When it comes to dental hygiene, you always bring your A-game: You're a flawless flosser and a brilliant brusher. Which is why you're also probably stumped, because you keep getting cavities.
So what gives?
Hate to break it to you, but brushing and flossing are only part of the cavity-fighting battle. Yep, even with a solid oral health regimen, it's still possible to develop dental issues like tooth decay.
Before you throw up your hands and toss your toothbrush in the trash, let's be clear: Proper oral hygiene habits are essential for healthy teeth and gums.
And they're especially important for people who are prone to cavities.
So, continue brushing twice daily and flossing regularly. With that in mind, we spoke with dentist David Mitola, DDS,
New York State Dental Association spokesperson, to understand why cavities can happen even when you take good care of your teeth, and what you can do to reduce your risk.
If cavities run in the family, you might wonder whether your DNA has something to do with your dental problems.
So, can you be born with bad teeth?
The answer is yes, to a degree. While things like your oral hygiene and diet (more on this later) can significantly contribute to (or curb) cavities, "research shows that genetics can also play a role in your risk for developing tooth decay," Dr. Mitola says. For example, "Genes associated with cavities are most commonly involved with enamel formation, saliva production or immune response," Dr. Mitola says. Genetics may also, in part, determine the type of bacteria that live in your mouth, which can make you (more or less) susceptible to cavities and gum disease, he adds.
That said, "The role of genetics in dental disease is not completely understood and further research will allow for better predictability in prevention and treatment," Dr. Mitola says.
Have you noticed your gum line getting lower lately? You likely have gum recession, a condition that occurs when your gums recede below the enamel layer and expose the root surface of the teeth, Dr. Mitola says.
Gum recession can spell trouble for your dental health. That's because your teeth's root surface is thinner and contains less mineral content than enamel, making it more vulnerable to the formation of cavities, Dr. Mitola explains.
Factors like periodontal disease, ill-fitting dentures and tobacco use, among others, can increase your chances of gum recession, he says.
Teeth grinding, also known as bruxism, is a common habit that can hamper your oral health.
"The pressure applied to teeth when grinding can cause fractures in existing fillings and in the teeth themselves, making them more susceptible to cavity formation," Dr. Mitola says. Grinding also causes gum recession, which, as we already know, can raise your risk of developing dental decay. "Night guards—that are worn while sleeping—can be an effective way to minimize the negative effects of teeth grinding," Dr. Mitola says.
"Despite good oral health habits like brushing and flossing regularly, a poor diet will often lead to the development of dental decay," Dr. Mitola says.
You probably already know that sugary foods like juices, sports drinks, soda, candy and cereals can contribute to cavities. But Dr. Mitola says there are other types of foods that are bad for your teeth because they may increase your chances of developing tooth decay too, including:
You don't have to avoid these foods completely, but consider limiting them in your diet if you're prone to cavities. And when you do eat them, try to clean your teeth as soon as possible afterward.
"People with chronic dry mouth may be at a higher risk for tooth decay because they do not produce enough saliva, which naturally rinses off teeth," Dr. Mitola says. Because dry mouth is often the side effect of another health-related issue, it's important to speak with your doctor or dentist who can help you identify the underlying cause. To ease the discomfort of dry mouth in the meantime, you can use alcohol-free mouthwashes and lozenges that help keep the mouth moist, Dr. Mitola says.
Although rare, it's possible you're prone to cavities if you have tongue-tie. This (possibly hereditary) condition occurs when you're born with an uncommonly short, thick or tight band of tissue (called the lingual frenulum), which remains attached to the bottom of the tongue, according to the Mayo Clinic. Because this condition restricts the tongue's range of motion, people with tongue-tie might struggle to clear away food debris from their teeth, per the Mayo Clinic. Consequently, this can contribute to the creation of cavities and gingivitis (inflammation of the gums). If tongue-tie is causing severe problems that interfere with your ability to eat or speak, your doctor may recommend a surgical procedure to resolve the issue.
Beyond good oral hygiene habits like daily brushing and flossing, there are other preventative measures you can take to decrease development of tooth decay. Here, Dr. Mitola shares a few:
The best way to curb cavities is to have a discussion with your dentist. Together, you can review your risk factors and come up with a customized oral hygiene plan, Dr. Mitola says. And of course, see your dentist regularly (every six months) to head off possible dental problems.
If you have a history of root cavities and gum recession, your dentist may prescribe a highly concentrated fluoride toothpaste to strengthen the exposed tooth below the enamel layer, Dr. Mitola says.
Topical fluoride varnishes also help reinforce the root surface of your teeth and can be applied by your dentist, he adds.
