Patient Guide
Looking after your teeth at home
Two minutes, twice a day, done well, prevents most of what we treat. Here is exactly what “done well” means, and honest answers about the gadgets and trends.
Reviewed by Dr. Ray Han, General Dentist, Dentistry at Vitality Health
Brush for two minutes, twice a day, with a soft brush and fluoride toothpaste, holding the brush at a 45-degree angle to the gum line. Clean between your teeth once a day with floss or an interdental brush. Spit out the toothpaste but do not rinse with water afterwards. That routine, kept up every day, prevents most cavities and gum disease.
Most people brush every day and still miss the same spots: the gum line, the inside surfaces of the lower front teeth, and the back of the last molars. This guide walks through the technique our hygienists teach chairside, explains what the evidence says about electric brushes, water flossers, mouthwash and the latest trends, and tells you when to see us instead of trying to fix something at home.
If your gums bleed when you brush or floss, do not stop. Bleeding usually means plaque has been left behind and the gums are inflamed. Gentle, thorough cleaning for a week or two normally settles it. If it does not, read about bleeding gums and book a check-up.
How should I brush my teeth?
- Use a soft brush. Soft, rounded bristles clean just as well as medium or hard ones and do not wear away the gums or enamel. The Canadian Dental Association recommends soft bristles for everyone.
- Angle the brush at 45 degrees to the gum line, so the bristles reach slightly under the edge of the gum where plaque collects.
- Use small, gentle circles or short back-and-forth strokes, a few teeth at a time. Do not scrub.
- Cover every surface: outside, inside and the chewing surfaces. Tilt the brush upright for the inside of the front teeth.
- Take two minutes. Most people stop at 45 seconds. Split the mouth into four quarters and give each one 30 seconds. A timer or an electric brush with a built-in timer helps.
- Brush twice a day, and make bedtime the one you never skip. Saliva flow drops while you sleep, so plaque left overnight does the most harm.
Can brushing too hard damage my teeth?
Yes. Scrubbing hard with a stiff brush wears a notch into the tooth at the gum line and pushes the gum away from the tooth. The result is gum recession, exposed roots and sensitivity to cold. Once gum tissue has receded it does not grow back on its own.
Signs you are brushing too hard: bristles splayed flat within a few weeks, gums that look pale or receded at the front teeth, and teeth that twinge with cold water. The fix is a soft brush, a lighter grip (hold it like a pen, not a hammer) and small circles instead of long strokes. An electric brush with a pressure sensor helps if the habit is hard to break. Read more about receding gums and sensitive teeth.
Should I floss before or after brushing, and how?
Either order works; what matters is that you do it once a day. Many hygienists suggest flossing first, so the fluoride from your toothpaste reaches between the teeth afterwards. Pick the order you will actually stick to.
- Take about 45 cm (arm's length) of floss and wind most of it around one middle finger, the rest around the other.
- Hold a few centimetres taut between your thumbs and index fingers.
- Slide it gently between two teeth. Do not snap it down into the gum.
- Curve it into a C shape against one tooth and wipe up and down from the gum to the tip two or three times. Then curve it against the neighbouring tooth and repeat.
- Move to a clean section of floss for each gap. Do not forget the back of the last tooth in each corner.
Floss reaches the third of each tooth's surface a brush cannot. Skipping it is why cavities so often start between the teeth, where you cannot see them.
Do water flossers and interdental brushes work?
Interdental brushes (small bottle-brush shapes on a handle) are excellent, and for many adults they are better than floss, especially where the gaps between teeth have opened up or around bridges and braces. Use the largest size that fits snugly without forcing.
Water flossers flush out food and loose debris and are very helpful for people with braces, implants, bridges or limited hand movement. They are less effective than floss or interdental brushes at scraping off sticky plaque that has attached to the tooth. If a water flosser is the only thing you will use, it is far better than nothing. If you can, use it alongside floss or interdental brushes rather than instead of them.
Does mouthwash help?
Sometimes, and it never replaces brushing and cleaning between the teeth. A fluoride mouthwash used at a different time from brushing (for example, after lunch) adds protection for people who get a lot of cavities. An antibacterial rinse can help calm gum inflammation for a short period, usually on our advice. Rinses that mainly freshen breath do nothing for plaque.
Do not rinse right after brushing, even with mouthwash; you wash away the fluoride you just applied. Choose alcohol-free rinses if you have a dry mouth, because alcohol dries it further.
