Ten things that actually keep teeth healthy

If you do only three of these, make them brushing properly twice a day, cleaning between the teeth daily, and reducing how often you consume sugar and acid. The other seven refine the result. Here they all are. What is the ideal daily routine for oral hygiene? is the condensed version, and top tips on how to avoid dental problems organises the same material by risk rather than by habit.

The first four items are not a matter of opinion. The Australian Dental Association's Policy Statement 2.2.3 on oral hygiene, amended by the ADA Board in October 2025, lists "the main oral hygiene strategies" as exactly four things: "brushing for two minutes twice a day; using an age-appropriate fluoride toothpaste; clean between teeth once a day using floss or interdental brushes; and visit a dental professional for regular check-ups and professional cleaning." Everything after that is refinement.

Why it matters, in the ADA's own words: "tooth decay (dental caries) and gum disease (periodontal disease) are two of the most common diseases experienced by Australians. Plaque is the primary cause of both diseases."

1. Brush twice a day for two minutes

Two minutes is longer than it feels — most people brush for around 45 seconds and believe they have done two minutes. Time it once and you will see. How often should I brush my teeth? and brushing your teeth: before or after breakfast? settle the two questions that usually follow.

Concentrate the bristles along the gumline, angled slightly into it. That is where plaque collects, and it is the area most consistently missed. Work systematically around the mouth so nothing is skipped, and give attention to the surfaces facing the tongue and the very back teeth — the two places almost everyone under-brushes. While you are there, do I need to use a tongue scraper? covers the surface nobody cleans at all.

One addition worth knowing: spit, don't rinse. healthdirect, the Australian government-funded health service, gives the instruction and the reason together — "spit out the toothpaste, don't swallow it. Avoid rinsing with water. This allows the fluoride in the toothpaste more time to strengthen your teeth" — and adds that the same applies to children. This costs nothing and is one of the highest-value habits in dentistry. The benefits of fluoride explains why.

2. Use a soft-bristled toothbrush

Gum recession from medium or hard bristles is a major cause of tooth sensitivity — and recession does not grow back. See over brushing: what can it do to my teeth?, how much pressure should I apply when brushing my teeth? and what to do if you suffer from sensitive teeth.

If you are someone who does not feel clean without a good scrub, use an electric toothbrush. It removes plaque effectively without requiring force, and most have a pressure sensor that tells you when you are pushing too hard. Technique matters more than the brush: let the bristles do the work, and do not saw. Which toothbrushes do dentists recommend? compares the types, and how to care for your toothbrush covers what happens to it between uses.

One easy thing to forget: healthdirect advises that you "replace your toothbrush or toothbrush head every 3 months, or when it looks worn." A splayed brush cleans the gumline poorly no matter how carefully it is used.

3. Clean between your teeth once a day

Many people avoid flossing because it makes their gums bleed. The opposite conclusion is the right one. Bleeding gums are a sign of gingivitis — inflammation caused by plaque build-up. Remove the plaque regularly and the bleeding stops, usually within one to two weeks. See bleeding gums, what is gum disease? and periodontal (gum) disease.

Healthy gums do not bleed. Bleeding is a symptom, not a side effect of cleaning.

Roughly a third of each tooth's surface sits between the teeth and is never touched by a brush, which is exactly where adult decay and gum disease most often start. Interdental brushes are often easier and more effective than floss where the gaps are large enough — the ADA names "floss or interdental brushes" as equal options, so ask which suits your mouth. healthdirect adds a sequencing tip: "it's best to floss before brushing your teeth." Is flossing really that important? is the fuller answer, and should I be using mouthwash as well as brushing and flossing? answers the next question.

4. See your dentist regularly

A check-up and hygiene appointment keeps dental disease in check. A professional clean removes tartar, plaque and staining that brushing cannot. healthdirect's general advice is to "see your dental practitioner every 6 to 12 months for a check-up." What does a dental hygienist do?, your Smile Solutions dental hygienist visit: what to expect and dental cleans and hygienists describe the appointment.

There are two less obvious benefits. Regular attendance builds a relationship with your dentist, which allows a treatment plan tailored to you rather than a generic one — see is it important to have a family dentist? and how important is communication in dentistry?. And preventive measures taken early avoid the complex and expensive treatment that follows problems left to run — the stages of dental decay shows exactly where that curve turns.

