I would be the last to say there is no butchery out there.  FWIW,
slowly and steadily decay is being approached more as a treatable
condition medically, and not merely microcarpentry.  Hope we see it in
practice in our lifetimes.

Steve

    Well, obviously you'll want to minimize your ingestion if you are on a
sodium restricted diet.

Steve

I don't know anything about Xylitol, so I'll leave that to others
to comment.

My present dentist doesn't like me using baking soda. At least
one of the dentists on this group has mentioned baking soda in a
positive light.

What I do know, from my own mouth, is that after using baking
soda, the hygenist appointment brings up a lot less stuff that
has to be scraped off my teeth. Also the healthy color is coming
back. My teeth had been chalky white near the gum line.

If you don't like baking soda, you can always go back. I have no
financial interest in your teeth. My dentist, who reccomends
fluoride, gets paid by the cavity. I think that's signifigant.

    If your cavities tend to be between the teeth, I think we've found your
problem.
    Usually it's not the tightness of the spaces per se; but often
roughness of any fillings in between the teeth that leads to shredding.
    There are shred-resistant flosses out there--most available probably
being Glide.  The other problem may be your technique, and your dentist
should spend some time with you making sure you're flossing correctly.
I have never found a patient whose teeth I haven't been able to floss
between, except in those cases where the fillings are so ragged that the
floss keeps shredding.
    Decreasing the frequency of snacks is likely to help, but you'll likely
still have a problem if you can't use something to clean between your
teeth.  I assume you are fairly young and don't have significant gum
recession; some patients can use something called a Proxabrush which
does a nice job cleaning between teeth, but not everyone has enough
space to use this.  In any case, your dentist and/or hygienist should be
able and willing to work on strategies that will enable you to clean
between your teeth.  That, coupled with decreasing between-meal snacks,
should help.  And unless your workplace has no washroom, you should be
able to brush (and floss!) after lunch.

No.

Steve

It's very difficult to diagnose everything over the internet.
Much of what you are doing sounds fine.  A couple more questions
and comments:

When exercising, do you drink Gatorade, Powerade, etc.?
They aren't much better for your teeth than Coke or Pepsi.

In 27 years of dental practice, I've never seen anyones teeth
so tight together that they could not floss.  You need some
help learning how and possibly some experimentation on which
floss to use (many different types, thicknesses, waxed/unwaxed,
Gortex fibers, etc.).  This should be a normal part of your
dentist's office care (not unavailable where you live<g>).

*ANY* sugar (including fermentatble carbs) exposure between meals
will feed the bacteria and create an acid environment with leads
to decay.  A few nibbles through the morning, afternoon, and evening
can be just as problematic as sipping on soda (soft drinks are just
the most common cause, not the only cause).

Another thing to consider is the total oral environment.  The bacteria
that are present in your mouth are the ones that have been thriving
under the present conditions.  You need to change the environment
in your mouth, and eradicate as many of the harmful bugs as possible.
*If* you truly brush well, learn to floss, use a topical fluoride
(not OTC stuff), possibly use a chlorhexadine rinse, and eliminate
all decay producing drinks/foods between meals, you should see a
big change over the next few years.

The only other catch could be the diagnosis and treatment of the
existing problems.  I haven't seen the decayed areas of your teeth,
nor have I seen any of the restorations.  It is important that decay
is completely removed from the teeth, and a restoration placed that
has an adequate seal, is properly shaped, smooth (including margins
that you may not see or feel), and has adequate strength.

A fast drill and patch job may not really be a very long lasting
repair.

I don't know your insurance situation, or if your dentist has
recommended more extensive (and expensive) restorations that
you have declined to have placed.

I wouldn't want to place a bunch of crowns in a mouth that is
crumbling from chronic decay problems, but HMO/Capitation dentistry
often leads to a steady decline in dental health over the years.

If you really want to change things, I think you can.

JMO,
D