"It's good practice not to eat a snack after brushing at night," Dr. Mitola says. "Food that stays in the grooves of the teeth is more likely to cause cavities." Especially steer clear of sugary, sticky, starchy and highly acidic foods before bed.
Staying hydrated can be a big help. Not only does drinking water wash away food particles, but it also helps dilute acids. "Each time you eat or drink, the acidity level in your mouth rises," Dr. Mitola says.
Remember, acid can erode your tooth enamel and increase the likelihood of tooth decay. Sipping H2O with fluoride also strengthens your teeth and keeps your mouth moist, minimizing cavity-causing bacteria, according to the American Dental Association (ADA).
OK, so this technically counts as oral hygiene. Still, while you may be a frequent flosser, water flossing can take your gum-health game up a notch and help protect your teeth from cavities.
Water-powered flossers can be effective for people who often get food debris impacted between their teeth, Dr. Mitola says. Because water flossers help with removing plaque, they may — in conjunction with twice-daily brushing — decrease your risk for cavities and gum disease, according to the ADA.
Water flossers can be an especially helpful option for people who find regular flossing difficult, including those with braces or bridgework, per the ADA.
Tooth pain can take many forms: Gnawing or throbbing. Sharp or shooting. Sore or radiating. But one thing is for sure — a toothache can make you miserable.
But why do your teeth hurt, exactly?
Here's what causes tooth pain in general: The innermost layer of your teeth—called the pulp—contains large blood vessels and nerves, which are some of the most sensitive in your body, according to the Cleveland Clinic.
So when they become irritated, inflamed or infected, you're likely to experience a painful twinge in your teeth. Here, New York State Dental Association member Christopher Calnon, DDS, shares some of the most common reasons why your teeth hurt along with tips to help you get to the root of your dental discomfort.
If you have a toothache, see your dentist right away. The longer you wait, the greater the problem — and the pain — can become.
Superficial decay — which begins on the outside surface of the teeth, as tartar buildup or calcium deposits — generally causes no symptoms, Dr. Calnon says. But sudden tooth pain can be a sign you have a cavity, because as the decay progresses in size and spreads inward to the inner core of the tooth (nearing the nerve), it can trigger a toothache or symptoms like sensitivity to sweets, heat or cold (more on this later), he says.
Fix it: A smaller cavity (i.e. superficial decay) is usually treated by placing a filling (a material used to fill in the area where your dentist removes the rot), while a tooth with larger decay may require a crown (a protective cap placed on top of the damaged tooth), Dr. Calnon says. "But if the decay progresses to a point where it impacts the nerve of the tooth, it can cause infection, which leads to the need for either a root canal or extraction of the tooth," he says.
Why Do Your Teeth Hurt When You Run?
Cavities may also be to blame for tooth pain when you run (or do other exercise), as the repetitive movement can trigger pulsating pain in the affected area. Outside factors—like exposure to cold weather— can likewise make a cavity ache.
Dental fillings don't last forever. Unfortunately, due to time or habits (like grinding), they can become damaged or loose. "Damaged fillings can lead to big problems, and patients may not know about it until it's too late," Dr. Calnon says. In other words, until they experience excruciating pain.
"A healthy filling has a good seal between the tooth and the filling itself," Dr. Calnon says. This prevents bacteria from getting underneath and causing more decay.
"But if a filling is damaged, the seal may be compromised," Dr. Calnon says. This means bacteria may enter and create decay. The problem is, because the filling is still in place, decay may go undetected and grow, he adds.
Fix it: Going to regular dental check-ups is a great way to catch this problem before it balloons into a bigger issue. Your dentist will want to replace the filling "as soon as possible to prevent more decay from happening," Dr. Calnon says.
Have you ever been curious why your teeth hurt when you're sick or have a cold? Believe it or not, the reason all your teeth ache could be a side effect of sinus issues. "Sinus infections can often mimic a toothache, especially on upper back teeth," Dr. Calnon says. That's because "pressure in the sinus cavity can be exerted on the nerves of nearby teeth, creating pain and sensitivity," he explains.
Fix it: Sinus infections are usually viral and clear up on their own in seven to 10 days, but you can try a few natural remedies to help you feel better in the meantime. If your symptoms don't improve in about 10 days, see your doctor, who may prescribe an antibiotic if they determine you're dealing with a bacterial infection. "But if the sinus pressure is due to things like seasonal allergies, over-the-counter decongestants can sometimes help," Dr. Calnon says.
If you're wondering why your teeth hurt at night or when you wake up, it could be the product of bruxism, a condition that happens when you unconsciously grind or clench your teeth. "Grinding and clenching are very common and usually done at night when jaw movements cannot be consciously controlled," Dr. Calnon says. Some people also grit their teeth during high-exertion activities like exercise, which is why your teeth may hurt when you bite down.
