What to do between check-ups (a realistic routine)

You see us for maybe an hour a year. The rest of it is you.

That sounds like the opening of a lecture, and it is not. The routine that actually works is much shorter than most people assume, and a couple of the things people add on top are useless or actively unhelpful.

Here is the whole thing.

The routine, in full

Brush twice a day, two minutes each time. Soft brush, angled about forty-five degrees into the gum line, small circles, gently.

Clean between your teeth once a day. Floss, interdental brushes or a water flosser.

That is it. Everything else is detail on those two.

The details that actually matter

Two minutes is longer than you think. Most people who believe they brush for two minutes are nearer forty-five seconds. Time it once. An electric brush with a timer solves this permanently and is one of its real advantages.

Gently. You are removing a soft film, not scouring a pan. Hard brushing wears enamel and makes gums recede, and neither grows back. If your brush splays out within a month or two, you are pressing far too hard.

Get the gum line. That junction between tooth and gum is where gum disease starts, and it is the strip most people brush straight past on their way across the front of their teeth.

Do not skip the night brush. Saliva flow drops while you sleep, so whatever is left behind sits there for eight hours with your defences down. If you only manage one properly, make it that one.

Spit, do not rinse. Rinsing with water straight after brushing washes away the fluoride you just applied. This takes one second to change and it is probably the highest-value line in this article.

Between the teeth, which is where the problems start

A toothbrush cannot get between two teeth that touch. Not with better technique, not with a better brush.

Those contact points are where a large share of decay and gum disease begins, precisely because nothing ever disturbs them.

If you dislike floss, use something else. Interdental brushes are often easier and are usually better with larger gaps, bridges or implants. Floss picks and water flossers work too. Consistency matters far more than the tool.

If your gums bleed, keep going. This is where most people give up. The bleeding is caused by the plaque you are removing, not the floss, and for most people it settles within one to two weeks. If it has not improved after that, get it looked at.

What you eat, and when

The single most useful idea: frequency beats quantity.

Every time you eat or drink something sweet or acidic, an acid attack starts, and your saliva needs time to recover. One serving at a meal is one attack. The same thing grazed over an hour is many, with no recovery between.

So:

• Sweet things with meals, not between them
• Water between meals, not soft drink, juice or sweetened coffee
• Never nurse a drink for an hour
• If you snack, cheese, plain yoghurt, nuts or crunchy vegetables

Rinse after acidic things. Do not brush after them. This trips people up because it sounds backwards. Acid softens enamel temporarily, and brushing it in that state scrubs some of it away. Rinse with water at the time, brush an hour later.

Small habits that pay off

• Sugar-free gum after a meal when you cannot brush. Chewing prompts saliva, which neutralises acid.
• Brush your tongue gently. It is the most common cause of ordinary bad breath.
• Replace your brush every three months, or sooner if it splays.
• Drink tap water. Most Australian mains water is fluoridated and bottled usually is not.
• A mouthguard for sport, and a night splint if you grind.

Mouthwash, and what it does not do

Mouthwash is an addition. It cannot physically remove the plaque wedged between two touching teeth, and rinsing over the top of it does nothing.

A fluoride rinse helps if you are prone to decay, used at a different time from brushing rather than straight after. And if an alcohol-based rinse leaves your mouth dry, switch to alcohol-free, because dry mouths get more decay, not less.

Be realistic about the routine

The best routine is the one you actually keep.

If you have never flossed, start with three nights a week rather than committing to every night and giving up by Thursday. If two minutes twice a day is not happening, make the night one non-negotiable and build from there.

Something imperfect done for years beats something perfect done for a fortnight. That is not a lowered standard, it is how habits work.

What home care cannot do

Two things, both physical rather than about effort.

Hardened tartar does not come off with a brush. Once plaque sets, which takes only a couple of days, it needs an instrument, and the part that matters most is below the gum line where you cannot see or reach.

Decay between teeth is invisible until it is large. Not just to you, to us as well without an x-ray. By the time it hurts, the conversation has usually moved from a filling to a root canal.

That is what the appointment is for. Not to check your homework.

A full check-up and clean is a fixed $249, covering the exam, the scale and clean, fluoride and any bitewing x-rays you need. We claim your health fund on the spot, and many funds cover it in full.

Read more: How to brush and floss properly