Clean between your teeth once a day, brush twice a day for two minutes with fluoride toothpaste, and when you finish, spit out the toothpaste without rinsing with water. Mouthwash is optional: it doesn't replace brushing or flossing, and if it contains fluoride, it's wise not to use it right after you brush.
Lots of people worry about the order, but the American Dental Association (ADA) is clear: it doesn't matter whether you floss before or after brushing, as long as you do it thoroughly every day. What does change the outcome comes down to three things: cleaning between your teeth daily, brushing long enough, and not washing away the fluoride when you're done.
That's why we suggest this order: between your teeth, brush, spit. It isn't the only order that works, but this way the fluoride from your toothpaste is the last thing that touches your teeth.
What about kids? The ADA recommends a smear of fluoride toothpaste the size of a grain of rice for children under 3, and a pea-sized amount for ages 3 to 6, with an adult supervising and reminding them not to swallow it.
Mouthwash is not a replacement for brushing and cleaning between your teeth; for some people it's a helpful add-on. The ADA describes two types:
On timing, ADA News explains that mouthwashes usually contain less fluoride than toothpaste and that rinsing right after brushing could reduce the fluoride left on your teeth. One way to avoid washing off your toothpaste is to use mouthwash at a different time of day; your dentist can tell you what fits your situation.
And always read the label and follow its directions, precautions and age limits. The ADA does not recommend mouthwash for children under 6, because swallowing a large amount can make them sick, especially with alcohol-based rinses. If you're using it for bad breath, keep in mind it only covers it up for a while: we explain where it comes from in Bad breath: where it comes from and what to do.
The ADA calls for brushing twice a day, and the nighttime session is the hardest one when you're tired. Don't skip it: it's usually when you have the most time for the full routine. The ADA suggests cleaning between your teeth at whatever time you can give it extra attention, and for many people that's right before bed.
After you spit, let the fluoride work. If you snack or have something sugary after brushing, you're giving bacteria food again; the practical move is to make brushing the last thing you do, other than water.
If you wear dentures, night is their time too: the ADA recommends taking them out at night and cleaning them thoroughly before wearing them again, and keeping them covered in water so they don't warp.
The goal is to clean between your teeth, not to force yourself to floss. The ADA says floss is just one option, and the right method is the one you'll actually use. Here are the alternatives:
Whatever you choose, look for the ADA Seal. Cleaning between your teeth shouldn't hurt: you may feel some discomfort at first while you learn the right pressure, but if it keeps hurting, tell your dentist.
If your gums bleed when you clean, don't ignore it. Gums that bleed easily are one of the gum disease symptoms listed by the NIDCR. We cover it in Bleeding gums when brushing.
During your teeth cleaning, beyond the cleaning itself, we use a mirror to show you where plaque builds up, which between-the-teeth cleaner fits your spaces and, if you have bridges, implants or dentures, how to clean them at home. We see patients in English or Spanish and verify your dental insurance for free before your visit.
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Brush first. If your mouthwash has fluoride, don't use it right after brushing so you don't reduce the fluoride from your toothpaste; use it at another time or as your dentist advises.
Not with water. Rinsing washes away part of the fluoride your toothpaste leaves on your teeth. The ADA recommends spitting without rinsing, especially if you're prone to cavities.
Exactly as the label says: amount, time, precautions and minimum age. It's not for children under 6, and if it's therapeutic or prescription, also follow your dentist's instructions.
According to the ADA, it doesn't matter as long as you do it thoroughly once a day.
Every three or four months, or sooner if the bristles look frayed or worn.
General information; not a substitute for an in-person evaluation. Responsible dentist: Dr. Yoan Suárez Zayas, DMD (FL License DN 21413). Sources: American Dental Association (MouthHealthy: flossing, brushing, mouthwash, dentures, bad breath and healthy habits for kids; ADA Oral Health Topics: home care, toothbrushes and interdental cleaners; ADA News), Cochrane (interdental cleaning devices, 2019) and the National Institute of Dental and Craniofacial Research (NIDCR).
