Everything you need to know to keep your teeth healthy
From brushing to whitening to the timing for dental cleanings, and everything in between.
Consumer Reports has no financial relationship with any advertisers on this site.With age comes a greater risk that things will go wrong with your teeth. Among adults, procedures such as filling cavities tend to peak in your early to mid-50s, according to the Health Policy Institute. By the time you reach your 60s, you’re almost certain to need treatment for tooth decay. Figuring out exactly what dental care you need and when can be challenging. Yet there’s one key step that’s simple and inexpensive: taking care of your teeth at home.Though certain dental problems may require extra attention, the basics of brushing twice daily and cleaning between your teeth by flossing haven’t changed. And while plenty of companies would like to sell you pricey gadgets and special products for your oral health, you don’t need to shell out big bucks to keep your mouth in great shape.How often for dental cleaning?Even with great home hygiene habits, you still need to see your dentist regularly for checkups and cleanings. Some people will need to visit more often than the standard twice a year, while others may be fine with less frequent visits. A 2020 review by Cochrane, an independent group of expert researchers, found that adults who visited the dentist every six months and those who visited on a schedule customized to their individual dental risk had comparable oral health.People who are being treated for periodontal disease or who have dental implants — which can fail more quickly than a natural tooth — may need to see their provider every three months or so, says Martha McComas, a clinical associate professor of dentistry at the University of Michigan School of Dentistry in Ann Arbor.Your dentist can help you figure out the right cadence for checkups, as well as your optimal at-home dental care strategy. “We can customize it based on what we see in your mouth,” says Karin Arsenault, program director of geriatric dentistry at the Tufts University School of Dental Medicine in Boston.Between visits, here’s what you need to know about the vital tools for keeping your teeth and your whole mouth as healthy as they can be.Your toothpaste mattersFluoride is important. Fluoride is crucial because of the power it has to help fight cavities and tooth decay — something proved by decades of research. While some ingredients, notably a chemical called hydroxyapatite, have shown promise as viable alternatives, fluoride is still your best choice right now, according to the American Dental Association.Cavities occur when the bacteria in our mouths consume the traces of food left on our teeth, particularly anything sugary. As the bacteria gobble up these sugars, they release acid, which can remove minerals from our teeth’s enamel, eventually creating cavities. Fluoride can help replace some of these lost minerals, strengthening the surface of our teeth and repairing some damage.When you’re shopping for toothpaste, look for one with the ADA Seal of Acceptance. To earn that seal, manufacturers need to not only include fluoride in their toothpaste but also meet other safety and efficacy standards, including one meant to ensure toothpastes aren’t too abrasive. (Very abrasive toothpastes can damage enamel.)Watch out for this ingredient: If you’re prone to canker sores inside your mouth, you may want to look for a toothpaste that doesn’t contain sodium lauryl sulfate (SLS). A 2019 research review found that using an SLS-free toothpaste might help reduce canker sores in people who get a lot of them (about 25 percent of adults).Skip charcoal toothpaste. Activated charcoal is often touted as a superior ingredient for a variety of products, including toothpaste. But it can be highly abrasive, which research has shown can damage your enamel and cause increased sensitivity.How much toothpaste to use: Generally, adults need only a pea-size amount of toothpaste — that will create enough foam to cover all the surfaces in your mouth, Arsenault says.Also, “one of the big myths about toothbrushing is that you should rinse your mouth out after you brush,” says McComas. Studies show that the fluoride in your toothpaste provides the biggest benefit if you don’t do this, instead allowing the fluoride to work its magic on your enamel for more time.What about prescription pastes? You may want to ask your dentist whether a prescription toothpaste, which generally contains a higher dose of fluoride, might be right for you. Severe dry mouth, which can be more common as you age (particularly if you’re taking certain medications for various chronic conditions, including for high blood pressure and depression), can raise your risk of cavities. So can periodontal disease, especially if the surfaces of the roots of your teeth, which lack protective enamel, are exposed.How to brush wellThe right bristles: Use a toothbrush with soft or extra-soft bristles. There are so many toothbrush options, but in the midst of considering the shape of the brush head, the brand name and other fancy features, don’t lose sight of bristle stiffness. Seek out a toothbrush with “soft” or “extra soft” on the packaging. Stiffer bristles are more likely to damage your gums or your teeth’s enamel, according to the American Dental Association.The advantages of an electric toothbrush: You can keep your mouth perfectly healthy with a manual toothbrush, but a 2014 Cochrane review found that three months of using an electric toothbrush resulted in 21 percent less plaque and 11 percent less gum inflammation (also called gingivitis).There