Brushing your teeth at least twice a day is one of the most effective ways to prevent cavities, according to a comprehensive analysis of dental health research across Nigeria. A new systematic review and meta-analysis published in PLOS One examined 23 studies involving thousands of people and found that poor oral hygiene was associated with a 76% increase in cavity risk, while regular twice-daily brushing provided strong protection against tooth decay.

The research, conducted by scientists at the Nigerian Institute for Medical Research and other institutions, synthesized data from studies conducted between 2001 and 2025 to understand the relationship between oral hygiene practices and dental caries, the medical term for cavities. The findings are particularly important because Nigeria has not conducted a comprehensive national dental survey since 1995, leaving a significant gap in understanding the country's oral health landscape.

What Does Poor Oral Hygiene Actually Do to Your Teeth?

The analysis revealed striking numbers about the impact of neglecting oral hygiene. When researchers pooled data from 10 studies, they found that people with poor oral hygiene had roughly double the odds of developing cavities compared to those with good oral hygiene practices. After accounting for variations in study quality, the risk remained substantial: poor oral hygiene was linked to a 76% increase in cavity prevalence with high certainty across the studies examined.

The mechanism behind this is straightforward. Dental plaque, a sticky film of bacteria that forms on teeth, initiates and advances cavity formation. When you don't brush regularly, plaque accumulates and produces acid that eats away at tooth enamel. Regular brushing with fluoridated toothpaste removes this plaque and reduces the availability of fermentable carbohydrates that bacteria use to produce cavity-causing acid.

How to Protect Your Teeth From Cavities

• Brush at least twice daily: The study found that brushing teeth at least twice per day was associated with significantly reduced cavity risk, making this the single most important preventive habit for dental health.
• Use fluoridated toothpaste: Regular toothbrushing with fluoridated toothpaste helps remove plaque and food particles while strengthening tooth enamel against acid damage.
• Combine brushing with other cleaning methods: Dental floss, interdental cleaning tools, antimicrobial rinses, and tongue cleaning all help control plaque accumulation beyond what brushing alone can achieve.
• Maintain consistent habits: The frequency and consistency of brushing matters more than the specific tool used, whether that's a traditional toothbrush, chewing stick, or other cleaning implement.

Does the Type of Toothbrush or Cleaning Tool Matter?

One surprising finding from the analysis was that the specific tool used for cleaning teeth was not significantly associated with cavity risk. This is important context for Nigeria and other regions where people use diverse oral hygiene tools, including traditional chewing sticks alongside modern toothbrushes.

The most common oral cleaning tool reported across the studies was a toothbrush with toothpaste, but researchers also documented the use of chewing sticks, cotton wool, and other traditional methods. The key takeaway is that what matters most is not which tool you use, but rather how frequently and consistently you use it. Brushing twice daily with any method provided protective benefits, suggesting that accessibility and cultural preferences should guide tool selection rather than concerns about effectiveness.

Why This Research Matters Now

Globally, untreated cavities in permanent teeth remain the most prevalent health condition, affecting an estimated two billion people as of 2022. Despite this enormous burden, Nigeria lacked current, nationally representative data on the relationship between oral hygiene practices and cavity risk. The most recent national oral hygiene survey in Nigeria was conducted in 2014, and the last comprehensive dental caries survey dated back to 1995.

Since then, major changes have reshaped oral health risks in Nigeria. Rapid urbanization, increased sugar consumption, and disparities in access to preventive dental services have likely altered how oral hygiene practices affect cavity rates. Additionally, significant differences exist between Northern and Southern Nigeria in health spending, disease burden, and oral health behaviors, yet most of the studies in this analysis (86.9%) came from Southern Nigeria. The researchers emphasized that more studies from Northern Nigeria are needed to provide truly representative national evidence.

This systematic review provides policymakers and oral health professionals with the evidence needed to design effective, culturally relevant prevention strategies that reflect both modern and traditional oral hygiene practices. The findings align with the United Nations Sustainable Development Goal 3 on good health and well-being, underscoring the importance of oral health as a component of overall public health.