Good oral hygiene begins with an understanding of where food and bacterial plaque get trapped in your mouth. The mouth is full of small areas that can be difficult to clean, including overlapped or crowded teeth, under dental work like bridges (fixed partial denture) or orthodontics, and the tooth pits and fissures of the back teeth.
That's why brushing and flossing are the most essential parts of your daily oral health routine. They remove plaque and food debris on your teeth, gums (gingiva), and tongue. Plaque contains bacteria that cause bad breath (halitosis), tooth decay , and periodontal disease (periodontitis). Plaque can also lead or contribute to other dental and medical conditions.
Many people do not brush long enough, often enough, or improperly. This can lead to painful and expensive treatment. According to one recent study, one in three Americans fail to brush their teeth at least twice a day, and more than one in five have gone without brushing for two or more days at least once in the last 12 months.1 It is estimated that people who brush regularly average only 45 seconds of brushing time, far less than their recommended two minutes.2
Mechanical toothbrushes have been shown to provide superior plaque and biofilm removal compared to manual brushes.3 There are different options available, including electric toothbrushes4 and sonic toothbrushes.5
Regardless of the type of brush you choose, use a toothbrush with soft bristles. Using stiff or firm bristles may cause your gums to bleed. It can also wear away part of your tooth surface over time.
You should change your toothbrush every 3-4 months or sooner if the bristles are frayed or broken. Some people use a calendar to remind them to change their toothbrush at the start of each season.6
Best practices for brushing
- Brush your teeth, gums, and tongue after every meal and snack. At a minimum, brush two times per day (typically after you wake up and again before you go to bed).
- If you have trouble holding a toothbrush due to hand injuries, arthritis , or other afflictions, there are companies that offer toothbrushes with larger handles to make them easier to grasp. Electric or sonic toothbrushes may also provide a good alternative.
- Use the correct toothpaste for your needs.
- Position the brush downward at a 45-degree angle to the gumline. Brush gently by moving back and forth along the gumline in short strokes, about the width of a tooth. Continue to the next tooth until all are cleaned.
- Do not brush too vigorously, as it can cause your gums to bleed and possibly even wear away part of your tooth surface over time ( abrasions ).
- To clean the inside surfaces of your front teeth, tilt the brush vertically and make several up-and-down strokes.
- Brush at least two minutes (30 seconds per quadrant ). Many electric brushes have timers that alert you when it is time to switch areas of your mouth and when two minutes have passed. If you use a manual toothbrush, consider a timer or put on your favorite song to ensure you brush long enough. This is especially helpful for children.
- The bacteria that cause bad breath also live on the surface of your tongue. Brush your tongue or use a tongue scraper to reduce the overall level of bacteria in your mouth.
- Use a toothpick.
- Use an interdental brush for large spaces such as where gums have receded or under bridgework.
- Alternate how you brush your teeth. Your habits may result in consistently missing a particular area of your mouth.
Oral hygiene for orthodontic braces and bridges
Orthodontics and bridges can be especially challenging to clean because there is no easy way to get between the teeth. Wires and brackets create barriers that make it difficult to brush exposed surfaces of the teeth and clean along the gum line. Likewise, the teeth of a bridge are fused together, so you cannot use floss to clean between them. There is a significant risk of developing tooth decay on the teeth that touch the replacement tooth if you do not clean effectively under the bridge every day.