Brushing Habits To Prevent Tooth Decay

  • Richa GuptaBachelor's degree, Dentistry, National Dental College, VPO Gulabgarh, Tehsil Dera Bassi
  • Jasmine AbdyBSc, Medical Microbiology with a Year in Industry, University of Bristol

Importance of oral hygiene

The mouth is a part of the digestive and respiratory systems which helps to perform daily functions like eating, speaking, and breathing. Proper maintenance of oral health can help prevent various dental and medical issues. Practising good oral hygiene is important for keeping your mouth clean and free from disease. It involves performing mechanical actions with the right tools like, a toothbrush and dental floss, properly and regularly1 for healthy teeth and gums. Poor oral hygiene can lead to problems such as tooth decay, gingivitis, bleeding gums, bad breath, and loose teeth. Conversely, practising good oral hygiene can provide benefits like healthier teeth and gums, a decreased need for dental work, and a beautiful smile.

Role of brushing to prevent tooth decay

Brushing teeth twice a day for two minutes using fluoride toothpaste is recommended by the American Dental Association (ADA). Routine toothbrushing is essential in getting rid of plaque and reducing plaque-related diseases, such as periodontitis and caries.2 The use of fluoride-containing toothpaste enhances fluoride concentration levels in biofilm fluid and saliva and is associated with improved remineralization of teeth and decreased risk of cavities.3

Understanding tooth decay

Teeth consist of two primary structures called the crown (part of the tooth above the gums) and root (part of the tooth below the gums). The teeth are made up of enamel, dentin, pulp, and cementum. The crown is covered by enamel, which is the hardest substance in the body and the root is covered by cementum. The dentin, found underneath the enamel and cementum surrounds the pulp which contains the nerves, blood vessels, connective tissue and specialised cells.

Dental Plaque is a layer of bacteria that forms on the teeth. Tooth decay starts when these bacteria metabolise sugars and starches from food and drinks to produce acids that attack the hard tissues of teeth. Tooth decay leads to holes in teeth known as dental caries. Dental caries is an irreversible disease which causes demineralization of the inorganic portion and destruction of the organic substance of the tooth.4 If left untreated, it may lead to pain, infection, and tooth loss. The most significant contributing factor in the initiation and progression of dental caries has been assessed as sugar consumption. Other contributing factors include poor oral hygiene and lack of fluoride exposure.5

Proper Brushing Techniques

Brushing regularly is an important part of the dental care routine. It is often recommended to brush after every meal since the bacteria start attacking teeth minutes after eating. The American Dental Association recommends brushing twice a day with a soft-bristled brush and replacing the toothbrush every three to four months after use.

Proper brushing technique involves the following simple steps:

  • Brush with a fluoride toothpaste for two minutes. Divide 30 seconds between the upper left, upper right, lower left, and lower right teeth. It is important to brush all the surfaces of the teeth.
  • Place the toothbrush at an angle of 45 degrees to the gums.
  • Make gentle circles with the bristles. Brushing too hard might irritate and possibly injure gums. 
  • Rotate the bristles in a gentle sweeping motion. The inner surfaces of the front teeth should be cleaned using up-and-down strokes by tilting the brush vertically.
  • It is important to brush the tongue to get rid of bacteria buildup.
  • Rinse your mouth and your brush to wash away all the traces of toothpaste and food debris. World Dental Federation suggests spitting out any excess toothpaste instead of rinsing to prevent the protective fluoride from washing away.  

Common Mistakes to Avoid

There are certain tooth-brushing mistakes to avoid for healthier teeth and gums:

  • Choosing the wrong toothbrush: Avoid using a toothbrush with hard bristles. Hard bristles may lead to abrasion of teeth and damage to the gums. 
  • Improper technique: Incorrect brushing technique might do more harm than good. Over-brushing and aggressive techniques can lead to tooth sensitivity and gum recession. Neglecting the gums and tongue can lead to the accumulation of plaque and bacteria. 
  • Using old toothbrush: Worn-out, frayed toothbrush doesn’t effectively remove debris and plaque.
  • Skipping night-time brushing routine: Neglecting your brushing routine at night can allow harmful bacteria to thrive increasing the risk of plaque buildup and dental issues.
  • Brushing right after drinking or eating acidic food: Brushing immediately after consuming acidic foods or drinks can spread the acid around and erode tooth enamel. Waiting at least 30 minutes after consuming acidic substances before brushing your teeth will allow the saliva to protect the enamel by neutralising the acid.
  • Brushing too quickly: Rushing through tooth brushing might not give enough time to effectively clean the teeth and gums. 

Additional Tips for Oral Hygiene

Here are some additional tips to improve oral hygiene:

  • Avoid sharing toothbrushes as it could result in an exchange of bodily fluids and microorganisms between people.6
  • After use, the toothbrush should be thoroughly rinsed to remove any remaining toothpaste and debris.6
  • The toothbrush should be allowed to air dry in an upright position after use. There is greater microbial growth in a moist toothbrush stored in a closed container as compared to the one exposed to open air.7
  • Regular use of floss and interdental cleaners helps to dislodge food and may reduce gum diseases and bad breath by removing plaque that forms along the gum line.
  • Regular dental check-ups are important to catch any dental issues in the early stages.
  • Drinking fluoridated water and using fluoride toothpaste protects the teeth. 
  • Maintaining a healthy lifestyle, such as eating a balanced diet and avoiding smoking can lower the risk of tooth decay and improve oral health.


