Brushing your teeth is an important part of maintaining good oral hygiene and preventing cavities, gum disease, and other dental problems. But with all the advice out there on how often to brush, some may wonder if brushing 3 times a day is overkill. Here we’ll look at the evidence behind brushing frequency recommendations and whether 3 times daily is too much for the average person.
Quick answers:
– Dentists generally recommend brushing twice a day – once in the morning and once before bed.
– Brushing after meals can provide extra protection against cavities and acid wear, so 3 times daily may be beneficial for some people.
– Brushing more than 3 times a day risks damaging tooth enamel and irritating gums.
– Factors like your oral health status, diet, saliva flow, and use of fluoride influence optimal brushing frequency.
– Most adults likely get sufficient oral hygiene from twice daily brushing, making 3 times a day unnecessary. Kids and those at high cavity risk may benefit from 3x/day.
– Proper brushing technique is just as important as frequency. Make sure to brush gently and thoroughly clean all tooth surfaces.
Official recommendations on brushing frequency
Professional dental organizations like the American Dental Association (ADA) and American Academy of Pediatric Dentistry generally recommend brushing twice per day – once in the morning and once before bed – as the standard for good oral hygiene.[1] Here’s a closer look at the official stance on brushing frequency from leading dental groups:
– The ADA recommends brushing twice a day with a soft-bristled fluoride toothpaste.[2] They note that higher frequency may be indicated for those at high risk of cavities.
– The American Academy of Pediatric Dentistry suggests parents brush infants’ teeth as soon as they come in and clean their child’s teeth twice daily as soon as they turn 2 years old.[3]
– dentalhealth.org, which is run by the American Dental Association, says twice daily brushing is “enough for most people” provided it’s done correctly and thoroughly.[4]
So while they consider two times per day sufficient for most people, major dental organizations do leave room for more frequent brushing depending on an individual’s oral health needs and risk factors. But they stop short of universally recommending 3 times a day for everyone.
When a third daily brushing may help
Some situations where a third brushing could provide extra oral health benefits include:
– Brushing after lunch – Helps remove food debris and neutralize the acids produced after eating, reducing cavity risk. This midday brushing may be most beneficial if you eat carb-heavy lunches.
– High cavity risk – Those prone to frequent cavities due to dry mouth, poor enamel, orthodontics, or health conditions may need extra brushing to control bacteria and food acids.
– Periodontal disease – Brushing 3 times daily may help control bacteria levels, reduce plaque, and minimize gum inflammation for those with gum disease.
– Braces – Brushing after meals helps keep braces and the surrounding teeth free of trapped food particles.
– At work – The midday tooth brushing can freshen breath and clean away lunch debris before meetings or visits with clients/customers.
So for certain individuals, a third daily brushing can provide helpful protection against dental decay, gum inflammation, bad breath, and staining. Kids may especially benefit since their oral hygiene habits are still developing.
Is 3 times daily brushing overkill?
While a third brushing can be advantageous in some cases, for most healthy adults it’s likely overkill and provides minimal additional upside. Here’s a look at why twice a day is sufficient for most people:
– Saliva helps clean the mouth between brushing sessions. Saliva contains antimicrobial substances as well as minerals that can help remineralize early cavities.[5]
– Fluoride toothpaste strengthens enamel against acid attacks. The fluoride is retained in the mouth and continues protecting teeth after brushing.[6]
– Brushing too often can irritate gums and wear down enamel over time.
– It’s unrealistic to brush after every snack or meal. Twice a day covers the most important times.
– Most adults have relatively stable oral flora and do not react strongly to food acids. Kids’ mouths are still developing.
– Proper twice daily brushing removes most plaque and bacteria. Infrequent brushers have more to gain from extra brushing.
Unless your dentist recommends otherwise, aim for a twice daily brushing routine if you have relatively healthy teeth and gums. The morning and evening brushings cover the most important times for removing plaque, food debris, and acid buildup.
Other factors influencing optimal frequency
Some additional factors to consider when determining your ideal brushing frequency include:
– Diet – Frequent snacking on sugary or starchy foods may call for extra brushing to control acid and bacteria production.
– Dry mouth – Reduced saliva flow means food acids and plaque bacteria persist longer before getting washed away.
– Gum disease – Gum inflammation needs more diligent plaque removal, so 3x/day brushing may help control bacteria overgrowth.
– Enamel issues – Those prone to erosion, cracks, or teeth staining may benefit from extra brushing sessions.
– Orthodontics – Brushing after each meal can help clean food particles from around braces.
– Medications – Drugs that reduce saliva flow, like antihistamines, may necessitate additional brushing.
– Fluoride exposure – Frequent fluoride from toothpaste, rinses, or tap water bolsters enamel defenses.
So consider your specific risk factors, oral environment, and dental health status when deciding how often to brush. Your dentist can provide personalized guidance based on your needs.
Brushing properly matters most
More important than exactly how many times a day you brush is doing it correctly and thoroughly each time. No matter how frequently you brush, use proper technique to maximize cleaning:
– Use a soft-bristle toothbrush. Medium and hard bristles can damage enamel.
– Apply a pea-sized amount of fluoride toothpaste.
– Brush for 2 minutes total, spending 30 seconds on each quadrant. Set a timer if needed.
– Use gentle circular motions to brush both inner and outer surfaces.
– Position the brush bristles at a 45-degree angle near the gumline.
– Finish by brushing your tongue to freshen breath.
