Electric or Manual Toothbrush? Everyday Brushing Questions Answered

Brushing looks like the simplest habit in dentistry, and it comes with a surprising number of small questions. Here are the ones people ask most, answered from the NHS and the American Dental Association (ADA).

Is an electric toothbrush better?

Both sources say no. The NHS says it does not matter whether you use an electric or a manual toothbrush: they are equally good, as long as you clean all the surfaces of all your teeth and use fluoride toothpaste. Some people find it easier to clean thoroughly with an electric one. The ADA agrees: in the manual versus powered debate, "it's a wash", and people who find a manual brush hard to use may find a powered one more comfortable (NHS, ADA MouthHealthy). Choose the one you will actually use, twice a day. Wearing aligners? How to Care for Clear Aligners Day-to-Day covers cleaning them.

How long, and how often?

Twice a day for about two minutes, according to both. The NHS says to brush last thing before bed, because night-time brushing is important, and on one other occasion. Make sure you clean the inside, outside and chewing surfaces of every tooth. The ADA's line is easy to remember: two minutes, two times a day.

How hard, and what kind of bristles?

For most adults the NHS suggests a small-headed brush with a compact arrangement of round-ended bristles, medium or soft. The ADA goes further and says to choose a soft-bristled brush whether manual or powered, because firm or even medium bristles may damage your gums and enamel, and not to scrub vigorously: brush only hard enough to clean the film off your teeth. Hard brushing is one of the causes of gum recession; see Receding Gums.

How often should you change the brush?

The ADA says every three to four months, or sooner if the bristles are frayed, because a worn brush does not clean as well. Rinse it with tap water after use, store it upright and let it air dry. Do not routinely cover it or keep it in a closed container, as a moist environment is better for unwanted bacteria than open air. Do not share a toothbrush.

Which toothpaste?

Fluoride is the key. The NHS says adults should use a toothpaste with at least 1,350 parts per million (ppm) of fluoride, and to check the packaging for how much each brand contains. Your dentist may advise a higher strength if you need it. The ADA notes that a toothpaste carrying its Seal of Acceptance contains fluoride. Labels differ from country to country, so if you are not sure what your toothpaste contains, bring it to your next visit.

Should you rinse after brushing?

Spit out the excess toothpaste, but do not rinse with water straight afterwards. The NHS says rinsing washes away the concentrated fluoride left on your teeth, which reduces its protective effect.

Floss first, or brush first?

The ADA says there is no "correct" order, as long as you do both. The NHS suggests flossing first. Cleaning Between Your Teeth covers the tools.

What does mouthwash do?

The ADA says mouthwash is not a replacement for brushing and flossing, but may be a helpful addition for some people. It sorts into two types:

Two practical points from the NHS: do not use a fluoride mouthwash straight after brushing, because it washes away the fluoride in the toothpaste, so choose another time such as after lunch; and do not eat or drink for 30 minutes after a fluoride mouthwash. The ADA says mouthwash is not recommended for children younger than six, who may swallow it. If bad breath is the reason you reach for one, Bad Breath: What Causes It and What Actually Helps looks at the causes.

Plaque is the target

All of this is aimed at one thing: removing plaque before it hardens. Plaque and Tartar explains why that matters.

Want advice on a routine that suits your teeth? Book a private consultation, or send a note on WhatsApp, +961 3 757 127.

This article is general information, not a diagnosis. Treatment plans and results vary from person to person.