Everyday habits that make a difference
Spit, don't rinse
After brushing, spit out the toothpaste and leave it at that. Rinsing with water washes the fluoride off before it can strengthen the enamel. It feels odd for a week and then becomes normal.
Clean your tongue
The tongue holds a large share of the bacteria that cause bad breath. Brush it gently from back to front with your toothbrush or a tongue scraper, once a day.
Wait after acid
After acidic food or drink (citrus, wine, pop, sports drinks) or after vomiting, enamel is temporarily softened. Rinse with water and wait about 30 minutes before brushing so you do not scrub softened enamel away.
Replace your brush
Every three months, or sooner if the bristles are splayed. A worn brush cleans poorly. Replace it after a cold or flu as well.
Mind the snacks
It is how often sugar touches your teeth that matters, not how much. Constant sipping and grazing keeps the mouth acidic all day. Keep sweet things to mealtimes and drink water in between.
Keep your check-ups
Even perfect home care leaves hardened tartar that only a professional cleaning removes. Most people do well with a visit every six months; we will tell you if your interval should be different.
How do I clean around implants, bridges and braces?
Implants need the same daily cleaning as teeth, plus attention to the gum line where the crown meets the implant. Floss, interdental brushes and a water flosser all help. Plaque left around an implant causes an infection called peri-implantitis, which can loosen an implant that would otherwise have lasted decades. Read our page on peri-implantitis.
Bridges have a false tooth joined to the crowns on either side, so you cannot floss between them from the top. Use a floss threader or super floss to pass underneath the false tooth, or an interdental brush if the space allows.
Braces trap food around every bracket. Brush after every meal if you can, angle the brush above and below the wire, and use interdental brushes or a water flosser between the teeth. White marks left on teeth after braces come off are almost always from plaque left around the brackets, and they do not fade.
Whitening toothpaste, charcoal and oil pulling: what does the evidence say?
Whitening toothpastes remove surface stains with mild abrasives or chemical agents. They can brighten teeth a little but cannot change the natural colour of enamel the way professional whitening does. Some are quite abrasive; if you have sensitive teeth or exposed roots, choose one with a low abrasivity or ask us.
Charcoal toothpaste has no good evidence behind it. Many charcoal products are abrasive, some contain no fluoride, and the black particles can lodge in the edges of fillings and crowns. We do not recommend it.
Oil pulling (swishing coconut or other oil) is harmless if you enjoy it, but studies have not shown it to whiten teeth or replace brushing and flossing. Use it in addition to your routine, never instead of it.
If something promises to whiten, cure or “detox” your mouth, be cautious. Fluoride toothpaste, a soft brush, daily cleaning between the teeth and regular check-ups remain the things that actually work. Ask us about professional whitening if colour is what concerns you.
Common questions
Is an electric toothbrush better than a manual one?+
A good technique with either brush works. Studies do show that electric brushes, especially the oscillating-rotating kind, remove a little more plaque and reduce gum inflammation slightly more than manual brushing for most people. The built-in timer and pressure sensor are the real advantages. If you brush well by hand, you do not need to switch.
How long should I brush for?+
Two minutes, twice a day. Most people who time themselves are surprised to find they stop well short of that. Thirty seconds on each quarter of the mouth is an easy way to keep count.
My gums bleed when I floss. Should I stop?+
No. Bleeding means the gums are inflamed by plaque that has been sitting there. Gentle daily flossing usually stops the bleeding within one to two weeks. If it continues, or if your gums are also swollen or receding, book a check-up so we can look for gum disease.
Should I brush right after eating?+
Wait about 30 minutes after acidic foods or drinks, because enamel is softened for a short time and brushing then can wear it. Rinse with water in the meantime. After a normal meal that was not acidic, brushing straight away is fine.
Is fluoride toothpaste safe?+
Yes. Fluoride toothpaste is the single most effective thing you can use at home to prevent cavities, and it has been studied for decades. The only caution is for young children, who should use very small amounts and be taught to spit rather than swallow. See our children's dentistry page for the amounts by age.
How often should I replace my toothbrush?+
Every three months, or as soon as the bristles start to splay. The same goes for electric brush heads. A brush that wears out in a few weeks is a sign you are pressing too hard.
Sources: Canadian Dental Association: Flossing and Brushing · Canadian Dental Association: position on the use of fluorides in caries prevention · Yaacob M et al. Powered versus manual toothbrushing for oral health. Cochrane Database of Systematic Reviews 2014
Want a technique check?
Bring your brush to your next cleaning and our hygienists will show you what you are missing. Book a visit or call (905) 479-7777.