Six months suits most people. Higher-risk patients — active gum disease, high decay rate, dry mouth from medication, smokers, poorly controlled diabetes — benefit from three- or four-monthly visits. The ADA's position is that "dentists, or delegated and suitably trained personnel, must have a role in identifying and maintaining suitable practices and recommending oral hygiene measures to suit individual needs and capability" — that is, the interval is a clinical judgement about you, not a fixed rule. See how often should I go to the dentist?, when do you need deeper cleaning?, my mouth is always dry and diabetes and oral health.

5. Use fluoride products

Fluoride toothpaste, and where recommended a fluoride mouthwash, strengthens enamel and prevents decay. The World Health Organization specifies toothpaste containing 1,000 to 1,500 ppm fluoride. Selecting a toothpaste: fluoride or non-fluoride? and choosing the right toothpaste for you narrow the choice.

Drink tap water rather than bottled, where the supply is fluoridated — Melbourne's is. Bottled water generally is not, so a household that has switched entirely to bottled water has quietly removed a background protection. The scale of that protection is measured: the National Health and Medical Research Council reports that "water fluoridation reduces tooth decay by 26 to 44% in children and adolescents, and by about 27% in adults," and supports fluoridation within a range of 0.6 to 1.1 milligrams per litre. Its 2016 review "confirmed that community water fluoridation helps to reduce tooth decay, and that there is no reliable evidence that water fluoridation at current Australian levels causes health problems." Fluoridated water — is it good for you? covers this, and the site also carries the opposing view in fluoridated water: why I worry.

If you use a fluoride mouthwash, use it at a different time from brushing, so it adds an exposure rather than washing one away. The truth and myths about mouthwashes explains what a rinse can and cannot do.

6. Eat a balanced diet

Calcium-rich foods — yoghurt, cheese, milk — support strong teeth and bones. The ADA's diet policy promotes "calcium rich foods and drinks such as milk, cheese and some fish" as the preferred dietary source. What can I do to strengthen my teeth? covers this properly.

Cheese after a meal genuinely helps: it raises the pH in the mouth, stimulates saliva, and supplies calcium and phosphate that support re-mineralisation. Drinking milk alongside something sweet reduces the sugar's capacity to cause cavities.

Raw, crunchy foods help clean teeth naturally and stimulate saliva. Vegetables and fruit supply nutrients that gums need, including vitamins A and C. How does your diet affect your teeth? is the fuller account.

Be aware that tea, coffee, red wine and curry stain teeth over time. That is cosmetic rather than harmful, and a professional clean addresses most of it. See what impact does wine have on my teeth?, are there antibacterial properties in tea? and, if the staining bothers you, how can I improve the whiteness of my teeth? and teeth whitening.

7. Limit sweet and acidic food and drinks

All forms of sugar can cause cavities, but sticky and highly processed foods pose a greater risk because they stay in contact with the teeth longer. How does sugar affect your dental health? and six foods to avoid for healthy teeth name the worst offenders.

On quantity, WHO recommends keeping free sugars below 10% of total energy intake, and ideally below 5%; the ADA puts the same limit as "no more than 6 teaspoons (24 grams) of free sugar... per day." Free sugars include what manufacturers, cooks and consumers add, plus the sugars naturally present in honey, syrups and fruit juices.

The most useful refinement: frequency matters more than quantity. The ADA states that "the form, frequency, timing and total amount of sugar intake are significant in the initiation of the caries process." Each exposure starts an acid attack lasting roughly 20–40 minutes. A dessert eaten in one sitting is one attack; the same sugar grazed across an afternoon is a continuous one. Keep between-meal snacks sugar-free.

Acidic items erode enamel directly, without any bacteria involved: citrus, vinegar-based dressings, sports drinks, and fizzy drinks — including sugar-free versions, because the acid, not the sugar, causes erosion. The Australian Dietary Guidelines put it the same way, noting water's advantage over soft drinks, fruit juice "and artificially sweetened soft drinks, because it has no kilojoules and a low acidity – acidity can erode the enamel of the teeth." Eroded enamel does not grow back. The ADA flags two habits that catch people out here: "sipping drinks, other than water, during interrupted sleep", and "chewing and sucking acidic vitamin tablets." See what is dental erosion and how is it addressed?, how does acidic food affect your teeth?, are sugar free soft drinks better for my teeth? and is soda water bad for your teeth?

And a timing point: after anything acidic, wait about an hour before brushing. The enamel is temporarily softened, and brushing straight away scrubs the softened layer away. Rinse with water in the meantime. healthdirect gives a shorter version of the same rule for meals generally — "ideally, wait 30 minutes after eating and drinking to brush your teeth."

