When is the best time to brush your teeth? How long should I be brushing for? Which is the best toothpaste? Here are some simple changes you can make to your daily routine to improve your oral hygiene level.

On Toothbrushing

• Your toothbrush should be discarded after 200 uses (2-3 months). Depending on how hard you brush, the bristles will fray over time and using a frayed toothbrush will not clean your mouth adequately. Furthermore, bacteria and plaque will start to accumulate on the bristles, thus making the whole tooth-cleaning process ineffective! 

Tip: I usually use a permanent marker and write an expiry date on my electric toothbrush head when I first use it to remind me when I need to replace it.

• Timing is everything! Electric toothbrushes have the advantage of having a built-in timer. The recommended time for brushing is 2 ½ minutes. This is to give enough time for the fluoride in the toothpaste to really get in there. It’s really helpful to look at a clock or use a timer because many of us zone out when we’re brushing and may even scrub too hard, trying to compensate for the fact that we’re rushing our brushing.

• Fluoride- Spit not rinse! We shouldn’t rinse our mouth with water or mouthwash directly after brushing. This is because Fluoride is active for at least 30 minutes after we have brushed. Fluoride is the active ingredient in toothpaste and we are really just washing it away when we rinse it out. Then how am I going to get all that toothpaste suds out of my mouth I hear you ask? The answer is to spit out as much as you can. Train your brain to accept the foaminess as your new normal.

• Make haste and store your brush in a case! Storing your toothbrush in a case is vital. A recent study from the University of Manchester has estimated that more than 10 million bacteria live on your toothbrush. If you’re storing your toothbrush anywhere near to your toilet, you can bet that the ‘toilet flush bugs’ are going to remain in the atmosphere and eventually find a warm and cozy home on the bristles of your toothbrush. Researchers from the University of Alabama confirms this in a study which found that brushes stored in the bathroom are contaminated with faecal matter lingering in the bristles.

• “Go medium, soft or extra-soft or go home!” said no one ever, except me, when I am giving advice about toothbrushes. Hard toothbrushes are really only good for cleaning Clarks. Very rarely would I recommend it for my patients. WHY? Because after 10 years of looking at teeth I see the damage that hard brushes cause. The enamel and sometimes dentine layers of your teeth can be irreversibly brushed away a lot quicker if you use a hard toothbrush. This can lead to sensitive teeth and even ‘abrasion’ cavities. Yes…..your toothbrush can cause cavities.

•  Move that toothbrush round and round. YES! The best way to brush is in gentle circles. Not side to side, not up and down, but round and round. Around all tooth surfaces. Believe it or not many many researchers have tested and researched the safest and most efficient technique to brush your teeth. The ‘modified bass technique’ is widely accepted as the best. The technique involves holding your brush at a 45 degree angle to your tooth surface and making gentle circles, ensuring that you brush your gum line also.

•  Don’t overbrush! Twice a day. First thing when you wake up and last thing before you go to bed and never brush immediately after eating. This is because your mouth becomes naturally more acidic after eating, and brushing in an acidic mouth can cause damage to your tooth enamel. If after lunch you want to freshen your mouth, floss, and mouthwash.

• Make sure your toothpaste has fluoride. Dentists will always recommend Fluoride. This is because we know how good it is for preventing cavities. The benefits and drawbacks of fluoride has been a contentious topic for decades in dentistry. When ingested at high levels, yes, fluoride is indeed toxic. But who is really swallowing toothpaste? Children. This is why it is extremely important that children are supervised up until the age when they are spitting all the toothpaste out.
• Those toothpaste commercials and that S-shaped toothpaste strip is possibly the best marketing visual in the history of toothpaste marketing. Seeing that my first name incidentally begins with ‘S’…As a child, I would try to put as much toothpaste as physically possible on my brush and indulged in the resulting foam party in my mouth. As an adult dentist, learning about toothpaste I realise that the pea-sized amount they taught me to recommend is adequate, your toothpaste will last longer also.
• Most Kinds of toothpaste contain an ingredient called ‘SLS’, Sodium Lauryl Sulphate. This is the powerful detergent that is added to shampoo, hand wash, shower gel and you guessed it toothpaste, to facilitate the foaminess. The main purpose is to give you that psychological connection with cleaning even though this makes very little difference to the effectiveness of the toothpaste. SLS has also been linked in some studies to mouth ulcers and patients who have tried a toothpaste without SLS have reported a reduction in their ulcers.  

 On Flossing 

I got a little too excited when I realised there was both a song AND dance craze this summer about flossing. My excitement bubble popped when I realised that this was, in reality, virtual flossing, Singing and dancing about flossing without actually flossing your teeth. From a flossing point of view though, any publicity is good publicity. You should be doing the actual flossing daily. Once a day. Every Tooth has 5 surfaces and brushing usually only gets 3 out of the 5 surfaces. The floss gets those in-between bits of plaque and bacteria out of the gums so that the chance of getting gingivitis, bad breath or cavities is greatly reduced.

On tongue cleaning 

Tongue Cleaning and scraping. Most of the bacteria in the mouth live on the tongue. Using a brush to gently clean your tongue so that it is a healthy pink color is one way of cleaning it. You can also get a tongue scraper. Most manual toothbrushes have a tongue cleaner on the back of the toothbrush head. When I realised exactly how many bacteria live on your tongue – I immediately started recommending tongue cleaning to my patients. The result will be fresher breath and less bacteria in your mouth.

On mouthwash

Actually, mouthwash is actually unnecessary after toothbrushing. I would usually suggest it after a meal like lunch. If you must use one, then choose one with fluoride. Also, wait at least 30 minutes after brushing to use mouthwash.