How to Brush and Floss the Right Way

Professional cleanings twice a year remove plaque, tartar and debris, but what you do at home every day matters just as much. Brushing and flossing well helps prevent tooth decay, gum disease, bad breath and staining. Regular check-ups are essential for catching problems early, but they aren’t a “fix-all.” A thorough routine at home, every day, is what keeps small problems from starting.

Why your routine matters

Each of those four problems starts with something brushing and flossing can remove:

• Tooth decayAcids in plaque erode the enamel. Decay is one of the leading causes of tooth loss, its treatment can be complex, and it’s easily prevented with good home care.
• Gum diseaseToxins in plaque cause periodontal disease, a serious, progressive condition that can lead to tooth loss, gum recession and jawbone recession, and to health problems elsewhere in the body. It’s also preventable in the vast majority of cases.
• Bad breathHalitosis usually comes from old food particles on or between the teeth.
• StainingSmoking, coffee and tea all stain teeth. The more regularly those stains are brushed away, the less likely they are to become permanent.

Choosing a toothbrush

The brand of toothbrush matters less than the bristles and the size of the head. The best toothbrush is small, with soft, rounded-end bristles, and no more than three months old.

• Soft bristlesMedium and hard brushes tend to irritate the gums and can contribute to gum recession. Soft bristles are far gentler on gum tissue.
• A small headIt reaches every area of the mouth and gets around each tooth more completely.
• Replace it every three monthsWorn bristles stop cleaning well.
• Consider an electric brushThe American Dental Association has given electric toothbrushes its seal of approval, and ones with rotating or oscillating heads are more effective than other toothbrushes. A manual brush can get the same result, but it takes more effort.

Brushing

Brush at least twice a day, ideally in the morning and before bed. Brushing after each meal is even better.

1. Hold the brush at a 45-degree angle where the teeth meet the gums.
2. Use small circular motions to gently brush the gumline and teeth.
3. Don’t scrub or press hard, which can damage the gums and enamel.
4. Brush every surface of every tooth: the cheek side, the tongue side and the chewing surfaces, paying special attention to the back teeth.
5. Use back-and-forth strokes on the chewing surfaces.
6. Brush your tongue too, to remove fungi, food and debris.

Flossing

Floss reaches between the teeth, where a toothbrush can’t. It’s one of the best ways to prevent gum disease, so floss daily. The flavor and type don’t matter; pick one that’s easy and pleasant to use.

1. Cut about 18 inches of floss and wrap the ends around your middle fingers, leaving 2–3 inches between your hands.
2. Work it gently between the teeth toward the gumline.
3. Curve it into a U-shape around each tooth and slide it carefully just beneath the gumline.
4. Move it up and down a few times to lift away plaque.
5. Don’t snap it in and out between the teeth, which can cut the gums.

Flossing also helps prevent cavities from forming between the teeth and limits the depth of the gum pockets. Be gentle if you use a floss holder: vigorous flossing with one can damage the gums and cause bleeding.

Other helpful aids

These aids can all help, but none of them replaces brushing and flossing:

• Interdental brushesTiny brushes, in various shapes and sizes, that gently clean the contours between the teeth. Hygienists often recommend them alongside floss.
• Oral irrigatorsWater jets spray into the gum pockets to flush out bacteria and food particles, and they’ve proven effective in lowering the risk of gum disease.
• Rubber tip stimulatorsTrace the tip gently along the outer and inner gumline at least once a day to remove plaque and stimulate blood flow.
• Tongue cleanersThey remove the bacteria, fungi and food debris linked to bad breath. Clean your tongue before brushing so you don’t swallow them.
• Mouth rinsesOver-the-counter cosmetic rinses only mask bad breath for a while. Therapeutic rinses contain active ingredients that can help reduce bad breath, plaque and cavities. Use a rinse after brushing.

Fluoride, diet and your check-ups

Brushing and flossing work best as part of a bigger routine. Fluoride, found in many toothpastes, slows mineral loss from the enamel and helps it remineralize. For children aged two to five, a pea-sized amount of ADA-approved fluoridated toothpaste twice a day is enough; under age two, use a non-fluoridated toothpaste. Read more about fluoride and how much is right for your child.

Young children can’t clean every area well on their own, so parents should brush and floss their child’s teeth twice a day until about age seven.

What you eat matters too. Bacteria in plaque feed on sugar and release acid, so cut back on sugary and sticky snacks and save sweets for mealtimes. Chewing xylitol gum can help as well: it neutralizes the acids that attack enamel and stimulates saliva, which washes away food and plaque.

Finally, keep up with your cleanings. They’re recommended twice a year, or every 3–4 months for patients with periodontal disease (periodontal maintenance). Your hygienist removes the hardened tartar that brushing and flossing can’t.

See the full guide to brushing and flossing, or book your next exam and cleaning.