Twice a day, most people in the Western world take part in a health intervention that started almost 3,000 years ago. Maybe that’s not surprising: we only get one set of adult teeth, and if something goes wrong with them it can seriously impact our quality of life (if not our health overall).
But with so many inventions and innovations promising to change the game for our oral health, what’s actually important, and what can you ignore? Here’s what the current science says…
1. Go Goldilocks on your gums
Not too soft, not too hard – though it’s a lot easier to do the latter than the former. “A lot of people tend to brush far too hard because they want to clean extra well,” says Dr Josefine Hirschfeld, a specialist in gum health and restorative dentistry.
“But the higher pressure damages both teeth and gums slowly over time. A lot of electric toothbrushes have pressure sensors, which are extremely helpful – but for people who prefer manual toothbrushes, we recommend using a digital kitchen scale.”
To test this, push a toothbrush – possibly an old one – against the scale itself to get a sense of what the right pressure feels like. 80g (2.8oz) is good, and more than 100g (3.5oz) is cause for concern.
2. Choose the right toothpaste
Whitening toothpastes do work if aesthetics are your concern – they can lighten your teeth by a shade or two – but, according to a recent review of studies, there’s some evidence to show that they also affect the mineral content of teeth by “increasing surface roughness and reducing microhardness.”
“These toothpastes often contain abrasive particles that rub off stains,” says Dr Matt Hopcraft, an associate professor at Melbourne Dental School, in Australia. “But such toothpastes also rub off parts of the tooth itself, not just stains, and the tooth surface gets scratched over time if you use them every day.
"For people who already have sensitive teeth or receding gums, wherever gums have receded this part of the tooth is not very protected and very prone to wear and tear, especially if you use an aggressive toothpaste.”
If you still want a whiter smile, consider using brightening pastes for brief periods – but for the long term, pick a toothpaste intended for normal or sensitive teeth.
3. Chew gum
Counterintuitive, maybe, but it’s a good way to give your body’s natural defences a bit of extra help in the middle of the day. One review of studies suggests that it provides “a small but significant reduction in plaque scores,” and the European Food Safety Authority has endorsed the sugar-free kind as a way of preventing tooth decay.
“One thing that people don't really think about is saliva, which is really important from a protective point of view,” says Hopcraft. “And if you have a dry mouth without much saliva, it significantly increases the risk of tooth decay. So, chewing gum is good because it helps to stimulate some saliva and remineralize teeth after eating.”
4. Cultivate your mouth bacteria
“The digestive process starts in your mouth so that’s where sugar starts to be broken down, and that causes a few issues,” says Dr Arosha Weerakoon, a senior lecturer in dentistry at the University of Queensland, in Australia.
“Firstly, if you eat sugar frequently enough, you start changing the type of bacteria that grows in your mouth. Some of these bacteria, like Streptococcus mutans, love sugar and create acid as a byproduct of digesting it. That acid sits next to the tooth surface and goes to work on our teeth.
“There’s a constant process of mineral dissolving and rebuilding that’s going on in everyone’s mouth – but of course, if there’s more dissolving than there is rebuilding, you start getting holes in teeth.”
5. Avoid hidden sugar
In the UK, the average male adult eats around 55g (1.9oz) of sugar a day (women take in slightly less), and in the US, the figure is even higher at 68g (2.4oz). Much of that doesn’t come from sweets, cakes or drinks, but the stuff that’s loaded into other food to make it tastier or less perishable.
“Many people don’t realise just how much sugar there is in everyday food – they’re consuming a lot of it without really realising,” says Hopcraft.
“All of the global evidence tells us that if you can get your sugar consumption down to less than six teaspoons a day, which is about 24g (0.8oz), that helps to really reduce your risk of tooth decay – while sugar is also implicated in type 2 diabetes, obesity, cardiovascular disease and cancer. If you’re going to do one thing in your life to make you healthier, this is the one to address.”
6. Think cleaning, not brushing
Almost everyone has the habit of brushing, but thinking of cleaning your teeth as a more holistic habit can help – it’s the difference between just tidying your room and actually vacuuming it. “More than anything else, this is what’s going to make the difference,” says Hopcraft.
“Two minutes in the morning, two minutes at night brushing your teeth, and a minute flossing is five minutes of your day. Those two things will almost guarantee you good oral health and minimal disease. Everything else comes after that.”
7. Learn your own brushing style
“No two people should have the same tooth-brushing technique,” says Hirschfeld. “How you clean your teeth and mouth is a very individual thing – it depends on your own, very specific situation, your current dental health and your mouth. It's difficult to give individual advice that fits everyone.”
“What we do in our hospital is to give tailored oral hygiene training. We show the patient in their own mouth how it’s done correctly given their situation. Then they practice it and we watch them and correct little mistakes. I’m literally sometimes guiding my patients’ hands into the right places in their mouths.”
If this isn’t a possibility, there are apps that show good brushing technique – and some dentists are starting to offer video consultations. But if possible, it’s a great investment to ask your dentist to show you your own personally-tailored technique.
Think of it like learning proper exercise form in the gym: do it once or twice, and you’ll benefit for the rest of your life.
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8. Use the right floss
“When plaque matures it gets more complex and virulent,” says Weerakoon. “That's where you start getting more acids produced that can trigger unpleasant effects.
“I liken flossing to Godzilla – what it basically does is to run through and strip down the infrastructure, really breaking everything down. Then all that bacteria has to then reform and put the infrastructure back together again – and then you floss again and keep disrupting it.”
In other words, quality flossing can prevent plaque from fortifying, which helps prevent gum disease and tooth decay – but the best way to do it depends on your teeth.
“Flossing is great if your teeth are really tightly packed together, but some people, especially if their gum shrinks a little bit, end up with little triangular gaps in the gum lines. That’s when we start recommending interdental brushes.
