Brushing your teeth effectively lowers your chances of getting a host of chronic diseases, as well as keeping your teeth and gums healthy. But the majority of us are doing it wrong.

What’s the best method?


“Lots of patients understand that what they need to do is remove food remnants,” says Hirschfeld. “That is only partially true. It’s much more important to remove bacteria from the teeth.”

The most important place to remove it from is not in fact the teeth, but the gumline. This is where microbes are best able to infiltrate the gum tissue and cause inflammation, and eventually conditions such as periodontitis. In fact, “brushing your teeth” is something of a misnomer. “Think of brushing your gumline, rather than the teeth themselves,” says Hirschfeld. “The teeth will then be brushed automatically.”

So what exactly is the best way to do this?

One of the most effective ways to clear the biofilm is known as “the modified Bass technique”.  The modified Bass technique involves placing the brush at a 45-degree angle to the tooth face (tilted down for the lower jaw and upwards for the upper, as if you are trying almost to edge the bristles below the gums). You then make small, vibratory movements back and forth at the gumline.

The trouble is, most of us are bad at estimating how long two minutes really is. The average duration that we actually brush for varies widely, from 33 seconds, 45 seconds, 46 seconds, to 97 seconds, according to different studies. Only around 25% of people brush their teeth for long enough.  Brushing twice also helps hedge against imperfect technique.

Before or after food?

Carter says that the before-or-after-breakfast question is nuanced, and depends on what you’ve had to eat. Acidic food and drink – such as citrus fruit, fruit juice and coffee – would be a reason to brush before rather than after breakfast, so you don’t have to worry about interrupting the remineralisation process.

More important than the breakfast question is the evening brush, which also has a simpler answer: it should always happen last thing before bed.

“Your saliva is your natural protective mechanism,” says Carter, inhibiting bacterial growth and tooth decay. “The saliva flow reduces overnight, so that’s why it’s very important that all the plaque is cleared away before you sleep.”

What should you clean your teeth with?

Medium-bristled brushes are best for adults, and a toothpaste that doesn’t contain small abrasive particles. A smaller brush head – allowing for more manoeuvrability around individual teeth – is also preferable, says Hirschfeld, as is making sure you replace a worn brush before its bristles become too misshapen.

What kind of toothpaste is best?

Toothpaste with Fluoride content  around at least 1,350 parts per million (ppm) for adults, and 1,000 ppm for children to protect the enamel from acids.

Tooth enamel is the hardest tissue in the human body, and one of the hardest found in nature. “Almost as hard as diamond,” notes Hirschfeld. But despite its resilience to mechanical force, enamel is easily dissolved in acid.

Many charcoal toothpastes don’t contain fluoride, and therefore offer less protection from cavities. Baking-soda toothpastes may give a slight reduction in bleeding due to gingivitis.

Effective brushing is emerging as an impactful way of lowering our risk of not just bad breath, yellow teeth and cavities, but developing conditions such as type 2 diabetes, cardiovascular disease and cognitive decline.



Martha Henriques is Editor of BBC Future Planet.