[superqd]

So... is the existence, or non-existence, of a certain bacteria why some people never get cavities? I'm sure there can be multiple factors, but I'm 51 and never had a cavity, but don't really know the specifics of what might be different about the environment of my mouth that seems to discourage, or not encourage, the formation of cavities.

[fsckboy]

lemme ask you a question, I'm guessing you grow up with flouridated water?

[selcuka]

I grew up without fluoridated water and have no cavities (I am over 40). I have gum disease, though, so apparently I am still susceptible to the bacteria that causes it.

[IIsi50MHz]

While evidence for temporary benefit from fluoride in toothpaste is somewhat positive, evidence for similar benefit from fluoridated water is mixed and has not been isolated from numerous confounding factors. Ingested fluoride at has some small potential for mildly adverse health effects. Whether common levels in municipal water supplier are a net benefit, harm, or neither remains debatable.

However, there is significant variation of thickness of tooth enamel, seemingly due to genetics.

[superqd]

Maybe. I grew up in a very rural area. Others I'm related to have plenty of cavities, and others my age do too...

[JeremyNT]

Not OP but I'm a similar age and never had a cavity either. I grew up in a rural area and drank well water as a kid. They did occasionally provide topical flouride in the schools.

I stopped going to dentists in my mid 20s. Routine cleanings are not actually shown to improve outcomes, and the lack of cavities leaves me no other reason to go.

I couldn't say why I'm so lucky in this respect, but the bacterial explanation seems plausible.

[TedDoesntTalk]

> stopped going to dentists in my mid 20s.

Then you don’t know if you have cavities. Not all cavities are painful. Good luck.

[basisword]

>> I stopped going to dentists in my mid 20s.

You don’t know if you have cavities. I was similar. No issues so I stopped going for 15 years. Needed multiple fillings when I finally got a checkup, one of which was quite deep and has caused tonnes of issues since. If I’d gone regularly it would have been caught early. I wish I’d kept going when I had no issues so things would have been caught earlier. Cavity != pain a lot of the time. Typically when you get pain it’s a bad cavity which could have been caught sooner and treated more easily.

[htss2013]

Mind expanding on the lack of data for cleanings?

I got busy, then pandemic, next thing I know it's been like 7 years since I've seen a dentist. No problems or discomfort whatsoever. It occurred to me that bi annual cleanings are the SaaSification of dentistry, but I've never seen any real evidence.

[toast0]

I'm happy to go for regular cleanings, but I don't know how you could construct a well designed study to get data showing objectively what interval of cleanings results in better outcomes over many years. There's just too many uncontrolled variables. And, I don't think you can glean it from population studies either, because again, there are too many variables.

[JeremyNT]

Routine dental visits are essentially cargo culted.

There is some robust evidence indicating that routine plaque removal does not improve outcomes for cavity prevention or gingivitis [0].

Routine consultation with dentists otherwise may be beneficial, maybe not, but it hasn't really been studied much yet. The studies that exist are insufficient to form any conclusions. [1]

My post was downvoted by those who feel going to the dentist is important. I should state clearly avoiding the dentist should not be considered medical advice from me, and YMMV. I did the research myself and determined that routine dentistry was unlikely to improve my health outcomes, this is a personal decision that people should make on their own.

[0] https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...

[1] https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...

[htss2013]

The fact that these were published in 2018, implying before then it was never really studied, is sort of crazy.

The cost of biannual dentist visits for life is huge across the entire population. I would have thought there was strong evidence for this a long time ago. If nothing else, I would have thought insurance companies would stop paying for the bi-annual visits if there wasn't good evidence it works.

Then again, maybe I'm giving insurance companies to much credit since they've been paying for acupuncture for decades.

[latchkey]

for many years, i went for cleanings every 6 months. zero problems, usually in and out without any pain.

i didn't go for a couple years and just had one of the worst experiences at a cleaning in quite some time. super painful, a lot of build up.

i haven't changed my brushing/flosing habits at all, but i did switch toothpastes to non-flouride.

now, i'm back on the 6 month schedule and back to flouride. i also switched to a tablet based toothpaste (tidalove). you chew it (don't swallow) and then brush. the pill has a bunch of other good stuff in it too. kind of neat cause it is also zero waste packaging.

[foobiekr]

The addition of vitamin c is absolutely baffling. You don’t want to brush your teeth within half an hour of eating anything acidic.

[latchkey]

Not trying to justify it, but fact is that even "popular" brands have it.

https://www.colgate.com/en-za/colgate-total-vitamin-c

[texuf]

I’ve never had a cavity. Still like to go to the dentist and get the plaque scraped off. I also cracked a tooth from grinding my teeth at night and he fixed that up for me.

[sydbarrett74]

The primary purpose of cleanings is not to prevent cavities. It's to remove the biofilm that exists at and below the gumline containing facultative anaerobes which cause periodontal disease. You can have gorgeous, cavity-free teeth that fall out because the supporting structures have been resorbed and destroyed by these anaerobes.

[superqd]

That is the main reason I go to the dentist is to prevent gum issues, which I have had once or twice.

[toomuchtodo]

https://pubmed.ncbi.nlm.nih.gov/12369203/ (2002)