“If you really can’t brush for some reason – for instance, I have patients with Parkinson’s – then water flossing is better than nothing, but it’s not going to be as good as physically breaking down the plaque.”
Ask your dentist for a recommendation – and get them to help you with your technique, so that you’re able to reach your back teeth as well as the easy front ones. The good news? You really only need to floss once a day.
9. Spit, don't rinse
While drinking water throughout the day can help keep your oral environment in good shape, it’s not something to do straight after you brush.
“Using a fluoridated toothpaste is really important, but if you rinse out after you’ve brushed your teeth, you’re just rinsing away all of that good fluoride,” says Hopcraft. “What you want to do is use a pea-sized amount of toothpaste on the brush, brush your teeth and spit out the excess. Don’t rinse, just spit.”
By the way, if you’re worrying about whether to run water over your brush before you start brushing, there’s no strong evidence either way – do whatever’s most comfortable, to help you build the brushing habit.
10. Get an electric toothbrush
Obvious, maybe, but the evidence on them is pretty definitive: one recent systematic review of studies found that powered toothbrushes show a significant improvement in plaque reduction over the manual kind.
“The oscillating, rotating brush action that modern toothbrushes use can be really beneficial, but another often under-appreciated benefit of electric toothbrushes is that the brush heads are really quite small,” says Hopcraft. “That means they can actually get into all of the areas you need, as opposed to a manual toothbrush with a really big chunky head.
“Also, if you’ve ever used one, your teeth just feel cleaner after using it – so there’s this feedback reinforcement loop that makes you want to keep doing it.”
There's yet another reason to go electric. In a 36-month clinical study published in 2024, researchers found that powered toothbrushes had a significant advantage over the manual kind when it came to keeping existing gum recessions in check.
11. Think twice about using mouthwash
Don’t worry: there’s no new scientific consensus saying mouthwash is definitely unhealthy for you. Healthcare services like the UK’s NHS don’t advise against using it and past research has claimed there’s no significant risk in normal daily use.
However, recent studies are giving scientists some cause for concern. For instance, one experiment in mice, detailed in prestigious journal Nature, claimed “prolonged use of antibacterial mouthwash is linked to an increased risk of systemic disease”.
Why? It theorised consistent use of mouthwash could cause a “disturbance” in the gut microbiome.
Another study, published in the Journal of Medical Microbiology, stated that the daily use of mouthwash should be “carefully considered” as it could cause “significant impact” to the oral microbiome, potentially increasing the risk of bacteria linked to health problems like gum disease and oesophageal cancer.
It's important to say that no hard conclusions can be found from one experiment alone – an analysis of 15 studies only found an association between oral cancer and mouthwash with people who used it upwards of three times a day for several years.
But, ultimately, experts like Hopcraft argue mouthwash isn’t essential for a healthy mouth.
“If you’re experiencing problems and you’ve been told by a dental practitioner that you can benefit from it in the short term, then mouthwash might help – but it’s unlikely to offer big benefits in the long term,” claims Hopcraft. “Physical removal, which you do with brushing and flossing, really is the key.”
12. Stop grazing
“There are a lot of dentists that also like sugar – but we try to be clever about it,” says Weerakoon. “If you eat something sweet then wait just 20 minutes or an hour before having another snack, you’re going to be dealing with elevated acidic levels in your mouth all day. When dentists have a treat, we probably won’t eat anything for a while afterwards.”
Incidentally, if you do snack throughout the day, then one of the best investments you can make is in a water bottle to carry around.
“That at least washes some of the acid and sugars away rather than leaving them sticking against our teeth,” explains Weerakoon. “You don’t need to sluice it around, or spit it out – but do try to drink regularly if you can.”
13. Don't brush straight after eating
It’s tempting to think that you should try to brush after every meal or snack, but after twice-a-day cleaning you quickly hit the point of diminishing returns. Besides, brushing straight after eating can actually damage your teeth.
“We generally recommend that you wait about 20 minutes after you’ve eaten before brushing your teeth,” says Weerakoon.
“The reason for that is toothpaste has a lot of ingredients, but one of those ingredients is an abrasive that’s used to get stains off. If you have what we call an ‘acidic challenge’, like fruit juice or something sweet, the pH environment in your mouth will be quite low, which means you risk scrubbing away part of the tooth surface itself.”
Think of it like cleaning non-stick pans: you wouldn’t use a heavy-duty scourer, because it removes the coating. If you can, change your daily routine so that you aren’t brushing straight after breakfast, and try to avoid eating for a while before you go to bed.
14. Don't brush for too long
“I won't discourage people from brushing more than twice a day, but I would discourage exuberant brushing,” says Weerakoon.
“I have patients that tell me that they brush for five or six minutes – and I’m grateful that they’re so enthused, but what can happen then is that they start to go past the therapeutic benefit of removing all the plaque and now all that you’re doing is starting to actually scrub away your tooth surface.”
Two minutes, especially with an electric toothbrush, is fine.
About our experts
Dr Josefine Hirschfeld is a specialist in gum health and restorative dentistry. She's also an associate professor and research lead for dentistry at University of Birmingham. Her work has been published in the likes of Journal of Oral Microbiology, Journal of Endodontics and Frontiers in Cellular and Infection Microbiology.
Dr Matt Hopcraft is an associate professor at Melbourne Dental School, in Australia. He has been published in journals including Health Promotion Journal of Australia, Australian Dental Journal and Journal of Dentistry.
Dr Arosha Weerakoon is a senior lecturer in dentistry at the University of Queensland, in Australia. She has been published in the likes of Archives of Oral Biology, Journal of the History of Dentistry and Journal of Structural Biology.
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