– Rinse with water when finished – do not swallow remaining toothpaste.
Proper technique ensures you remove plaque from every tooth surface without damaging gums or enamel at each brushing session. This matters more than the sheer number of times you brush.
Key points
To summarize the key takeaways from the evidence:
– Twice daily brushing covers the most important times to remove plaque, food, and acids. This frequency is recommended for most adults by dental organizations.
– Brushing a third time can offer extra protection from cavities, gum disease, and bad breath in certain situations like after lunch or for those at elevated risk.
– Brushing more than 3 times starts to provide diminishing returns and may begin eroding enamel over time.
– Factors like diet, medications, dry mouth, orthodontics, and enamel issues can indicate a need for extra brushing. Consult your dentist.
– Proper technique with a soft brush is critical regardless of how many times you brush per day. Gentle circular motions cleaning all surfaces.
So aim for twice daily brushing, but add a third session as needed for high-risk situations identified by you or your dentist. And be sure to brush correctly each time for optimal oral health benefits regardless of frequency.
Answering common questions
Here are quick answers to some additional frequent questions about brushing three times a day:
Is it bad to brush too much?
Brushing more than 3 times daily risks over-abrading and weakening enamel over time. Irritation of gums from over-brushing can also occur. Most adults get sufficient cleaning from twice daily.
When is the best time for the extra brushing?
The midday brushing after lunch helps clean away food debris and neutralize post-meal acids before they can damage enamel. Late afternoon may be another option.
Why don’t dentists just recommend 3 times a day for everyone?
The twice-daily frequency covers the most important oral hygiene times for most people. Three times provides diminishing returns and risks gum irritation and enamel erosion when overdone.
Should adults brush 3 times a day?
Is 3 times daily necessary with braces?Brushing after meals is smart for orthodontic patients to clean away food particles that readily get trapped near braces. But proper twice-daily brushing can still be sufficient.
Is brushing 3 times daily overkill for kids?
Kids can benefit more from the extra brushing while their oral hygiene habits are still developing. The third brushing provides added protection against cavities and acids.
What’s most important – brushing force, time, or frequency?
Gentle, thorough technique cleaning all surfaces is most vital. Brushing too hard risks enamel damage and gum recession. Time matters more than force.
The impact of brushing on oral health
Regular brushing with toothpaste has significant impacts on improving and maintaining good dental and gum health. Here is an overview of the scientific evidence showing the oral health benefits of brushing:
– Fights cavities – Tooth brushing removes sugars and fermentable carbs that would feed cavity-causing bacteria. It also removes plaque buildup before it can harden into tartar that cavities form within.[7]
– Prevents gum disease – Brushing controls bacteria levels and reduces plaque that causes gingivitis and periodontal inflammation when allowed to persist near the gumline.[8]
– Freshens breath – The mechanical brushing action removes odor-causing bacteria and food debris to clean and refresh the mouth.[9]
– Prevents staining – Daily brushing helps prevent stains from foods, drinks, and tobacco products that discolor the tooth enamel over time.[10]
– Removes debris – Careful tooth brushing clears away any stuck food particles, mucus, or other debris left behind after eating and drinking.
– Spreads fluoride – Toothpaste contains topical fluoride that gets spread over all your teeth surfaces during brushing to strengthen enamel.[11]
– Cleans orthodontics – For those with braces, bridges, implants, or other appliances, brushing keeps these surfaces clean of trapped particles.
Twice daily brushing provides the maximum preventive effects for most people. Additional frequency can provide extra protection for those at elevated risk of oral health problems.
Tooth brushing guide
To gain the most from your daily brushing routine, follow these evidence-based tips:
Use a soft-bristled brush
The ADA recommends a soft brush since hard bristles can damage enamel over time.[12] Medium brushes are acceptable for those who don’t apply excess pressure.
Replace every 3-4 months
Old brushes become frayed and clogged reducing their efficiency. Replace regularly or sooner if bristles are obviously worn.
Apply fluoride toothpaste
Use a pea-sized amount of paste with at least 1000 ppm fluoride to benefit from its cavity-fighting properties.[13]
Brush head at 45-degree angle
Tilt bristles to a 45-degree angle where they meet gums to clean just below the gumline more effectively.[14]
Gently brush all surfaces
Use gentle circular motions as you brush the outer, inner, and chewing surfaces of each tooth.
Brush for 2 minutes total
Divide the 2 minutes over the 4 quadrants of your mouth. Set a timer if needed.
Brush tongue last
Gently brushing the tongue at the end removes bacteria and freshens breath.
Spit don’t rinse
Simply spit out excess paste rather than rinsing which washes away protective fluoride.[15]
Wait before eating/drinking
Avoid eating or drinking for 30 minutes after brushing to allow time for fluoride absorption.[16]
Store brush upright and capped
Let your brush air dry upright and put a cap over the bristles to avoid contamination between uses.
Conclusion
While brushing 3 times per day offers some potential benefits in certain situations, twice daily brushing covers the most important times for removing plaque, food debris, and acids for most adults and kids. Proper gentle brushing technique and using a soft toothbrush matter more than frequency. The midday brushing after lunch can provide helpful additional cleaning for some, but is unlikely critical for otherwise healthy individuals who already brush properly twice a day. Discuss your oral hygiene habits with your dentist and adjust your frequency as needed based on your unique risk factors and dental health status. Consistently brushing twice per day with good technique remains the standard recommendation for maintaining optimal oral hygiene and preventing cavities and gum disease.