• drToothChampion

Why must we brush our teeth twice daily?

Updated: Aug 14, 2019

In my other post, I talked about the types of toothbrushes for infants, toddlers and young children. Here I’ll be talking about the toothbrushing habit and why dentists advise twice a day brushing. When we brush our teeth, what are we trying to brush and how clean is clean? The general brushing advice is to brush your teeth (and your child’s teeth) twice daily. This is the minimum needed to ensure that your teeth are clean enough (ie almost no plaque and no food remnants). What is plaque? Plaque is like a sticky film of mainly different types of bad bacteria and other components such as polysaccharides, lipids and glycoproteins.

It is impossible to brush away all the plaque 100% of the time but it is possible to remove 80 to 90% of the plaque. And brushing should be thorough…meaning brush for about 2 to 3 minutes and I mean real proper brushing, not just gliding the brush along the teeth surfaces. For young children, you need to slowly build their tolerance to brushing longer so don’t expect to be brushing your toddlers’ teeth continuously for 2 minutes; you may have to give the occasional breaks in between to allow the child to close the mouth, fidget a bit and then continue again. At the early stages during infancy and toddler stage, you may only last for about a minute or so. Most importantly, you need to make sure you brush all the surfaces of the teeth.

Many parents ask why must the child brush in the morning after the child had already brushed the night before without any food or drinks after that. The answer is that plaque forms continuously all the time and at night while you are asleep, the flow of the saliva is slower. And therefore the plaque film starts to build up throughout the night. The longer the plaque remains and continues to thrive on the tooth surface, the harder it will be to brush away. This contributes to bad breath, higher risk of dental decay (caries) and gum disease. Therefore to prevent such thick plaque deposits and oral diseases, brush in the morning too. Similarly, brushing should be done as the last thing before bedtime. You wouldn’t want your child (or yourself) to be sleeping with a mouth full of bacteria and food remnants…this is like paradise for the bacteria to thrive and colonise rapidly.

Brushing for children should always be assisted until the child is about 8 years old when the manual dexterity is usually adequate by then. You should change the toothbrush if the bristles are splayed. Splayed bristles will not remove much plaque, if any at all. As your child moves towards independency for brushing, make sure that he/she spends at least 2-3 minutes brushing his/her teeth. It is a higher chance that the child will get rid of more plaque if he/she brushes longer. Try using sing-along songs or timer apps like "Brushez - The Little Monsters Toothbrush Timer", "Brush DJ" or "Disney Magic Timer". Also, at this stage above 6 years of age, your child will be getting adult teeth so you wouldn’t want to risk getting dental diseases in the permanent dentition!

The last part I will touch on briefly is the use of fluoride toothpaste during brushing. It is related to the frequency of brushing. Fluoride has been proven to help in preventing dental caries. Since the introduction of fluoride in toothpaste, dental caries rates have dropped worldwide. Fluoride works well topically (on the tooth surface in the mouth) and constantly (always in the mouth if possible). Toothpaste is the most convenient vehicle to deliver fluoride but it is not practical to be brushing your teeth every hour. Therefore, the recommendation is that if you need to brush your teeth with fluoride toothpaste, you need to do this at least twice a day (this has been proven scientifically). Brushing once a day with fluoride toothpaste means that the teeth only get exposed to fluoride once a day which may not be sufficient, especially if you or your child has history of dental decay. You can find out more about toothpaste in my other post "Which toothpaste to use".

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