8. Chew sugar-free gum after meals

Chewing sugar-free gum for around 20 minutes after a meal helps prevent decay. It works by stimulating saliva, which buffers acid, clears debris, and carries the calcium and phosphate that re-mineralise enamel. Gum containing xylitol has additional evidence behind it. Does chewing sugar-free gum really help prevent cavities? looks at how much difference it makes.

The ADA lists sugar-free chewing gum among its "proven aids to oral hygiene", alongside the toothbrush, fluoridated toothpaste and interdental aids — and describes "sugar-free confectioneries without added acids, including chewing gums" as dentally safe alternatives to sugary confectionery. Note that qualifier: without added acids. Some sugar-free products are acidic, and those do not belong in this category.

(To be clear about the twenty minutes: that is how long to chew for, not how long to wait.)

9. Protect teeth from injury

Wear a mouthguard for contact sport — during training as well as matches. That is the ADA's explicit position: "protective equipment such as helmets and mouthguards should be used during training as well as competition."

Its Policy Statement 2.2.5 sorts sports into tiers, and the list for which mouthguard use is "strongly recommended" is broader than most people assume: "off-road bike riding, skateboarding, rock climbing, white-water rafting, trampolining, combat sports, football, basketball, squash, and field hockey." Lower tiers cover sports where a guard could be justified in certain circumstances, and those where the injury risk makes it unwarranted.

On which kind: "the most effective protection against oral damage is a custom fitted mouthguard, where precision fit and quality materials offer maximum comfort & injury prevention," made "by a dental practitioner from a dental impression (mould) and a plaster model of the teeth." The ADA is not entirely consistent on the shop-bought alternative — the policy body says over-the-counter guards "provide better protection than no mouthguard," while its appendix says boil-and-bite types "offer little or no protection and can dislodge during play." Read together: a custom guard is the one to have, and a shop-bought one is a stopgap rather than an equivalent.

The policy also makes the economic point plainly: "the cost of an injury to the teeth or jaw far exceeds the cost of a mouthguard," and adds that "the need to wear a mouthguard should be assessed by a dentist based on risk factors, including an individual's sporting or occupational activities and dental anatomy" — occupational, not just sporting. See should I wear a mouthguard while playing sports?, getting a new mouthguard — a trip to the chemist or the dentist? and sports mouthguards. If a tooth is knocked out anyway, what should I do when a tooth is knocked out? is the article to have read beforehand — the ADA directs dentists to the International Association of Dental Traumatology guidelines for exactly that situation.

Do not chew ice, popcorn kernels or hard lollies — these crack teeth and fillings. Be careful with stone fruit, meat on the bone, and drinking from glass bottles. What should I do if I have a chipped tooth? and chipped and cracked teeth cover the aftermath. Are tongue and lip piercings bad for teeth? is the other avoidable source of chipped front teeth.

And if you grind or clench at night, an occlusal splint is the highest-value protective appliance available — far cheaper than restoring the wear it prevents. See what is bruxism and how is it managed?, night time tooth grinding and clenching and TMD and teeth grinding.

10. Smile

Follow the above and there is nothing to hide.

Common questions

Should mouthwash be an eleventh item? Do I need one at all?

For most people with healthy gums, no — and the professional literature is unusually firm about the reason. Australian Prescriber states it in one line: "Mouthwashes are an adjunct to, not a substitute for, regular brushing and flossing." It goes further in the body of the article: rinsing "should always be used in conjunction with mechanical hygiene. Mouthwashes should only be used for short periods of time and should never be the sole means of oral hygiene."

The reason a rinse cannot replace a brush is mechanical. Plaque is a biofilm stuck to the tooth; it is disrupted by contact, not by liquid passing over it. A rinse can reduce what is left after cleaning. It cannot reach what a brush and floss did not disturb.

Where an antiseptic rinse genuinely earns a place, it is usually a short course for a specific reason, and it comes with trade-offs worth knowing before you start. A Cochrane review of chlorhexidine mouthrinse as an adjunct to mechanical cleaning found a large reduction in plaque on high-quality evidence — but also that "rinsing for 4 weeks or longer causes tooth staining, which requires scaling and polishing carried out by a dental professional," along with calculus build-up, temporary taste disturbance and, in some people, shedding of the lining of the mouth. The reviewers note that staining appeared even at low concentrations, so it is not a dosing problem that can be avoided.

That is why this class of rinse is something a dentist recommends for a defined period and a defined reason, rather than something to add to the bathroom shelf indefinitely. See the truth and myths about mouthwashes and should I be using mouthwash as well as brushing and flossing?

