Dental care: how to brush, floss and protect your gums

In short

• Brush twice a day for about 2 minutes with fluoride toothpaste, covering every tooth surface.
• Clean between your teeth every day with floss or interdental brushes, because a toothbrush cannot reach there.
• Spit out the toothpaste but do not rinse with water, so the fluoride stays on your teeth.
• Red, swollen or bleeding gums are signs of gum disease, which can often be reversed in its early stage.
• Limit sugary foods and drinks, avoid tobacco and see a dentist for regular checkups.

Why oral health matters

The WHO estimates that about 3.7 billion people worldwide have oral diseases, and tooth decay in permanent teeth is the most common health condition. Severe gum disease affects more than 1 billion people. The CDC says cavities and gum disease are the leading causes of tooth loss and that oral diseases are largely preventable.

The same risks shared with other chronic diseases matter here: high intake of free sugars, tobacco, alcohol and poor hygiene. Diabetes and gum disease affect each other in both directions, because poor gum health can make blood sugar harder to control.

Brushing that works

1. Pick your brush.Most adults do fine with a small head and medium or soft bristles. Electric and manual brushes work equally well if you clean every surface, according to the NHS.
2. Use fluoride toothpaste.Adults should use toothpaste with at least 1,350 ppm fluoride, which is printed on the tube. The WHO suggests 1,000 to 1,500 ppm.
3. Brush for 2 minutes, twice a day.Once last thing at night and once at another time. Clean the inside, outside and chewing surfaces of every tooth.
4. Spit, do not rinse.Spit out the excess toothpaste and skip the water, so the fluoride stays on your teeth.
5. Time your mouthwash.If you use a fluoride mouthwash, use it at a different time from brushing, for example after lunch.

Cleaning between your teeth

• Clean between your teeth daily with floss, an interdental brush, a pick or a water flosser.
• The NHS suggests floss before brushing, or interdental brushes if there are gaps.
• Do not use wooden toothpicks, as they can damage your gums.
• Ask your dentist or hygienist which size and method suit your teeth.

Plaque is a sticky film of bacteria. When it builds up, it can harden into tartar, which only a professional cleaning can remove. Cleaning between your teeth every day stops plaque from building up where the brush cannot reach.

Bleeding gums are a signal

NIDCR describes early gum disease as swollen, red, bleeding gums that can often be reversed with daily brushing and flossing. If untreated, it can spread to the bone that supports the teeth.

• Red, swollen or tender gums, and gums that bleed easily.
• Gums pulling away from the teeth.
• Loose or sensitive teeth and pain when chewing.
• Persistent bad breath.

Smoking or tobacco use is the most significant risk factor and slows healing. Older age, diabetes, genetics, stress, obesity, hormonal changes and certain illnesses also raise the risk. Do not clean less around bleeding gums. Keep going, and book a dental visit.

Sugar, fluoride and dry mouth

Bacteria in the mouth turn sugars and starches into acid, which wears away enamel. Fluoride helps enamel repair itself. It comes from toothpaste, fluoridated tap water, mouth rinse or dentist treatments, and a white spot on a tooth can be early decay that can be stopped or reversed at that point.

• Limit sugary drinks and snacks, and drink mainly water.
• Avoid tobacco in every form and cut back on alcohol.
• Chewing sugarless gum stimulates saliva, and gums with xylitol may help prevent cavities.
• Hundreds of medicines, including some for blood pressure, depression and bladder control, can reduce saliva and raise the risk of cavities. Ask your provider about it, and do not stop a prescription on your own.

Children

Children need help or supervision with brushing until at least age 7, according to the NHS. Under age 3, use only a smear of toothpaste, and from ages 3 to 6 a pea-sized amount. Young children can get early childhood caries, also called baby bottle tooth decay, and sealants on permanent back teeth can help prevent decay.

When to see a dentist, and red flags

The CDC advises a dental checkup and cleaning at least once a year, and checkups are a good time to talk about your own risks. Book a visit for bleeding, red or swollen gums, loose teeth, receding gums, sensitivity to hot, cold or sweet foods, pain when chewing or persistent bad breath.

Advanced decay can cause toothache and, if infected, an abscess, facial swelling and fever. Get urgent care for a swollen face with fever, and call 911 if swelling spreads to the face or neck or you have trouble swallowing or breathing.

What a dentist does

• Checks for decay through staining, soft or sticky spots and X-rays.
• Checks for gum inflammation and bleeding, measures the spaces around teeth and may take X-rays to look for bone loss.
• Treats cavities by removing decayed tissue and filling the tooth. Fluoride can reverse very early decay.
• Treats gum disease by controlling the infection, with deep cleaning such as scaling and root planing, sometimes a rinse, and surgery for advanced cases.
• May refer you to a periodontist, a gum specialist.

Questions and answers

Sources

1. WHO — Oral health fact sheet
2. CDC — About Oral Health
3. NHS — How to keep your teeth clean
4. NIDCR — Periodontal (Gum) Disease
5. NIDCR — Tooth Decay
6. NIDCR — Dry Mouth

Sources checked on 29 October 2026.