Why you are brushing your teeth all wrong

With Britain’s mouths in a state of decay, Eleanor Steafel asks dentists what habits we need to ditch – and which to brush up on

If you started the day with a green juice, you may be feeling virtuous – but have you spared a thought for what it’s doing to your teeth? Thought not. Which is perhaps why Britain appears to be in the grip of a tooth decay epidemic. Last year, a Yougov survey found that three in 10 Britons only brush their teeth once a day, while a recent American survey found that the average millennial will happily go for two or more days without brushing.

Bad habits are starting even earlier; according to new figures, dentists remove 170 rotten teeth every day from the mouths of children, and performed 42,911 extractions last year – a fifth more than five years ago.

The culprit? As always, sugar. But don’t be fooled into thinking that chocolate and fizzy drinks are solely to blame. Naturally sweetened “healthy” snack bars, fruit juices and smoothies that are the preserve of the middleclass store cupboard can be just as bad for your family’s teeth.

As fully-functioning adults, keeping our teeth clean was one area we imagined we had covered. Taught as children, brushing our teeth is a ritual we all perform without question – right? So how wrong can we be getting it? Very, it would seem.

The older you get, the harder tooth decay is to reverse. Worse still, experts now believe that poor dental hygiene can lead to a whole host of seemingly unconnected mid-life diseases, including pancreatic cancer.

So how does the layman cut through the headlines screaming about the merits of using a traditional or electric toothbrush, brushing with cold or warm water, the benefits of flossing or using mouthwash?

Here, then, is a definitive guide to how to really look after your teeth …

Go electric

Your dentist wasn’t exaggerating: an electric toothbrush is infinitely more effective than a regular brush. The good news is you don’t need a top-of-the-range one to get the job done, but you might need to change the way you brush to feel the benefit.

Toby Edwards-lunn says that the sticky plaque on your teeth comes away with much less effort with an electric toothbrush, “and, for that, you don’t need to spend hundreds of pounds,” says the dental practitioner.

“You could spend £150 on one with a sensitivity function, a tongue-brushing action, and an app for your phone so you can find out if you’re brushing the right areas of your mouth and where you’re missing,” he explains. “But a £30 model – such as something from the Oral B’s 2000 range – will do fine. You just need one with a two-minute timer”, which is the minimum recommended brushing time.

Studies have confirmed that brushes with rotating heads are more likely to reach every bit of your mouth than manual brushing – just as long as you follow a few rules. Rather than the traditional method of up-and-down brushing, hold the rotating head still on the tooth for a couple of seconds, before moving slowly to the next. It’s recommended that you mentally divide up your mouth into quartiles and spend at least half a minute on each zone. “You can get electric brushes that buzz every 30 seconds as a reminder,” says Dr Edwards-lunn. “Just make sure your toothbrush is fully charged at all times: the speed of its head rotation is key.”

Steer clear of fancy toothbrushes

If you prefer a manual toothbrush, pay attention to the bristles. Using a “Firm” toothbrush may deliver a more satisfying, deep-clean feel, but studies show they can be abrasive and contribute to enamel erosion. Instead, dentists recommend sticking to toothbrushes with “Medium” or “Soft” bristles. Small-headed brushes are also preferable, as they can better reach all three external surfaces of your teeth – the outside, the inside and the biting surfaces. Just make sure to change it every three months.

Replacements for electric toothbrushes aren’t as cheap as the analogue variety, but don’t be dazzled by the entire range of orthodontic rotating brush heads on sale, says Dr Edwards-lunn. “One with endrounded bristles and a small head the size of a molar tooth with suffice for a few months.” For all-round daily use, try Oral-b’s Cross Action heads (£32.99 for eight), which have angled bristles to remove significantly more plaque than the traditional kind.

Don’t bother with mouthwash

“If you’ve got a good toothbrush and toothpaste, you don’t need a mouthwash,” says Dr Edwardslunn. “Use it to freshen up between brushes if you want to, but otherwise it’s a waste of money.”

In recent years, some experts have also argued that mouthwashes, which mostly all contain alcohol, could be a contributory factor to mouth cancer. But, Dr Edwards-lunn says, while there has been no conclusive evidence to suggest as much, there is really no need to use it on a daily basis.