I have read that mouthwash containing alcohol causes oral cancer. Is that true?

The honest answer is that two bodies of evidence point in different directions, and a page that gives you only one of them is not being straight with you.

The case for concern. A review in the Australian Dental Journal in 2008 concluded that "there is now sufficient evidence to accept the proposition that developing oral cancer is increased or contributed to by the use of alcohol-containing mouthwashes," and that "it would be inadvisable for oral healthcare professionals to recommend the long-term use of alcohol-containing mouthwashes." Its recommendation was to restrict such products "to short-term therapeutic situations if needed", with written instructions and a clearly defined reason.

The case against. A later pooled analysis from the International Head and Neck Cancer Epidemiology Consortium, published in 2016, combined 8,981 cases of head and neck cancer and 10,090 controls from 12 case-control studies, adjusting for age, sex, pack-years of smoking, alcoholic drinks per day and education. Ever having used mouthwash was not associated with head and neck cancer overall — odds ratio 1.01, 95% CI 0.94 to 1.08. The authors did find raised estimates for particular subsites and for heavy or very long-term use, and they described their own study as "limited by the retrospective nature of the study and the limited ability to assess risks of mouthwash use in nonusers of tobacco and alcohol."

What follows practically. Occasional use of an alcohol-containing rinse is not something the larger dataset supports worrying about. Daily use for decades, as a habit rather than a treatment, is the pattern where the estimates start to rise, and it is also the pattern that nobody can justify on oral-health grounds in the first place — because of the adjunct rule above. Alcohol-free formulations exist, and the 2008 review suggested they "may be equally effective." If you use a rinse daily and would rather not, that is a conversation to have at your next check-up. Separately, tobacco and alcohol themselves remain the dominant risk factors for oral cancer: see what are the causes, symptoms and treatment of mouth cancer?

Should I be scraping my tongue?

Gently, and only when there is something there to clean. The Australian Dental Association's consumer material is careful in a way that most advice on this subject is not: cleaning the tongue "can reduce the amount of bacteria on the tongue," but "while the impact of reducing the amount of bacteria on the tongue has not been proven yet, some studies suggest it may improve gum and tooth health as well as mouth freshness."

That is the defensible position, and it is worth noticing that the same ADA page's summary box states it more confidently than its own body text does. Tongue cleaning is a reasonable habit with modest and not-fully-proven benefit — not a treatment, and not a cure for bad breath.

Practically: the ADA advises starting gently at the back of the tongue and pulling or brushing forward, using water to lubricate, because "the tongue surface is delicate and sensitive." A soft toothbrush does the job; a dedicated scraper is optional. If your tongue has no visible coating, there is nothing to gain from scraping it, and over-vigorous cleaning irritates the surface. Persistent bad breath that survives good cleaning is a reason to be examined rather than to scrub harder — see Bad Breath and do I need to use a tongue scraper?

This page says wait an hour after something acidic, and quotes 30 minutes after eating. Which is it?

Both, and they are answers to slightly different questions — which is worth spelling out because the mismatch looks like an error.

healthdirect's "ideally, wait 30 minutes after eating and drinking to brush your teeth" is general advice about meals, aimed at the ordinary case. The longer interval on this page applies to the specific situation of a strongly acidic exposure — a citrus drink, a fizzy drink, vinegar dressing, or an episode of reflux or vomiting — where the enamel surface is measurably softened and brushing it immediately removes the softened layer rather than the plaque.

The practical rule that covers both: the more acidic the thing was, the longer you wait, and never brush straight after. In the meantime, rinse with plain water, or with milk, to bring the pH back up sooner. If you have reflux or you are vomiting regularly, tell your dentist — that pattern erodes teeth from the inside of the arch where you cannot see it, and it changes what should be recommended for you. See what is dental erosion and how is it addressed?

Related reading

Practical details

Specialist registration can be verified on the AHPRA register, or by calling 1300 419 495. The clinical team is listed by name.

Smile Solutions, Level 1, 220 Collins Street, Manchester Unity Building, Melbourne VIC 3000 — getting here. Phone 13 13 96, contact us, or theteam@smilesolutions.com.au. Monday–Friday 8.00am–6.00pm, Saturday 8.30am–1.30pm, Sunday by appointment.

Published 5 December 2013, by Dr Madeleine Hoopmann. General information only; it does not replace advice from your treating practitioner.

Smile Solutions trades under ABN 28 193 514 103.

Images on This Page