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Cavity Risk Assessment Quiz

Tooth decay, or dental caries, is caused by bacteria that live in the sticky material known as plaque that builds up on your teeth.

When you eat, the bacteria in plaque use the sugars in your food to produce acids that eat away at the tooth enamel. Enamel is the protective outer surface of the tooth. Eventually, a cavity (or hole) forms in the tooth surface.

To find out your risk for cavities, answer each question and total up your points to come up with the risk score.

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Question 1:
Do you see any white spots, dark spots or holes in your teeth that you think might be tooth decay?

About Your Answer

Tooth decay looks like a chalky white spot in the early stages progressing to a brown spot in the later stages.

If you answered "Yes" or "Not Sure" make an appointment with your dentist to have an exam as soon as possible. Don't wait too long because dental decay won't get better on its own. The earlier the decay is treated, the less likely you'll need more expensive or uncomfortable dental procedures.

If you answered "No," keep your teeth healthy by visiting your dentist regularly even if you don't see any spots or holes because decay can form in places that you can't see.

Question 2:
Have you had any fillings or crowns (restorations) in the past 3 years?

About Your Answer

Even if you're good about brushing and flossing, many other factors can increase your risk for tooth decay:

  • Bacteria present in the mouth
  • Diet
  • Medications
  • Medical conditions
  • Braces

Question 3:
Do you see heavy plaque on your teeth?

About Your Answer

Plaque is a soft, sticky film that builds up on teeth and contains millions of bacteria. The bacteria in plaque cause tooth decay and gum disease if they are not removed daily through brushing and flossing. Plaque is colorless and difficult to see. Heavy plaque deposits are easier to see and may look like food stuck to the teeth.

If you're not sure if you see plaque on your teeth, you should make an appointment with your dentist as soon as possible. If there is plaque and it's not removed, it can lead to cavities and gum disease.

To see plaque more easily, you can use a disclosing tablet or solution with a few drops of food coloring in 2 ounces of water; this temporarily stains the plaque so you can see it more easily. You can then brush and floss until the stain is gone. You can find disclosing tablets in a drugstore or get some from your dentist.

If you answered "Yes," you should make an appointment with your dentist to have your teeth cleaned as soon as possible. The bacteria in plaque cause decay and gum disease. If you don't remove the plaque, you are at much higher risk for developing cavities and gum disease.

Question 4:
Do you brush your teeth at least twice a day with a fluoridated toothpaste?

About Your Answer

Fluoride is a mineral that is naturally found in low concentrations in many foods and water. Fluoride helps to prevent tooth decay by:

  • Making the tooth more resistant to acid attacks from the bacteria that live in the plaque on your teeth
  • Promoting remineralization of the tooth
  • Inhibiting the bacteria that cause tooth decay

Research has shown fluoride to be both safe and effective.

It's important to brush your teeth at least twice every day with a fluoridated toothpaste. Fluoride helps prevent tooth decay by making the tooth more resistant to acid attacks from the bacteria that live in the plaque on your teeth. In addition to using fluoride, be sure you're using proper brushing technique with the head of your toothbrush placed at a 45 degree angle to the gumline.

If plaque and food are not removed daily through brushing and flossing, the bacteria in plaque will feed on sugars in your food and produce acids, which can cause tooth decay.

The label on your toothpaste will indicate whether fluoride is an ingredient. You should also check for the ADA (American Dental Association) Seal of Approval to ensure that your toothpaste contains the proper amount of fluoride. If it doesn't contain fluoride, consider switching.

Question 5:
Do you use a fluoridated mouth rinse daily?

About Your Answer

Fluoride is a safe, effective method for controlling tooth decay. It helps prevent tooth decay by making the tooth more resistant to acid attacks from the bacteria that live in the plaque on your teeth.

You should talk to your dentist about the safe, decay-preventing properties of fluoride and ask what treatments might be right for you. Your dentist may suggest an over-the-counter fluoride rinse or an in-office fluoride treatment. Your dentist also can prescribe a fluoride gel or mouth rinse that you can use at home.

To find out if your mouth rinse does contain fluoride, check the label to see if fluoride is an ingredient. If it's not fluoridated, consider switching.

Question 6:
Do you live, work or go to school in a community with fluoridated water?

About Your Answer

Water fluoridation is the adjustment of fluoride levels in the community water supply to the optimum level to protect oral health. By simply drinking tap water in communities with a fluoridated water supply, people can benefit from fluoride's protection from decay.

Research for the past 60 years has shown community water fluoridation to be safe and the single most effective public health measure to prevent tooth decay in adults and children.

If your local water supply is not fluoridated, you can still gain the benefits of fluoride through other sources. To help prevent cavities, you should make sure that your toothpaste contains fluoride.

You might want to also ask your dentist about:

  • Fluoride supplements (tablets or drops)
  • Fluoride mouth rinses
  • Topical fluoride gels

The easiest and most accurate way to find out if your community's water is fluoridated is to contact your local water company and ask.

