How does your oral health hygiene measure up? Maintaining a consistent oral care routine can help prevent numerous oral health concerns, including cavities (dental caries), gum disease, and tooth loss. (15) Keep reading to learn the top oral health basics for a healthy smile and the most important reasons to stay on top of your oral health hygiene.

Good oral hygiene promotes a healthy smile.
Top strategies for promoting good oral health
Good oral hygiene helps promote a healthy mouth by preventing plaque build-up, gum disease, and dental decay. Incorporate these simple strategies into your daily routine.
1. Brush twice daily
Brushing your teeth at least twice daily helps to prevent plaque build-up, a sticky film of bacteria. (24) Use these simple tips when brushing your teeth:
- Use a soft-bristle toothbrush.
- Angle the bristles of your toothbrush toward the gumline. Doing so allows you to clean between the gums and teeth.
- Move your toothbrush in small, circular motions.
- Brush all sides of your teeth.
- Brush your tongue with your toothbrush or use a tongue scraper.
- Brush for two minutes each time you brush your teeth.
- Replace your toothbrush or electric toothbrush head every three to four months, or when the bristles become frayed. (24)(26)
Did you know? It’s best to wait approximately 60 minutes after eating before brushing, especially after consuming acidic foods or beverages such as citrus or soda. Acidic foods can temporarily soften the enamel, leaving your teeth more prone to damage. (3)
Using the right toothpaste for your needs is another important consideration. The American Dental Association (ADA) recommends the use of topical fluoride for the prevention of tooth decay, and the ADA seal is only featured on products containing fluoride. (9) Fluoride is a mineral that helps protect teeth from decay by strengthening the outer surface of the teeth, known as the enamel. Some experts warn against the use of topical fluoride and the consumption of fluoridated water, suggesting that it may pose some health risks ranging from fluorosis (stained pitting of enamel) (9) to thyroid dysfunction. (18) The health concerns associated with fluoride appear to be brought on by excessive consumption of fluoride; therefore, normal daily use of fluoride is widely considered safe and effective for most people. (9)
Hydroxyapatite, a calcium phosphate mineral, is another ingredient in dental care products that has gained popularity as an alternative to fluoride. One study demonstrated that hydroxyapatite toothpaste prevents cavities similarly to fluoride toothpaste. (2)

Daily flossing helps prevent plaque build-up and removes food particles that have become stuck between the teeth.
2. Floss daily
Flossing helps remove plaque build-up and leftover food particles between the teeth that are often missed with normal teeth brushing. Use dental floss, pre-threaded flossers, or a water flosser every day. Rinse your mouth with water after flossing. (26)
A 2020 study demonstrated that older adults who floss are less likely to lose teeth as they age. At a five-year follow-up visit, flossers lost an average of one tooth compared to non-flossers who lost approximately four teeth in the same time period. Flossers also had fewer cavities and were less likely to have gum disease. (19)
The ADA recommends flossing once per day. It doesn’t matter whether you floss in the morning, mid-day, or evening. Choose the time of day that works best for you and build it into your oral care routine. (8)
Should I brush or floss first? Either way is fine. If you floss after brushing, just be sure to rinse your mouth with water to ensure that all food particles are removed from your mouth. (8)
3. Chew sugarless gum
Chewing sugarless gum stimulates saliva which helps wash away leftover food and debris in the mouth and neutralizes acids produced by the bacteria in the mouth. (5) A systematic review concluded that chewing sugarless gum after a meal can help prevent cavities. (23) Look for gum that contains no added sugar (sucrose) and instead includes natural alternatives to sugar such as xylitol or sorbitol. Furthermore, look for gums with the ADA seal on the label, which confirms that the product meets criteria for safety and effectiveness set by the ADA. (5)
Note: Chewing sugarless gum is not a substitute for regular brushing and flossing and is intended to be used between brushing.
4. Eat a healthy diet
Consume a varied diet that’s rich in whole foods, such as fruits, vegetables, whole grains, beans and legumes, nuts and seeds, and lean proteins. Various minerals, such as calcium, found in dairy, soy, almonds, and leafy greens, as well as phosphorus, which is found in eggs, fish, lean meat, dairy, nuts, and legumes, can help promote strong, healthy teeth. Furthermore, consuming vitamin C-rich foods, such as citrus, peppers, and broccoli, can help promote healthy gums. (1)
5. Limit sugary foods and beverages
Consuming sugar is known to contribute to dental decay; therefore, sugary beverages and desserts are best consumed sparingly. (10) If you choose to drink sugary beverages or juices, avoid slowly sipping on the beverage over extended periods of time, as sipping allows the bacteria in the mouth more time to consume the sugar, thus contributing to cavities. (11) Instead of sugary beverages, opt for healthier options such as water or tea.
6. Minimize snacking
Try to avoid frequent snacking between meals as doing so introduces acid into the mouth. Furthermore, less saliva is released when snacking compared to when consuming a meal, which can promote cavities. If you do snack, try to rinse your mouth or brush your teeth shortly after. (1)(7)(21)
7. Visit your dentist for bi-annual check-ups
Visiting your dentist twice a year for check-ups and professional cleaning is essential for good oral health. Dentists also perform oral cavity cancer screenings during regular dental visits, helping to detect early signs of oral cancer. Signs may include a lump or spot on the lips, roof of the mouth, under the tongue, along the gumline, or on the inside of the cheek. (20)

