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Writer's pictureDavid Chen, DDS

How Often Should You Really Be Brushing Your Teeth?

Some people brush twice a day while others brush just once and then there are the rare few who barely brush at all. How often should you brush your teeth? What is appropriate or rather what is the most optimal brushing frequency for keeping your teeth, gums, and mouth healthy?


foam after brushing teeth

Our purpose here is to explore how many times a day you should really be brushing. We'll look at what the American Dental Association (ADA) says and also what the makers of toothpaste recommend. Then we'll come up with a consensus for what you should do so that you can chew and eat whatever you want!


Table of contents:


ADA recommendation for brushing frequency

According to the American Dental Association (ADA), you should brush for two minutes twice a day with a soft toothbrush.

  • Place the toothbrush against the gumline at a 45-degree angle.

  • Move the toothbrush gently back and forth in short strokes.

  • To clean the inside surfaces of the front teeth, they should tilt the brush vertically and make several up-and-down strokes.


That's basically all that the ADA had to say about the frequency of brushing. They didn't really give additional information as to why twice a day. All they listed was a study about how the minimum brushing time should be two minutes.


We will apply some common sense to explain the recommendation for doing it twice per day, once in the morning and again before bed.


Rationale for brushing in the morning

You should brush your teeth in the morning when you wake up so that you can get rid of morning breath. Your breath will feel fresher and your breakfast will be more enjoyable if you do that.


The primary reason for morning breath is because your saliva flow decreases significantly when you're asleep. Due to insufficient flow of saliva, the pH in the mouth drops and the bacteria begin to thrive and produce a lot of sulfur.


Studies have shown that a major cause of bad breath or morning breath is due to the presence of volatile sulfur compounds (VSC) in the mouth. One of the purposes of your saliva is to continuously wash away the bacteria and prevent them from building up a large concentration of VSC.


Now you know why people's breath are usually not the most pleasant right when they wake up! That is also the reason why we recommend brushing in the morning. It just makes the rest of your day that much more pleasant.


Rationale for brushing before bed

You should definitely brush before bed if being cavity-free is a top priority for you. At the end of the day, all of that food that you've been eating should not be left on your teeth. That is especially true if you had any type of carbohydrates such as sugar because bacteria feast on it.


Leaving residual carbohydrates on your teeth is a recipe for getting cavities. If you don't brush before going to bed, all of this food will eventually cause tooth decay. The first thing that will happen is your enamel will demineralize and that is the first stage of tooth decay.


Therefore if you don't want cavities you should definitely brush with a fluoride toothpaste before going to bed. The fluoride has many anti-cavity benefits and will make your teeth stronger and can even repair them.


There are in fact consequences if you stop using a fluoride toothpaste so please be mindful of it. You'll lose all of the preventative effects if you choose to use an all natural toothpaste.


 

Toothpaste manufacturers recommendation

Most of the toothpaste makers recommend that you brush your teeth at least twice a day, once in the morning and once at night. However some of them also say that it is preferable to brush after each meal.


Adults and children 12 years of age and older: apply at least a 1-inch strip of the product onto a soft bristled toothbrush. Brush teeth thoroughly for at least 1 minute twice a day (morning and evening) or as recommended by a dentist. Make sure to brush all sensitive areas of the teeth. - Colgate

Adults and children 2 years of age and older: brush teeth thoroughly, preferably after each meal or at least twice a day, or as directed by a dentist or physician. - Hello

The Colgate total says at least twice a day OR as recommended by a dentist. That means their recommendation is to brush two times but whatever your dentist recommends will override their suggestion.


The Hello toothpaste is interesting in that they say at least twice as well but they would prefer it if you brushed after every meal. Like Colgate, they also stated that if your dentist recommended otherwise, you should follow their recommendation instead.


Ultimately it seems like toothpaste manufacturers want you to brush your teeth at least two times a day, in the morning and at night. It would also be preferable if you can brush after every meal as well. However at the end of the end of the day if your dentist recommends doing it at a different frequency, you should follow their suggestion.


Brushing frequency for children

According to the ADA, children should be brushing twice a day once in the morning and at night. In fact, they should start as soon as the first tooth erupts in their mouth which would be around 6 months of age.


While they're infants the parents will have to assist them in brushing their teeth for them.

  • Use a soft bristled brush.

  • Toothbrush head is small enough to be able to fit in their mouth.


When they get a little older and have enough hand eye coordination, they should brush on their own with adult supervision. Adults must make sure that they spit out the toothpaste properly so they don't swallow it!


How much toothpaste to use for children:

  • Under 3 years old - use a smear about the size of a grain of rice.

  • Over 3 years old - pea sized drop of fluoride toothpaste.


While they're young, make sure you supervise them and teach them how to brush properly. Building good habits while they're young will keep them out of teeth problems like decay in the future.


Last but not least, make sure they do not swallow any of the fluoride toothpaste. Due to their smaller body size, they are more sensitive to fluoride overdosing. As long as they spit it back out properly it is safe to use toothpaste. They should also rinse after brushing to eliminate the risk of swallowing any residual paste.


Is brushing too much harmful?