are not significant performance differences between oscillating (or rotating) electric toothbrushes, which typically have round heads, and sonic toothbrushes, which usually have rectangular heads. So get the kind you like and will use.How much to brush: Do it twice a day for at least two minutes. Some research suggests that people may brush for a lot less time than this on average, possibly around a minute or less. But common sense and a 2009 Journal of Dental Hygiene study suggest that brushing longer will remove more plaque — though the added benefit of extra time beyond two minutes is probably marginal, and brushing too hard can exacerbate problems, including receding gums, which can expose the roots of your teeth to a greater risk of cavities and tooth decay.How to flossWhy flossing matters: Use any standard string floss (waxed or unwaxed), floss pick or interdental cleaning brush. The scientific evidence for flossing is not as strong as it is for brushing: A 2019 Cochrane review found that flossing in addition to brushing may reduce plaque and gingivitis more than brushing alone, but the authors cautioned that the evidence supporting this conclusion was weak. Still, dentists say the biological justification for flossing is sound: Without it, the bacteria that cause decay can build up between your teeth even if you’re brushing regularly.Do water flossers work? While not quite as effective as string floss, water flossers can be a great option if you have a hard time using string floss, have mouth hardware like braces or a permanent retainer, or have other kinds of dental work like implants, bridges, or crowns. Dentist Sally Cram, a spokeswoman for the American Dental Association, says the evidence on the benefits of a water flosser is encouraging, but it’s not enough for her to recommend it as a replacement for flossing just yet. Still, if you know you won’t use string floss every day, a water flosser is better than nothing.Avoid floss with PFAS. Skip floss that’s coated with these environmental contaminants, which are associated with a variety of health problems. You can look for flosses that use non-PFAS coatings such as beeswax or plant waxes like carnauba or candelilla.CR partnered with Made Safe, an independent organization that certifies products as safer and more sustainable, to find flosses made without PFAS. Read our special report, “How to Choose Dental Floss Without PFAS and Other Harmful Chemicals,” for the details, including three good floss options made from silk instead of plastic.How often should you floss? Do it once a day. Whether you floss or brush first doesn’t matter, as long as you do both.What if you have implants or gum disease? If you have an implant, you may want to opt for an interdental brush instead of regular string floss, particularly if your implant doesn’t touch the teeth next to it on either side.These are tiny round brushes designed specifically to clean in between teeth, and they work well with teeth that have gaps in between them. They come in different sizes, so Jennifer Harmon, a registered dental hygienist and clinical associate professor at the University of North Carolina Adams School of Dentistry in Chapel Hill, recommends working with your dentist to figure out which size you need for your teeth.If you’re dealing with bleeding gums, Arsenault says, you can consider using prescription chlorhexidine mouthwash after you floss. Just be sure to follow your dentist’s instructions, because chlorhexidine can also cause some tooth staining and changes in taste.Do you need these dental tools?Tongue scrapers: The experts we spoke with say this is a great tool. The bacteria that cause tooth decay don’t just live on your teeth; they can collect on your tongue, too. That means you should clean your tongue daily. You can do this with your toothbrush bristles or the ridged back of some brushes, but a tongue scraper can be a little more effective, Cram says.Plus, scraping your tongue is a great habit if you struggle with halitosis (bad breath), says Roxanne Dsouza-Norwood, a registered dental hygienist and clinical assistant professor of dental hygiene at the University of North Carolina at Chapel Hill. But be gentle; otherwise you could accidentally lacerate your tongue. And you may need to experiment with different types of tongue scrapers to find one that doesn’t activate your gag reflex.Whitening strips: Over-the-counter whitening strips can help your teeth look whiter, but it can sometimes be difficult to spot the change, McComas says. You can try using them only on the upper teeth first so that the difference is more visible. (Then apply them to the lower teeth.) Keep in mind that the older you get, the more you can see the yellowish dentin underneath your enamel, which — along with crowns and implants — is not affected by strips. So you might end up with uneven colors.Strips can also cause sensitivity, particularly if you already have sensitive areas from gum recession, Cram says. So leave them on only as long as instructed on the package.Mouthwash: Because swishing it around can coat parts of your teeth’s surface that are harder to reach with other tools, mouthwash can be a nice adjunct to your dental care routine, particularly if you choose one that has fluoride. Prescription washes that contain chlorhexidine can also be helpful for people with bleeding gums or other severe gum problems.Consumer Reports is an independent, nonprofit organization that works side by side with consumers to create a fairer, safer and healthier world. CR does not endorse products or services and does not accept advertising. Read more at ConsumerReports.org.