The problem is, "this [pressure] places far more force on the teeth than they are designed to receive," producing pain and sensitivity, Dr. Calnon says. Clenching can even cause cracked or chipped teeth and/or wear down your tooth enamel.
According to Johns Hopkins Medicine, other signs and symptoms of bruxism include:
Fix it:
To break the habit of bruxism, your dentist may make you a custom mouthguard to wear at night, Dr. Calnon says. These mouthpieces help absorb the force of biting and decrease damage to the teeth, per Johns Hopkins Medicine. (If a custom guard isn't in the budget, you can consider buying an over-the-counter night guard.)
Learning to incorporate stress-reduction techniques is also an essential part of treatment, as tooth-grinding and stress have a strong correlation, Dr. Calnon says.
If you've ever winced after sipping on an icy slushy because all your teeth hurt suddenly or had front tooth pain after biting down on an ice cream sandwich, you've likely experienced the discomfort of cold sensitivity. Cold sensitivity is extremely common and has several possible causes. If the sensitivity is brief in duration and minor in severity, it's likely related to tooth grinding or recession of the gum tissue, Dr. Calnon says. "Cold sensitivity that lingers for several minutes or is severe in nature can indicate a bigger problem, like decay or tooth fracture," he says. Fix it: "Controlling the grinding with a mouthguard or using sensitivity toothpaste for gum recession are typical first-line treatments," Dr. Calnon says. But if you're dealing with decay or a tooth fracture, treatment options may include placement of a filling, a root canal or, possibly, extraction of the tooth, depending on the diagnosis, he says.
Just like a broken bone, a crack in your tooth can create pain. A fractured tooth can occur due to something simple like biting into a hard candy or something more serious like a sports injury, according to the Cleveland Clinic.
Tooth grinding and clenching also increase your chances for a fracture. "Tooth fractures have a wide range of severity based on the size and depth of the fissure," Dr. Calnon says. "Many teeth with superficial fractures cause no symptoms."
But as a fracture grows, it can become painful. "This happens when either a piece of the tooth breaks off or neighboring pieces of the same tooth are forced in opposite directions when biting down," he says.
Fix it: To fix a tooth fracture, your dentist may place a filling or a crown on the tooth. In some cases, if the fracture extends deeper into the tooth, it may require a root canal or extraction, Dr. Calnon says.
Visit your dentist right away if you fracture your tooth. In the meantime, you can ease tooth pain by using an ice pack, rinsing your mouth with salt water and taking over-the-counter pain medicine, per the Cleveland Clinic.
Your gums could be the reason why your teeth hurt. Yep, mild forms of gum disease like gingivitis can initiate inflammation and irritation of the gum tissue (think: red, swollen or itchy gums that bleed when you brush your teeth), Dr. Calnon says.
And if you're wondering why your teeth hurt when you eat, that's because gingivitis can also create sensitivity to hot or cold foods and tenderness or pain when chewing (which is why all your teeth may hurt on one side), according to the Cleveland Clinic.
Severe cases of gum disease can even lead to infections of both the gums and the surrounding teeth, Dr. Calnon says. What's worse, when not properly treated, gum disease can weaken the bone structures that support the teeth, causing them to become loose, according to the Centers for Disease Control and Prevention.
Fix it: Mild gum disease is best managed with proper oral hygiene practices and regular dentist visits (including professional cleanings), Dr. Calnon says.
"Depending on the severity of gum disease, treatment may also include deep cleanings, gum surgery or even removal of the teeth," he adds. To avoid gum problems, prevention is key.
Here are some tried-and-true tips to counteract gingivitis, per the Cleveland Clinic:
Sometimes seemingly harmless habits can damage your gums, like brushing your teeth too hard. Avoid hurting your gums by using soft-bristled toothbrushes and only applying light pressure while you scrub.
An abscessed tooth can be agonizing. An abscess is a painful pocket of pus caused by a bacterial infection inside the tooth, according to the Cleveland Clinic.
"Tooth abscesses often result from large decay that has entered the nerve tissue of the tooth," Dr. Calnon says.
"The abscess can travel beyond the tooth and into the surrounding tissues, leading to swelling and significant pain." Per the Cleveland Clinic, other signs of an abscess besides tooth pain include:
Fix it:
"Tooth abscesses should be treated immediately," Dr. Calnon says. Initial treatment usually involves draining the abscess and/or taking antibiotics, but sometimes an abscess may require a root canal or extraction of the tooth, he says.
