Brushing your teeth might seem like a boring and time consuming task, but the importance of doing so should not be underestimated.
But, just how long and how often should you be brushing for?
Twice a day for 2 minutes.
This is the general advice given in some of the largest countries of the world.
Brushing for 2 minutes, twice a day with the correct brushing technique will in most instances ensure you have generally good oral health.
You should floss regularly as well, cleaning the interdental spaces that a toothbrush does not reach. Some 40% of your tooth surface is not cleaned with regular brushing.
Differing research and opinion
Globally the research and recommendations vary.
In 2014, UCL researchers, Dr John Wainwright and Prof Aubrey Sheiham, analysed 66 different sources of advice from around the world. Their findings were published in the British Dental Journal.
Most recommendations were for cleaning the teeth twice a day, but when it came to stating how long to brush, 26 sources advised brushing for 2 minutes, 12 for 2-3 minutes and 2 recommended 3 minutes of brushing.
In Korea for example, they are encouraged to brush 3 times a day for 3 minutes. Dentists and the Korean Dental Association call it the 3-3-3 approach (3 times a day for 3 minutes within 3 minutes of eating).
A 2017 study concluded that Korean adults who are encouraged to brush three times a day for at least three minutes had lower incidences of periodontal disease than Americans and Australians who are taught to brush twice a day.
Whilst within the UK and the USA the general consensus and advice has been for 2 minutes twice a day, recently completed research by YouGov found that 1 in 3 within the UK are brushing their teeth just once a day, rather than the recommended 2 times.
This is concerning, particularly when some 87 percent of those surveyed were more likely to brush in the morning, yet NHS information advises brushing before bed and another time in the day, not necessarily in the morning.
If recommendations were to change to follow the oral health pattern of Koreans, the routine would be after breakfast, lunch and dinner.
Whilst 2 minutes twice a day is the recommendation as it encourages people to brush enough, this is not necessarily appropriate for everyone and there is the need to consider personal circumstances and lifestyles, no 2 people are necessarily the same.
Individuals with an increased risk of gum disease or tooth decay may be advised by dental professionals to brush for longer or take extra steps when brushing to ensure optimum dental health. Those with limited dexterity or control may may too be subject to personalised recommendations. It is about taking the time that is appropriate for you to get your teeth clean, be that 2 or 5 minutes.
There must be consideration for using the right brushing technique too. By applying the correct technique you improve your chances of effectively removing plaque and bacteria. See our post on how to brush your teeth properly for detailed instructions.
The ADA demonstrate what they consider to be the correct technique in the following video.
The Journal of Dental Hygiene in 2009 published results of a study that confirmed that plaque removal increased with brushing time and that 2 minutes should be the minimum recommended time, but dental professionals should continue to coach the correct brushing technique.
Detailed analysis showed that brushing for 180 seconds (longer than 2 minutes) removed 55% more plaque than brushing for 30 seconds. Brushing for 120 seconds removed 26% more plaque than brushing for 45 seconds.
This correct brushing technique is something that Wainright and Sheihams research picked up on. They found that 6 different techniques were actually being offered and that the unacceptably large diversity in recommendations on what tooth brushing method to use should concern the dental profession.
In a BBC article Dr Nigel Carter, from the British Dental Health Foundation, said there was little evidence for recommending one brushing technique over another.
“Dentists generally feel it is better to take a person’s existing habits and modify them if necessary,” he explained.
“Even children have a preferred way of brushing their teeth, and dentists should point out the areas that are not being cleaned well, rather than teaching them a whole new technique.”
Thus, there is evidence to suggest that actually brushing for longer than the 2 minutes advised by the ADA and NHS is beneficial, but it is ultimately a balance and generally encouraging, you, I and the population of countries around the world to brush to a certain standard.
A number of research pieces such as including that by Menzies Health Institute Queensland and School of Dentistry and Oral Health has shown that brushing twice-daily, is optimal for reducing risk of tooth decay, gum disease and recession.