Why do I need to brush twice a day?

There are two main reasons we encourage you to brush your teeth.

1. To remove bacteria which cause tooth decay and gum disease.

Seconds after you brush your teeth, a thin protein layer coats the enamel called the dental pellicle. Within minutes, bacteria start to bind onto this pellicle in a very organised and specific pattern. The first types of bacteria that attach are not so bad but as the pattern becomes more complex it forms what is called a biofilm. If left for too long, the bacteria that colonise the biofilm at later stages (the nasties!) start to cause the two major problems in dentistry: decay and gum disease.

Decay and gum disease do not occur within a day. Both conditions are progressive and are a result of longterm imbalance in your mouth. Every time you eat or drink and throughout the day and when you are not actively brushing your teeth, bacteria are threatening to cause tooth and gum destruction. If you brush your teeth regularly, this destruction process is continuously disrupted and no permanent damage is done. If regular removal of biofilm is not achieved, that’s when you will start to get symptoms of decay and gum disease and when dentists will tell you there is a problem that now needs to be treated. By the time a dentist can diagnose a cavity or gum disease, bad things have been progressing in your mouth for a long period of time. (It didn’t happen overnight!)

Basically, we recommend you brush twice a day to increase your chance of maintaining a balance that is going to result in no rotten teeth or broken down gums.

2. To introduce fluoride into your mouth.

Fluoride is extremely important in decay prevention. Luckily, Ballarat has been reaping the benefits of fluoridated tap water since the end of 2009. Dentists encourage the use of fluoridated toothpaste to further aid decay reduction. This is especially important for those residents living on tank or bore water (or just can’t stand the taste of Ballarat town water  ) Children 18months – 6 years should use a low dose fluoride toothpaste. Children older than 6 years of age and adults should use a 1000ppm dose fluoride toothpaste (most supermarket ones are this dose) unless specified otherwise by your dentist. Sometimes, high risk patients are prescribed an even stronger fluoride toothpaste (up to 5000ppm). These toothpastes are usually available from the pharmacy over the counter.

Fluoride works by creating a stronger type of tooth structure on the surface layer of teeth. It is most beneficial when it is placed in the mouth regularly. For this reason dentists LOVE fluoridated tap water as most people will be regularly adding fluoride to their mouth environment. Fluoride in toothpaste is wonderful as it is added directly where we want it and onto clean teeth. Use of fluoridated toothpaste twice a day will maximise your chance of preventing dental decay.

Frequently asked Questions

Should I brush before or after breakfast?

The bottom line is, it doesn’t matter so much. The important thing is that they are done twice a day. During the night there is limited salivary function and bacteria are able to colonise freely. It is important that these bacteria are removed in the morning before you feed them with the sugar and carbohydrates you will consume during the day. Generally it is better to brush them after breakfast (so you have a clean, sugar free mouth until lunchtime) but we are happy even if your morning routine is teeth first, then breakfast.

If I really can’t brush twice a day, when is the best time to brush?

If you REALLY, REALLY can’t do twice a day, then the best time is definitely at nighttime. Your mouth will be full of bacteria and acid/food debris from a day of eating. If you go to sleep without removal of this mess, during the night when your salivary glands switch off, the bacteria in your mouth will do lots of damage. Saliva is very important in washing away bacteria and acid. Definitely no eating/drinking after nighttime brushing. (nb. no milk for children after toothbrushing)

Are water filters ok?

Each filter is different. You will need to check the manual whether fluoride is being filtered or not. Luckily, because fluoride is a small ion, most readily available filters will remove larger heavier particles but allow the fluoride ions to pass through. Brita filters (available at supermarkets and major retail outlets) definitely let fluoride through.

Is bottled water ok?

Unfortunately, bottled water (mount franklin, pump etc) do not contain fluoride.

Should I give my children fluoride tablets?

Fluoride tablets are no longer recommended. You will find they are actually hard to find now for this reason. Fluoride works best topically (flowing over the site required). Swallowing fluoride tablets is no longer believed to help prevent decay and may be in fact harmful as the strong dose increases the chance of fluorosis in children (damage to permanent, unerupted teeth).

Please feel free to ask any questions regarding this post (or any other dental matter). You are welcome to leave a comment below or email me at info@oaktreedental.com.au

Hope this post has been helpful!


Dr. Jess BDSc. (The University of Melbourne.) (Honours.)