As long as you brush properly, it is safe to brush as often and for as long as you want. It only becomes dangerous if you brush incorrectly such as using a hard bristled toothbrush or brushing aggressively.


Proper brushing is not harmful

If you brush gently with a soft bristled toothbrush and a low abrasive toothpaste, it shouldn't cause any harm to your gums and teeth.

  • Soft toothbrush. The softer the bristles, the safer it will be on your gums. Due to it not being rough, it makes it very difficult to cause any damage to your mouth. It is similar to trying to cut bread with paper. The paper is too soft to do any damage.

  • Gentle brushing motions. Soft and gentle brushing motions are not likely to harm the gums. It is if you brush overzealously that it can cause the gums to recede.

  • Low abrasive toothpaste. All toothpastes come with a certain abrasiveness or grittiness. It is similar to how sandpaper has various levels of grit (fine/coarse). Your toothpaste can be more or less abrasive depending on its ingredients. A low abrasive one will be the least likely to cause harm to your mouth.


If your toothpaste feels very rough or has a gritty texture, you may want to switch to a smoother one. If you're unsure about how abrasive your toothpaste is, you should look up their RDA value (relative dentin abrasivity value). It is a quantitative measure of your toothpaste's abrasiveness.


Toothpaste RDA chart

Just as a word of caution, some of the charcoal toothpastes can be very abrasive and they aren't recognized by the ADA as safe. With that being said, according to some of the activated charcoal toothpaste makers, their RDA values are within acceptable limits. Our recommendation would be to do your own due diligence to make sure it is safe enough to use.


Improper brushing is hazardous

Contrary to proper brushing, doing it improperly can cause significant damage to your teeth and gums.

  • Gum recession. This is when the gums shrink and recede, thus exposing the sensitive root surfaces of your teeth.

  • Tooth abfractions. This can cause notches in your teeth by the gumline. It looks like someone took a bite out of your tooth and you're missing a piece. This is even worse than gum recession because you not only have receded gums but also missing tooth structure.


The adverse effects above may happen if you brush overzealously with a hard toothbrush. The effects can be exasperated if you couple it with an abrasive toothpaste.

  • Hard bristle toothbrush - hard bristles can be very damaging to your mouth. Even Colgate says that you shouldn't be using a hard brush, you should only use a soft one.

  • Aggressive brushing - even a spoon can dig through a wall if you attack it with enough fervor. Evidence of that can be seen by people escaping prison! The same is true with brushing your teeth, if you brush aggressively enough even with a soft brush you can destroy your mouth.

  • Abrasive toothpaste - rubbing your gums and enamel with a very abrasive toothpaste can cause serious damage. The roughness will eventually abrade your gums and enamel. Please do not use such rough toothpaste.


Brushing your teeth is meant to help it by preventing tooth decay, sensitivity, and gum disease. The purpose is to keep your teeth clean so that they can be healthy. Doing it properly will not harm it but doing it improperly can cause unintended consequences.


So how often should you brush your teeth?

You should brush your teeth as many times as your mouth needs to stay healthy because everyone's oral hygiene needs are different. As long as you brush with proper techniques it will be safe to do so.


For the average person, brushing twice a day will suffice in minimizing tooth decay and gum disease like gingivitis. However for individuals that are more prone to cavities or have a propensity towards gum disease, it would be wise to brush more often. Their needs are greater than the average person.


What you need to understand is that the twice a day recommendation is based on the needs of the average individual in a population. If you happen to be someone that is 1-2 standard deviations away from the middle, your needs will be different.


You can't follow the brushing management protocol for the average person. You will need your own customized and personalized oral hygiene regime. In order to figure that out, you should discuss with your dentist on how to best manage your condition.


If you need to brush more than twice a day then THAT is how often you should be brushing. However if you happen to be "average" then twice a day will be all that you'll need.


Remember, at the end of the day you're not brushing your teeth to meet the recommended quota. You're brushing your teeth to keep your teeth, gums, and mouth healthy. So, how many times it takes to keep you healthy is how often you should be brushing your teeth.

After all, the toothpaste makers all state you should brush twice a day OR as directed by your dentist. The latter takes precedence above all else!

David Chen 200 x 200.jpg

About the author: Dr David Chen, DDS

Hello, I'm Dr Chen and I'm an actively practicing dentist in Long Island City, NY. I graduated from Columbia University College of Dental Medicine in 2016 but prior to going to dental school I was already working in the dental field. It's been more than a decade since I first got to know dentistry and let me tell you, time flies by quickly. Since then I've developed a fondness for writing, which is how this all got started!

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Medical Disclaimer:

This blog is purely meant for information purposes and should not be used as medical advice. Each situation in your mouth is unique and complex. It is not possible to give advice nor diagnose any oral conditions based on text nor virtual consultations. The best thing to do is to go in person to see your dentist for an examination and consultation so that you can receive the best care possible.

The purpose of all of this oral health information is to encourage you to see your dentist and to inform you of what you may expect during your visit. Due to the unfortunate nature of dentistry, there isn't really any true home remedies that will get rid of dental problems. Roughly 99.99% of them require in-person intervention by a healthcare professional.

Hint: That is the reason why you can't eliminate seeing dentists in your life!

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