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The Villages
Monday, November 14, 2022

Floss before you brush your teeth

Dr. Gabe Mirkin12

Dentists do not agree on whether it is better to brush before or after breakfast. I think you should brush after breakfast, but you should try to wait and brush at least 30 minutes after eating. If that doesn’t fit into your schedule, do whatever works best for you. Any brushing is better than no brushing.

Reasons to Brush Before Breakfast
When you wake up, your mouth is loaded with bacteria that accumulate in your mouth while you sleep. Most breakfasts contain sugar and refined carbohydrates, which bacteria convert into acids that can dissolve the enamel covering your teeth. Brushing increases saliva production to help wash away some of the bacteria before they are exposed to your breakfast foods (Biomed Res Int, Feb 26, 2018;2018:3904139). Brushing before breakfast removes lots of the bacteria before they can convert the food you eat to acids that dissolve enamel to form cavities. Your mouth is more acidic after you eat and brushing then is likely to remove more enamel.

Reasons to Brush After Breakfast
After you eat, the bacteria in your mouth have started to convert the food you eat to enamel-dissolving acids. The longer you leave food in your mouth, the more enamel-dissolving acids are formed. Brushing after eating removes more food from your mouth, so that less acid is formed. It also prolongs the time fluoride from toothpaste stays in your mouth to reduce the number of acid-forming bacteria and to make your enamel more resistant to acid. However, brushing mechanically removes enamel, and the more acid is in your mouth, the more enamel is removed, so it is best to wait at least 30 minutes after eating for a reduction of the meal-induced acidity. Foods that increase acidity include orange or grapefruit juices, citrus fruits, dried fruits, bread, pastries and most dry breakfast cereals.

Floss Before You Brush
Toothpicks are ineffective at removing food particles and plaque. Flossing helps to remove plaque and food between your teeth that your toothbrush cannot reach. Flossing after you brush can leave extra food particles between your teeth. Brushing removes bacteria more effectively if you remove the larger food particles first by flossing before you brush (J Periodontol, July 2018;89(7):824-832).

More Brushing Tips
• Don’t rinse your mouth right after brushing; wait a while before you use mouthwash or breath fresheners that remove the fluoride left in your mouth from your toothpaste.

• Replace your toothbrush every 3-4 months. Frayed toothbrushes are less efficient at removing food particles and plaque from your teeth.

• Water flossers (waterpiks) use a pressurized stream of pulsating water to clean away food particles, bacteria, and plaque between teeth and under the gumline. You may want to use a waterpik if you wear braces, have non-removable bridgework, have crowns, have dental implants, or have difficulty brushing your teeth because of arthritis.

• Symptoms of gum disease can include bad breath, tender and bleeding gums, or loose teeth; check with your dentist.

My Recommendations
To help prevent cavities and gum disease, floss and then brush your teeth at least twice a day. Use fluoride toothpaste to help prevent cavities. It may be best to brush your teeth half an hour after eating breakfast or supper, because brushing immediately after you eat can increase the loss of tooth enamel. To help keep fluoride from your toothpaste in your mouth, don’t rinse your mouth or use mouthwash immediately after you brush.

Dr. Gabe Mirkin is a Villager. Learn more at www.drmirkin.com

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