A lot of it must be genetic. Possibly also diet related... but I have gone multiple stretches in my life without seeing a dentist, stretches of approx 5 years. Yes it took the hygienist a lot longer than usual to clean my teeth, and there was bleeding, but no cavities. I have had 2 cavities in my life and they both occurred when I was in high school drinking 5 cokes a day and eating French fries daily. I was also on my mother's benefit plan and went to regular hygiene appointments every 6 months. Since I aged out of my Mother's coverage, I have gone those long stretches without seeing a dentist or hygienist and not had any cavities. I don't avoid sugar, but I don't drink sodas as a rule and I avoid seed oils as much as is reasonable. I have never been one to floss, I just started doing it maybe 2 times a week over the past year, and I only started using an electric toothbrush about 3 years ago. It has been approximately 15 years since I have had regular checkups. I don't see how hygiene could have had anything to do with whether or not I've developed cavities.