This is a legitimate question that has been asked of me countless times by frustrated patients who have made huge strides towards achieving better oral health and, yet, continue to get “new” cavities. In fact, I had a patient ask me this very question just last week when she was in for her semi-annual check-up. We took new x-rays and, lo and behold, there was a “new” cavity. She was very frustrated and disappointed because she has made many changes to her routine to try to reduce her risk of cavities, including using an electric toothbrush, flossing daily, reducing her sugar intake and her frequency of eating (particularly coffee consumption), and using a daily fluoride rinse.
She also recently quit smoking. Given all these changes she has made, she had expected to get a “cavity-free” check-up. This patient is not alone in her frustration. Many people have had similar experiences and, though it may be discouraging, it is important to continue with any positive changes as they will pay off in the long run. The thing about cavities is that they can take years to develop and show up clearly on an x-ray. A “new” cavity may have actually started years ago, before the patient had begun to improveher oral hygiene…so the cavity is not truly a “new” one. X-rays are also not an exact science, meaning that there are a number of factors that will affect whether or not a cavity will be seen on an x-ray at an early stage.