Brushing twice a day still matters – setting the record straight

“Brushing once well is better than twice quickly.”

This claim not only lacks evidence, it risks undermining one of the cornerstones of good oral health.

Brushing technique is, of course, important – brushing thoroughly for two minutes, covering every surface of every tooth, is essential. But this should never replace brushing twice a day.

Plaque builds up constantly, day and night. If it’s not removed regularly, it produces acids that damage enamel and irritate gums, leading to decay and gum disease.

That’s why the NHS and dental professionals all agree: brushing twice daily with fluoride toothpaste is the most effective way to protect your mouth.

Dr Nigel Carter OBE, Chief Executive of the Oral Health Foundation, says: “Brushing once a day simply isn’t enough for most people. Very few of us clean perfectly every time, and plaque keeps forming throughout the day. Brushing twice daily – in the morning and before bed – remains the single most effective thing you can do to protect your teeth and gums.”

The evidence says: Brush your teeth last thing at night and at one other time during the day using fluoride toothpaste.

“Brush before breakfast, not after.”

The science suggests this could be right, but it’s not a slam dunk – the real-world evidence is limited.

Brushing before breakfast coats your teeth with fluoride, forming a protective layer against the acids in foods and drinks.

Brushing straight after eating, especially after acidic items like fruit juice or coffee, can wear down enamel while it’s temporarily softened.

If you prefer brushing afterwards, simply wait at least 30 minutes before you do.

Dr Nigel Carter says: “Brushing before breakfast gives your teeth a protective barrier for the day ahead. If you do brush after eating, make sure you wait a little while to let the enamel recover – half an hour is ideal.”

The evidence says: Brush before breakfast when you can – or wait 30 minutes after eating.

“Don’t rinse after brushing.”

This claim is misleading and doesn’t reflect the full evidence.

You should never rinse with water straight after brushing – it washes away the fluoride your teeth need for protection. But that doesn’t mean avoiding mouthwash. In fact, a fluoride mouthwash can be a valuable part of your daily routine.

The correct advice, backed by NHS guidance and Delivering Better Oral Health (the UK’s evidence-based toolkit for dental professionals), is simple: Spit, don’t rinse with water after brushing.

Dr Nigel Carter OBE, Chief Executive of the Oral Health Foundation, says: “This advice is wrong. You should never rinse with water after brushing – but mouthwash absolutely has its place. A fluoride mouthwash gives extra protection against decay and gum disease.”

The evidence says: After brushing with fluoride toothpaste, spit – don’t rinse with water. For extra protection, especially if your gums bleed, use a clinically proven fluoride mouthwash.

“Expensive toothpaste isn’t better.”

This isn’t right – and it’s far too simplified.

A low-cost toothpaste with fluoride will do the job for most people, but that doesn’t mean all toothpastes are the same. Fluoride is the key ingredient – adults should use one containing between 1,350–1,500 ppm fluoride to protect against decay and strengthen enamel.

More expensive toothpastes often include additional ingredients designed to help with specific conditions, such as sensitivity, gum health, or dry mouth – and these can make a real difference for those who need them.

Dr Nigel Carter OBE, Chief Executive of the Oral Health Foundation, says: “The key thing is fluoride – it’s what protects your teeth. A basic fluoride toothpaste works well for most people, but if you have particular dental concerns, a specialist toothpaste can offer added benefits. Your dental team can help you choose what’s right for you.”

The evidence says: A basic fluoride toothpaste is all most people need – but specialist options can help with specific dental problems.

Interdental cleaning

The BBC article also touched on flossing and “rubber” interdental brushes, but this again is not grounded in science.

The best evidence supports interdental brushes – whichever size and material fits comfortably – as the most effective way to clean between teeth.

Dr Nigel Carter says: “Cleaning between your teeth daily is absolutely essential. Interdental brushes are the most effective way to clean between your teeth – but it’s important to use the right size for you. Your dental team can help you choose the correct ones to make sure you’re cleaning properly and comfortably.”

The evidence says: Clean between your teeth daily with interdental brushes or floss to help prevent gum disease.

The bottom line

The BBC article risks spreading confusion and undermining one of the most important messages in oral health. Brushing twice a day with fluoride toothpaste isn’t a suggestion – it’s a proven, evidence-based necessity.

These aren’t opinions; they’re facts backed by decades of research and reflected in NHS and Delivering Better Oral Health guidance.

The evidence is crystal clear:

• Brushing frequency: Brushing twice a day with fluoride toothpaste remains essential – once a day simply isn’t enough to prevent decay and gum disease.

• Brushing timing: Brushing before breakfast can help protect enamel, but if you brush afterwards, wait at least 30 minutes to avoid damaging softened tooth surfaces.

• Rinsing after brushing: After brushing, spit don’t rinse with water. You can use a fluoride mouthwash for extra protection.

• Toothpaste choice: Any toothpaste with fluoride (1,350-1550ppm) will protect your teeth, but specialist pastes can help if you have particular dental concerns.

• Interdental cleaning: Clean between your teeth daily with interdental brushes – they’re the most effective way to remove plaque and protect your gums.