The Centers for Disease Control (CDC) website also has a page My Water's Fluoride that allows consumers in participating states to learn the fluoridation status of their water system.

If most of your water comes in the form of bottled water, you are missing out on the valuable fluoride found in tap water, which helps to protect teeth from cavities. In most cases, the fluoride concentrations in bottled water (even in some that are fluoridated) fall below the U.S. government's recommended range of 0.7-1.2 parts per million (ppm) of fluoride, the ideal range to prevent cavities. If you drink mostly bottled water, you should talk to your dentist about fluoride supplements (tablets or drops), fluoride mouth rinses and topical fluoride gels.

Question 7:
Do you frequently snack between meals?

About Your Answer

The more often you snack, the more frequently you supply sugars to the bacteria that live in your mouth. When the bacteria feed on these sugars, they produce acid, which dissolves the tooth's outer layer and leads to tooth decay.

Although you may already know that sugars are found in sweet foods, you may not know that starchy, non-sweet foods such as pasta, rice and bread quickly break down into sugars in your mouth.

If you snack, choose your foods wisely. Some foods like peanuts and cheeses may actually help prevent tooth decay. Other foods, such as crispy fruit and raw, crunchy vegetables, also can help to clean the teeth.

Be sure to brush and floss after snacking or at least rinse your mouth with water. Chewing gum or mints with xylitol can also help because they stimulate the flow of saliva, which washes away food particles.

Talk to your dentist about what you can do to make your eating habits more tooth-friendly.

Question 8:
Do chew gum or use mints or candies that contain xylitol?

About Your Answer

Xylitol reduces tooth decay and plaque formation. Xylitol is a natural sweetener and has been used as a sugar substitute in foods and candies since the 1960s. Because it looks and tastes like sugar, it is sometimes used as a sugar substitute in foods and candies. Studies show that the sweetener xylitol reduces tooth decay and plaque formation because the bacteria in your mouth can't feed on xylitol like they feed on sugars. Also, chewing gum or sucking on mints stimulates the flow of saliva, which washes away food particles.

Several national dental associations officially endorse sugar-free chewing gums and candies made with xylitol as the principal sweetener.

Check the package to see if xylitol is an ingredient.

Question 9:
Do you have a dry mouth?

About Your Answer

Saliva is an important ally in the fight against cavities. It helps wash away food particles, neutralize the acids in your mouth and add important minerals back to teeth.

Dry mouth has a number of causes, including the use of recreational, over-the-counter and prescription drugs. Many common medications such as antihistamines and high blood pressure medications can cause dry mouth. Dry mouth can also result from a number of medical conditions.

If you have dry mouth, try using sugar-free candy or chewing sugar-free gum to help your mouth produce more saliva. Sipping water frequently or using an over-the-counter saliva substitute may also help. See your dentist; he or she can recommend ways to keep your mouth moist.

If you don't have dry mouth, you should pay attention to any changes in your medications or overall health as dry mouth can be a side effect of many common over-the-counter and prescription drugs.

Question 10:
Do you wear braces, retainers or partial dentures?

About Your Answer

Because braces, retainers, partial dentures and other dental appliances trap food particles and plaque against the teeth and gums, they can increase your risk for tooth decay. They can also make it more difficult to brush and floss properly.

If you answered "Yes" to this question, be sure to brush thoroughly after meals and snacks. If your appliance is removable (like a retainer or partial denture), you should remove it and brush it carefully each time you brush your teeth. Disinfect your appliance weekly by using an over-the-counter denture cleanser.

There are many oral care products on the market designed especially for people with braces or partial dentures to help you keep your teeth clean. Ask your dentist if any of these products might be helpful for you.

Question 11:
Do you use drugs recreationally?

About Your Answer

Recreational drug use is the use of drugs for recreational purposes rather than for approved medical purposes. Although this term is often applied to the use of illegal drugs such as heroin or cocaine, it can also apply to the non-medicinal use of legal prescription and over-the-counter drugs.

People who use drugs recreationally often suffer from severe tooth decay. Certain drugs such as marijuana and heroin can cause cravings for high-sugar foods or lead to poor oral hygiene habits. Drugs such as cocaine and ecstasy can contribute to dry mouth or cause you to clench or grind your teeth. Methamphetamine (or "meth") and cocaine can create highly acidic conditions in the mouth, leading to rapid tooth decay. All of these effects lead to higher risk for tooth decay.

Be aware: even over-the-counter and prescription medications may affect your oral health.

If you take any over-the-counter or prescription medications, check with your dentist, doctor or pharmacist to see if your medication may affect your oral health. Some common medications such as antihistamines, asthma medications and blood pressure medications can contribute to problems with your teeth and gums.

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Risk Score Results


Your risk for cavities is low if you scored between -1 and -4 points.

Decrease your risk for tooth decay:

Read our recomendations


Your risk for cavities is moderate if you scored between 0 and 3 points.

Decrease your risk for tooth decay:

Read our recomendations


Your risk for cavities is high if you scored 4 points or higher.

Decrease your risk for tooth decay:

Read our recomendations

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