How Do I Prevent Cavities as an Adult?

You had perfect teeth as a kid. You’ve brushed twice a day for thirty years. At the dentist, a new gray shadow on an X-ray: a cavity at the gum line of a tooth you’ve never had a problem with. You’re asking what you did wrong.

How a cavity forms

The ADA¹ says plaque, a sticky film of bacteria, constantly forms on your teeth, and when you eat sugary foods or drinks, the bacteria produce acids that attack enamel and eventually leave small holes. The National Institute of Dental and Craniofacial Research (NIDCR)³ says bacteria make acids from the sugars and starches in food and drinks. The CDC² adds that your saliva clears away the acid and helps repair the enamel, and if the repair isn’t fast enough, bacteria get inside the tooth. See waking up with a dry mouth.

Why adults get them

The NIDCR³ says older adults are vulnerable because receding gums let decay-causing bacteria reach the tooth’s root. The ADA¹ says gum recession exposes the softer root, and that weakened fillings can leak and harbor bacteria. The CDC² says nearly all adults aged 65 and older, 96%, have had a cavity. See bleeding gums and sensitive teeth.

What prevents them

The ADA’s¹ list:

• Fluoride toothpaste, twice a day. It suggests asking your dentist about supplemental fluoride.
• Balanced meals and limited snacking.
• Sealants. It says to ask about a plastic protective coating on the back molars, where decay often begins.
• Regular professional cleanings and exams.
• Daily cleaning between teeth with floss or an interdental cleaner. See flossing.

The NIDCR³ recommends fluoride from toothpaste, tap water or rinse, brushing and flossing, limiting sugary foods and drinks, avoiding tobacco, and regular dental visits. The CDC² adds that fluoride toothpaste significantly reduces cavities, and that avoiding sugary or acidic foods and drinks between meals helps. For mouthwash, see our article.

Can a cavity heal?

The NIDCR³ says early decay can be reversed with fluoride, but once a cavity forms, a dentist removes the decayed tissue and fills the tooth.

When it’s spreading

The NIDCR³ says early decay typically gives no warning. As it advances, you may notice sensitivity to sweets, heat or cold. Severe infection can cause an abscess, a pocket of pus, with pain, facial swelling and fever.

Cost

The CDC² says the HHS website lists low-cost services, and that dental schools often provide care based on ability to pay.

The play

Try this: a mouth check and a plan

Look at your teeth in good light. Note any dark spots, chips, sticky or leaking fillings, or gum recession.

Switch the habits you can: brush twice a day with fluoride toothpaste, clean between your teeth once a day, and trim between-meal snacks and sugary or acidic drinks.

Book a checkup if it’s been a while, and ask your dentist about sealants and fluoride.

When to get checked

Book an appointment if any of these fit:

• A tooth is sensitive to sweets, heat or cold
• You see a dark spot, a hole or a leaking filling
• Your gums have receded
• Your mouth is often dry
• You haven’t had a dental exam in a long time
• You have a toothache that doesn’t go away, or swelling or fever with tooth pain. Get urgent care for those.

Early decay can be reversed, and later decay is fixable. Both are easier to deal with sooner.