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  • Writer's pictureDr. Pearl E. Whites

Do I Use Mouthwash or Toothpaste 1st?...& Other Hygiene Questions

Updated: Aug 18, 2022

When asking many patients what are the proper steps to cleaning teeth we get as many different answers like if you asked an array of people what the best remedy is to stop hiccups! So many feel their remedy is the only one that works for hiccups--same for oral hygiene. So what is right?

This is what we hear:"brush your teeth like you're mopping the floor: back and forth, and aggressive." "Floss only if food is stuck or if you're going to the dental office soon." "Mouthwash is only for bad breath."

Know that if you are only brushing your teeth 1-2x/day then you're missing the mark and just as prone to getting cavities.

Below are general principles and correct techniques that should answer most life-long family debates on the proper way to care for your teeth along with answering questions like, "do I use mouthwash or toothpaste first."

We list (5) steps that if used daily and in this recommended order (for most patients) this will drastically improve your chances of not getting cavities:

1. Tongue Scraper

Start with this. The majority of bacteria live on your tongue. Brushing the tongue with a toothbrush or other methods are good but the best tongue scraper we have found is the Oolitt Tongue Scraper. Several strokes will remove quite the smear layer from your tongue. The benefits of brushing your tongue is that it removes the majority of bacteria that cause bad breath and plaque accumulation. We provide these upon request to patients.

2. Floss

Research has answered which is better: String or flossers, waxed or unwaxed, smooth or course. The results say, "yes." Just floss! For the most part they're all just as effective. When inserting floss between teeth do so gently since traumatic forces to the gums will blunt them over time. Floss should hug each tooth as you come out. We tell our anti-flossing teenage patients to brush extremely well. Then floss and smell the floss. That's what you leave behind when you brush only. Flossing is crucial because the toothbrush does not remove ALL plaque or food especially in between your teeth.

3. Water Flosser

Use a waterpik (water flosser). It's a glorified squirt gun that is more effective than brushing and flossing in some areas like bridges, implants, deep gums, and braces! Unfortunately nothing at this time should ever replace the mechanical force of brushing and flossing...but this is a great 2nd place!

4. Mouthwash

Mouthwash reaches in between the teeth and underneath the gums that your toothbrush AND floss do not reach. Ideally rinse for 30 seconds for it to be most effective unless it burns--burning means it's been in your mouth for too long and is actually causing damage.

So do I mouthwash or brush first? The answer is do last whatever is most important. If you worry more about bad breath, dry mouth, periodontitis then use mouthwash last. If cavities are your concern then use toothpaste. For most dental needs, toothpaste is the most important and thus is usually done last.

5. Toothpaste

Fluoride is the main shield used to prevent cavities and usually is the most important priority for most people. Fluoride is heavily regulated, controlled, and dispensed so think of this analogy for products that contain fluoride: mouthwash fluoride is like a BB gun, OTC toothpaste is like a shotgun, and prescription toothpaste (like Prevident 5,000) is like a cannon. The main reason we use fluoride is it makes cavities harder to grow causing a shield to reinforce your teeth.


Some Tips on caring for your teeth
  • Do I Rinse with Water When Done? Do NOT rinse your mouth out with water after the last product you use. You would simlply be rinsing out all that medicine and shield you put on to protect your teeth.

  • How to Brush Brush using soft circular patterns and angle it 45 degrees towards your gums. Brush each of the (4) quadrants for 30 seconds up to 2 minutes minimum.

  • How NOT to Brush Brushing aggressive and in a back-and-forth motion is contraindicated. 1) It destroys the gums and flattens them causing recession 2) it causes the tooth area closest to the gums to wear away leading to sensitivity and tooth structure erosion.

  • Toothbrush Bristles Use the softest that you can, NEVER hard. Even the "fine" toothbrushes sold at your retail store may be too hard. What's wrong with hard toothbrushes anyway? If brushing too aggressively, this causes erosion from your teeth at the gum line. Only use hard bristles on dentures, mouth guards, or retainers. We suggest the softer the better, and we give all our hygiene patients an ultra soft Nimbus toothbrush.

  • How Much Fluoride is Needed? The ADA states to protect your teeth adequately you need at minimum 2,000ppm per day of fluoride used in toothpaste. That equates to brushing (2) times per day preferably after breakfast and before going to sleep. Use a pea-sized amount of toothpaste REGARDLESS how large the brush may be.

  • What Nullifies your Hygiene Efforts? Drinking coffee between meals, snacking, or smoking is a major factor that causes cavities even if you're amazing at oral hygiene. This will undo all your efforts. If you must drink coffee or snack, rinse your mouth out with water right afterwards.

  • Automatic Toothbrush Technique If using an automatic toothbrush, don't brush like you would a regular toothbrush going back and forth. Slide the brush along your teeth and let the brush do all the work.

  • I'm bleeding! If your gums bleed easily when caring for them the usual reason is because you are not flossing enough. Floss daily and if that doesn't calm the bleeding, contact our office in Central Point.

...PS my go-to way to stop hiccups is eating a spoon full of peanut butter. It works:)

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