve been consistently following all of the previous six steps but find that you’re still
getting cavities occasionally (it shouldn’t be often) then it may be time to look at a couple
of professional interventions.
The easiest of these would be to get started on prescription strength fluoride toothpaste.
Normal toothpaste you can buy at the store has around 1000-1500 parts per million
(ppm) of fluoride. Prescription strength fluoride toothpaste has 5000 ppm of fluoride and
will reduce your risk of cavities even further. A $20 bottle of this toothpaste usually lasts
6 months and pays for itself 5 times over if it reduces the number of cavities you get by
Another option is to have your dentist make you fluoride trays. These are very similar to
the trays used for whitening your teeth except you put a fluoride solution in them
instead of whitening material. If you already have whitening trays ask your dentist about
getting a fluoride product to put in them instead. The trays will keep the fluoride in close
contact with your teeth and allow them to take it up much more easily.
Work on implementing these changes in your life one at a time. I’d recommend going
step by step and adding something new once a week or whenever you feel like you’ve got
a good handle on the previous step. Once you’re consistently doing these things, you
have to give it some time. Your first dental visit after these changes you may still have
some cavities. The cavities probably started before you created better habits and will still
need to be fixed. Once all these cavities have been fixed though, it is very unlikely that
you’ll develop cavities at any significant rate going forward.