Basics of Brushing and Oral Health

 

Are You Holding Your Toothbrush Wrong? Should You Floss or Rinse?

Many people never learned the basics of brushing their teeth. Here’s how to correctly preserve your pearly whites.

By Susan K. TreimanMedically Reviewed by Elizabeth V. Simpson, DMD

Reviewed: November 30, 2022

Medically Reviewed

Allow enough time — two minutes twice a day — to ensure that you remove the bacterial sludge, or plaque, that can damage teeth and irritate gums.Stocksy

You’re probably brushing your teeth wrong. Luckily, though, you can set everything right in the two minutes it takes to clean your choppers correctly.

Adrienne Malcolm, a registered dental hygienist at B&D Dental Excellence, the office of Mark Dunayer, DDS, in West Nyack, New York, has spent 30 years helping people master the art of brushing. That includes convincing them that flossing is an essential part of the ritual. 

“If you took 100 people from all walks of life, I’d say about 60 percent just don’t do it,” says Malcolm.

The reluctance to floss (her personal bugaboo) is just one of the most glaring mistakes people make when it comes to dental hygiene. Here are the dos and don’ts that any respectable tooth owner should know.

Follow the 2 x 2 Rule

Spend two minutes brushing twice a day. Divide your mouth into four sections: upper left, upper right, lower left, and lower right. “Spend 30 seconds on each quadrant,” Malcolm says. If needed, use a timer to ensure you’re giving your teeth adequate attention.

It doesn’t seem like a big ask. But two minutes far exceeds the mere 45 to 70 seconds a day that, according to National Association of Dental Plans (NADP) Research, most Americans devote to dental care. That’s nowhere near sufficient to rid the mouth of plaque, the sticky bacterial sludge that can erode teeth and inflame gums. 

Think Gentle: Massage, Don’t Scrub

Adopt a kinder, gentler touch, using small circular motions or tooth-wide back-and-forth strokes with your brush rather than aggressive scrubbing up and down. This goes for electric toothbrushes as well, which you should try to hold with your fingertips. 

“Back in the day, our parents told us to ‘really get in there and brush hard,’ but we now know that being too aggressive can injure gum tissue, cause irritation, and even wear away the structure of the tooth,” says Malcolm.

Stick With Soft

Whether you prefer manual or electric brushes, opt for pliable ones instead of stiff, hard versions. Flexible bristles are less threatening to gums and teeth, while making it easier for you to maneuver into tight spaces in and around the mouth.

Aim for a 45-Degree Angle to Your Gums

Tilting the brush against the front surface of the teeth — upward for your top teeth and downward for your bottom teeth — allows bristles to slip ever so slightly under the margin where tooth and gum meet, the Grand Central Terminal of decay-promoting debris. Abundant detritus that collects there tends to promote gingivitis, a gum (gingiva) inflammation caused by the sticky plaque mixture of food, bacteria, and mucus. Left alone, gingivitis can develop into periodontal disease, which damages teeth, gums, and general health, and can be difficult to repair.

“The 45-degree angle works best for the front surfaces of the teeth,” Malcolm says. “You can use the bristles flush against the biting (horizontal) surface on the tops of the teeth, the spot where they meet, to attack plaque there.”

To reach the inside back surfaces of teeth, the American Dental Association recommends tilting the brush vertically and using up-and-down strokes that loosen and sweep away debris.

Tackle the Tongue

Plaque buildup on the tongue is bad enough; then there’s the foul breath it can create. Gentle tongue brushing scrapes away many of the roughly 300 bacterial species that take up residence there. Many people, however, would rather use special tongue-cleaning devices.

“Particularly for those who say that brushing the tongue makes them gag, we recommend scrapers,” Malcolm says. These inexpensive tools “rake away” bacteria in seconds. (Just avoid the roof of the mouth as the tissue there is too sensitive.)

Available at major drug stores, scrapers are easily cleaned, maintained, and stored.

Floss

Whether you prefer dental string or a water flossing device, it’s critical to dislodge trapped food and other waste products from between teeth. Failing to floss leaves roughly 40 percent of teeth surfaces susceptible to bacterial damage. A single nighttime flossing session is usually adequate, though some dentists suggest flossing twice daily. Don’t be alarmed if there’s some bleeding after you floss.

“If the gums already are irritated or infected by plaque or tartar, they can bleed,” Malcolm says. “I reassure patients that this minor bleeding usually diminishes in a matter of days and it definitely shouldn’t stop them from flossing.”

Rinse if You Like — but Not Immediately After Brushing

Floss first, brush second, spit out as much toothpaste as possible, then wait at least 15 minutes before rinsing “preferably with something antibacterial instead of breath-sweetening,” Malcolm says. Waiting before rinsing or swishing (or just drinking water) allows the residual fluoride from the toothpaste to better protect your teeth. Afterwards, if you wish, cap off your nightly ritual with an antibacterial rinse to further preserve your best dental efforts.

Regularly Replace Your Brush

Toss your toothbrush every three to four months; sooner if your brush or brush head becomes misshapen, worn, or dirty. (Some services offer brush subscription plans or add reminders to your calendar.)

Store Your Devices Properly

A toothbrush within droplet-reach of a toilet (tiny beads of moisture can travel surprisingly far!) easily picks up the microscopic fecal particles released by flushing. A toothbrush cover or a sanitizing container (which accompanies some brushes) will shield bristles from contaminants. To be super-careful, consider relocating brushes and other tools to a spot well removed from the bathroom.

Visit the Dentist Twice a Year

“You’d be surprised how many people think you only see a dentist when something hurts,” Malcolm says. “That’s completely incorrect. Periodontal disease can lead to bone loss and loosened teeth without causing any pain.” Teeth should be cleaned and examined twice a year, more often if you have actual periodontal problems.

Stay Healthy

Healthful eating, regular exercise, and good overall health promote thriving teeth. Smoking, high-sugar foods, and poor self-care have the opposite effect. So, follow tooth-care basics, skip the bad stuff, and set yourself up to enjoy those pearly whites for many years to come.