People of all ages can get tooth decay. As the tooth decay advances it may form a cavity, which, if left untreated may cause tooth pain, sensitivity, infection, and loss of a tooth.  Good oral hygiene plays an important role in preventing tooth decay. Brushing teeth twice a day prevents the accumulation of dental plaque and bacteria. The use of fluoride-based toothpaste is recommended as it protects teeth against decay by strengthening the enamel and improving remineralization. To maintain good oral hygiene, it is important to adopt proper tooth-brushing techniques. Prioritising good oral hygiene can prevent tooth decay and reduce the need for restorative dental procedures such as fillings, crowns, etc, which can save time and money in the long run.


How common are dental caries?

Dental caries is the most prevalent disease worldwide. The incidence of dental caries increased with the increase in the availability of processed sugar. However, improved oral hygiene practices along with increased use of fluoride (fluoridation of the public water supply, fluoride in dentifrices, mouth rinses), has greatly reduced the prevalence of dental caries.8

According to the World Health Organization (WHO), dental caries is a major public health problem globally and is the most widespread noncommunicable disease (NCD). In the 2015 

Global Burden of Disease Study, is also the most prevalent condition, ranking first for decay of permanent teeth (2.3 billion people) and 12th for deciduous teeth (560 million children).9

When should I see a dentist?

The patient might not experience any symptoms in the early stages of tooth decay, therefore, regular dental visits are important. Dentists can easily identify and treat early stages of tooth decay, and prevent permanent damage. A dentist should be immediately consulted in case of tooth sensitivity, pain, or swelling in or around the mouth. These issues may indicate tooth decay or a dental condition that needs attention.


Good oral health can be maintained through practices like regular brushing with fluoride toothpaste which help prevent issues such as tooth decay. The ADA suggests brushing twice daily using a soft-bristled brush and replacing the brush every three to four months to effectively remove decay-causing plaque and bacteria. Proper brushing technique involves brushing for two minutes with fluoride toothpaste, using gentle circular motions and ensuring all tooth surfaces are cleaned. The tongue collects a load of bacteria and should be brushed, too. Regular dental check-ups and a balanced diet also help intercept tooth decay. Good brushing habits can prevent tooth decay and support a healthy smile.


  1. Robo I, Heta S, Kapaj S, Llanaj M, Ostreni V. Adolescents, self-perception versus oral hygiene. Bulletin of the National Research Centre [Internet]. 2023 Jun 1 [cited 2024 Feb 27];47(1):79. Available from:
  2. Gallagher A, Sowinski J, Bowman J, Barrett K, Lowe S, Patel K, et al. The effect of brushing time and dentifrice on dental plaque removal in vivo. American Dental Hygienists’ Association [Internet]. 2009 Jun 1 [cited 2024 Feb 27];83(3):111–6. Available from:
  3. Newby EE, Martinez-Mier EA, Zero DT, Kelly SA, Fleming N, North M, et al. A randomised clinical study to evaluate the effect of brushing duration on fluoride levels in dental biofilm fluid and saliva in children aged 4–5 years. Int Dent J [Internet]. 2020 Nov 5 [cited 2024 Feb 27];63(Suppl 2):39–47. Available from:
  4. Av JA, Santhadevy A, Sivaramakrishnan M, G U. Dental caries – A review on its immunology & vaccines. International Dental Journal of Student’s Research [Internet]. [cited 2024 Feb 27];10(2):31–6. Available from:
  5. Pitts NB, Zero DT, Marsh PD, Ekstrand K, Weintraub JA, Ramos-Gomez F, et al. Dental caries. Nat Rev Dis Primers [Internet]. 2017 May 25 [cited 2024 Feb 27];3(1):1–16. Available from: 
  6. Bunetel L, Tricot‐Doleux S, Agnani G, Bonnaure‐Mallet M. in vitro evaluation of the retention of three species of pathogenic microorganisms by three different types of toothbrush. Oral Microbiology and Immunology [Internet]. 2000 Oct [cited 2024 Feb 27];15(5):313–6. Available from: 
  7. Frazelle MR, Munro CL. Toothbrush contamination: a review of the literature. Nursing Research and Practice [Internet]. 2012 Jan 24 [cited 2024 Feb 27];2012:e420630. Available from: 
  8. Lamont RJ, Egland PG. Chapter 52 - dental caries. In: Tang YW, Sussman M, Liu D, Poxton I, Schwartzman J, editors. Molecular Medical Microbiology (Second Edition) [Internet]. Boston: Academic Press; 2015 [cited 2024 Feb 27]. p. 945–55. Available from:
  9. Dye BA. The global burden of oral disease: research and public health significance. J Dent Res [Internet]. 2017 Apr [cited 2024 Feb 27];96(4):361–3. Available from:
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Richa Gupta

Bachelor's degree, Dentistry, National Dental College, VPO Gulabgarh, Tehsil Dera Bassi

I am a dental graduate with several years of experience in healthcare industries such as pharmacovigilance and medical writing. I have a keen interest in writing educational content for readers which presents actual medical information in an interesting manner.

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