8 Ways to Never Get a Cavity or Lose a Tooth - Evidence-Based

Everything you wanted to know about dental health and hopefully preventing dentures in the future.

UPDATED: September 18, 2025

Welcome to the Healthy Aging Newsletter, a free publication that turns trustworthy medical research into simple habits so adults in their 30s and 40s can stay healthy and avoid common chronic conditions.

Fluoride? Dental cleaning? Screening X-rays? Hard bristles? Toothpaste type? Let’s dive into everything you need to know to keep your teeth for as long as possible. Saving you money and heartache.

Everything here is evidence-based. I don’t make anything up.

1. Your Diet is The Biggest Factor

What is the most effective way to have super healthy teeth? By having a healthy diet.

What’s a tooth-healthy diet? The same as a heart-healthy, brain-healthy, bone-healthy, and longevity-healthy diet. They are all the same.

More sugar, more alcohol, more acidic sodas and you’ll slowly erode the enamel, feed the cariogenic bacteria and create inflammation that can harm your gums.

Even snacking constantly without giving your mouth a break is harmful.

If your body’s insulin and sugar levels go up from a bad diet, even with the best oral hygiene, you’ll have a lot of other jaw bone, gum, and tooth nerve problems.

2. Brushing - Even Without a Toothbrush

The goal is to disrupt the plaque (we all have it) to allow some oxygen in there and make it less habitable for bacterial like Streptococcus mutans. Even without toothpaste the manual act of brushing helps keep your plaque healthy.

If you’re going to brush, set a timer. 2-3 minutes is good, light pressure, and soft or medium bristles.

Can hard bristles damage your teeth and gums? Maybe, if you have a tiger grip on your toothbrush.

3. Flossing or Waterpicking

#1. Diet
#2. Brushing (even without toothpaste)
#3. Flossing

Is it dangerous if you don’t floss every day? Unlikely, unless your diet is bad, in which case flossing more frequently may even be a good idea.

If you’ve had a lot of dental work done in the past or have the kind of dental anatomy where food collects easily, your dentist might even recommend more frequent flossing and/or a water pick.

Do you pull out a head of broccoli or a rib eye with your floss? Then you probably should floss regularly. But if your floss is relatively clean and odorless when it comes out, missing a day or two here and there may not be dangerous.

For me, it’s one of those things that if I don’t floss every night I’ll lose the habit. So I do it daily. I don’t use a waterpik but would consider if the gaps between my teeth change with age.

4. Toothpaste Options

I’m not giving medical advice, I’m just a family medicine physician who believes in prevention over treatment and who wants to keep his teeth as long as possible. Toothpaste is the least important of all.

Fluoride, fluoride-free, toothpaste tablets, powders, baking soda, salt, or whatever else that’s out there, they are all incredibly safe and can help the bristles get a little deeper into the plaque if your brushing duration and technique isn’t the best.

If you use something that’s more abrasive such as powders or clay type material, you should have a good brushing technique, not starting on the same teeth every time, brushing lightly, and ask your dentist if they notice any excess wear for whatever reason.

5. Mouthwash and Mouth Rinses

I wasn’t able to find good studies that were done to my liking to recommend these things. The idea that a liquid “kills 99.9% of harmful bacteria” is a little suspect. How is it able to target the good and not the bad?

Why can’t we use it in an IV - our ICU docs would love it!

If you can’t floss, consider a mouthwash. But I wouldn’t do this routinely.

6. Dental Cleaning

In the US, hardly anyone will argue with you if you say “everyone needs routine dental cleaning.” In the rest of the world, people will give you blank stares? Routine? Why? Don’t you brush and floss??

There are definitely groups of people who would greatly benefit from dental cleaning. I hope by now it’s clear that I’m not talking about the average person but someone who is proactive about their dental health.

If you see a lot of plaque building up regularly consider revisiting your hygiene routine and diet. And definitely get more regular dental cleanings done.

7. Dental X-rays & CTs

In high-risk people routine x-rays and CTs do find more cavities, though the data is unclear if that also means fewer tooth suicides/homicides because of these discovered cavities.

In other countries where people still have most of their teeth, routine x-rays don’t exist.

8. Xylitol Chewing Gum

If diet is #1, brushing #2, flossing #3, then xylitol gum is #18. If it doesn’t give you gas, chew it. Some people already grind their teeth at night or have bruxism, so chewing more during the day might make their TMJ pain act up.

Other Dental Myths Worth Busting…

1. Dirty toothbrush: I have never treated someone in the urgent care or in my private practice who had some infection from a contaminated toothbrush. I understand the fear, but it’s not substantiated.

2. Brushing immediately after meals: If you’re not having something very sugary or acidic and want to get your brushing out of the way, do it. But, it’s always best to wait 30-45 minutes because the enamel gets a little delicate after certain types of food.

3. Oil pulling: It won’t help much with oral health but if you’re doing it for other reasons, chance of harm is low. But it will throw off your oral flora.

4. Brush BEFORE breakfast: Don’t like brushing until after your coffee or breakfast? Don’t. As long as you brush, you’re good.

5. Brush 4x per day: You should brush based on your individual risk factors. Eat healthy? Don’t get a lot of plaque? You don’t need to brush that often.

6. Swap toothbrush every 3 months: Not only does nobody follow this but as long as the bristles seem fairly straight and aren’t bowing excessively, it’s unlikely that you’ll prevent many more cavities from this action.

7. Regular dental visits are a waste: Having a fantastic, open-minded dentist who can help assess your risk is critical. They can assess your bite, catch things early, give you flossing tips, and help identify concerning signs in your oral cavity.