Toothbrushing: The Practical To-Do List
Toothbrushing: what is worth doing, what is worth avoiding, and when to stop and see a doctor.
Mechanical removal of plaque with a fluoride toothpaste, twice a day. Tooth decay is almost entirely preventable, and the single largest determinant is fluoride contact time rather than brushing force.
Key takeaways
- Frequency: twice a day, including last thing at night
- Fluoride, adults: at least 1,350 to 1,500 ppm
- Most useful single change: Spit out toothpaste and do not rinse; rinsing washes the fluoride away.
- Commonest mistake: Rinsing with water or mouthwash straight after brushing.
- See a doctor if any of the signs under "When to speak to a doctor" below apply to you.
Do
- Spit out toothpaste and do not rinse; rinsing washes the fluoride away
- Brush last thing at night and on one other occasion
- Use a small-headed brush and gentle pressure
- Use an electric brush if you find manual technique difficult
Do not
- Rinsing with water or mouthwash straight after brushing
- Brushing hard, which wears enamel and gums
- Brushing immediately after acidic food or vomiting; wait an hour
The numbers behind the list
Those two lists follow from the published figures here.
| Measure | Figure |
|---|---|
| Frequency | twice a day, including last thing at night |
| Fluoride, adults | at least 1,350 to 1,500 ppm |
| After brushing | spit, do not rinse |
| Duration | two minutes |
If you change one thing
Spit out toothpaste and do not rinse; rinsing washes the fluoride away. That one first, and the others when you get to them.
Where to go next
- The Evidence on Toothbrushing, Without the Hype
- Making Sense of Toothbrushing
- Toothbrushing — the reference entry
- Gum Disease: Sorting the Evidence From the Noise
- Tooth Decay: Sorting the Evidence From the Noise
When to speak to a doctor
See a dentist for bleeding gums that persist, loose teeth, persistent bad breath, or toothache lasting more than a day or two. See a dentist or GP urgently for any mouth ulcer, red or white patch, or lump lasting more than three weeks, which needs assessment for mouth cancer.
Where this comes from
- NHS — How to keep your teeth clean
- Delivering Better Oral Health — toolkit
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarised or generalised beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to a GP, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 999.
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