What’s more, a new health study has suggested red wine could actually be beneficial to oral health, reducing the ability of plaquecausing bacteria to stick to the teeth and gums. Researchers found compounds from the drink, known as polyphenols, helped fend off harmful bacteria in the mouth. But before you start rinsing with pinot noir, bear in mind that the acidic nature of wine means it can damage the enamel.

Which is why you should…

…Never brush your teeth after a night out

The one occasion you should not brush your teeth before going to bed is after a spot of heavy carousing. With that horrible furry feeling still on your teeth, Dr Edwardslunn explains that, rather than reaching for the toothbrush, the best course of action is to swill a little mouthwash and then brush in the morning. Otherwise,

you could be doing more damage than good – especially if your alcoholic drink of choice was fizzy.

“If you have been on the prosecco, or spirits with a cola mixer, the surface of your teeth is going to have been softened by the drink’s acidity. This is not the time to be brushing that softened enamel, as you risk causing permanent damage. If you want to freshen up before going to bed, this is one of the few times mouthwash is of any use at all.”

Either floss every day or not at all

Flossing is, without doubt, the best way to release the plaque that builds up between your teeth. But if you aren’t going to do it every single day without fail, Dr Edwardslunn says it isn’t worth the effort at all.

“After 24 hours, plaque – that film you feel if you run your tongue around your mouth – is starting to do its damage. If you leave it two or three days between flosses, your gums will already have begun to react to that plaque, and that damage just carries on.”

If realistically you’re only ever going to be an occasional flosser, it’s time to give up altogether, as you’re not achieving a great deal by this sporadic flossing.

Check your toothpaste contains enough fluoride

Do you choose your toothpaste based on the number of PPM (parts per million) of fluoride it contains, or the mintiness?

Dr Edwards-lunn explains that it is the amount of fluoride in toothpaste that counteracts the “demineralisation” which occurs in the mouth when we eat sugar. “With tooth decay, the only two things we can have an impact on is the amount of plaque in your mouth, and the amount of sugar that you put together with that plaque. Because if you put sugar with plaque, you are going to get tooth decay, or demineralisation.

“But that is a reversible process. You can put the mineral back into your teeth with the fluoride in toothpaste.” Adults should be using a toothpaste with at least 1,400PPM of fluoride, he explains.

“Toothpaste brands like Sensodyne and Colgate will often have added ingredients like calcium phosphate which aids remineralisation.” But if you’re looking for fluoride – the most important ingredient in toothpaste

– opt for a supermarket brand, which will usually have 1,400PPM. Beware of toothpastes claiming to be dentally sound. Euthymol, with its strong

medicinal taste, apothecary-style packaging and which brands itself as a “scientific dental preparation”, actually contains no fluoride at all.

And Dr Edwards-lunn has one word of warning: “For children under the age of six, use a children’s formula toothpaste, because kids often swallow it and an adult level of fluoride is too much for them to ingest every day.”

Never brush straight after breakfast

The time of day when you choose to brush is crucial. It should be the last thing you do before you go to sleep, but you should never, Dr Edwards-lunn warns, wash your mouth out after brushing. Spit… and go to bed.

“That way, it stays on your teeth as you hit the pillow. It’ll be in your mouth for around 20 minutes, really doing some good, remineralising your teeth.”

Then, in the morning, resist the temptation to wait until after breakfast to brush your teeth – do it as soon as you wake up. “You’ll have less plaque after brushing your teeth, which means fewer cavity-forming bugs. That way, when you sit down for breakfast, the risk of decay is lower.”

Use sugar-free gum

The worst time to brush your teeth is immediately after drinking or eating anything acidic – so, instead of brushing, it’s better to neutralise the acidity a different way. Drink or eat something which contains a high level of calcium and phosphate, such as cheese or a glass of milk, as they will help to reverse the damage being done to the outer surfaces of the teeth.

“Chewing sugar-free gum will also help by encouraging your mouth to generate more saliva, which in turn will start to neutralise the acidity in your mouth,” says Dr Edwards-lunn – who has created Dr Heff ’s Remarkable Mints (£2.79, Holland and Barrett), a range of suckable dental mouth fresheners that are clinically proven to help reduce plaque, strengthen teeth and fight tooth decay.