Learn the basics of oral health hygiene. (4)
Consequences of poor oral health
Failing to maintain good oral hygiene can contribute to various dental issues as well as chronic health concerns.
1. Gum disease
Gum disease, also known as periodontal disease, is the result of infections and inflammation of the gums and bones in the mouth. This condition is very common among adults; in fact, a survey concluded that approximately 40% of adults over the age of 30 had some form of gum disease between 2009 and 2014. (25) Gingivitis, or mild gum disease that is in the early stages, is the most common form of gum disease and is characterized by tender, red gums that are prone to bleeding. (26)
Risk factors for gum disease include:
- Certain medications that cause dry mouth
- Defective dental fillings
- Diabetes (type 1 and type 2)
- Immuno-deficiencies (e.g., individuals with HIV, organ transplant recipients, patients using immune-suppressing medications)
- Stress
- Tobacco use
- Poor oral hygiene
- Pregnancy (14)
If left untreated, gum disease can lead to bone loss in the mouth which can cause teeth to become loose. In some cases, individuals with gum disease may need to have some of their teeth extracted. (26)
Did you know? The hormonal changes that occur during pregnancy can make an individual more prone to cavities and gum disease. (13)
2. Chronic health conditions
Research has linked oral health conditions, particularly gum disease, to some chronic diseases, such as type 2 diabetes and cardiovascular disease. (17) Current research concludes that:
- Gum disease is linked to an increased risk of heart disease. One study demonstrated that individuals with gum disease are 25% more likely to develop heart disease. (16)
- Poor dental health may contribute to a bacterial infection in the bloodstream, which may harm the heart valves. (12)
- Gum disease is the most common dental health concern among individuals with diabetes, often a result of poor blood sugar control. In fact, approximately 22% of those diagnosed with diabetes have gum disease. Advanced gum disease may also increase blood sugar levels. (6)
- Regular dental cleanings may help lower hemoglobin A1C (HbA1c) levels, an indicator of blood sugar management over a three month period. (6)
3. Tooth decay
Tooth decay occurs when bacteria in the mouth produce acids that damage the enamel, leading to cavities, which are damaged areas of the teeth that can develop into tiny holes on the surface of the teeth. Multiple factors contribute to the development of tooth decay, including:
- Chipped or cracked teeth
- Consumption of sugary foods and beverages
- Bacterial makeup in your mouth
- Family history of cavities
- Frequent snacking or sipping of beverages containing sugar
- Poor oral hygiene (4)(22)
Cavities are permanent and should be treated by a dental professional. Treatment typically includes any of the following measures depending on the severity of the cavity:
- Topical fluoride treatments
- Fillings
- Root canal
- Extraction (tooth removal) (22)
Did you know? 80% of people will develop a dental cavity by age 34, and 26% of adults in the United States have untreated tooth decay. (14)(15)
The bottom line
Maintaining good oral hygiene throughout your life helps promote healthy teeth and gums, and even plays a role in chronic disease prevention and management. Prevent dental problems such as gum disease, cavities, and tooth loss by brushing and flossing your teeth regularly, minimizing sugary foods and beverages, and visiting your dentist at least twice per year.
- Academy of Nutrition and Dietetics. (n.d.). Healthy nutrition for healthy teeth. https://www.eatright.org/food/vitamins-and-supplements/nutrient-rich-foods/healthy-nutrition-for-healthy-teeth
- Amaechi, B. T., AbdulAzees, P. A., Alshareif, D. O., Shehata, M. A., Lima, P., Abdollahi, A., Kalkhorani, P. S., & Evans, V. (2019). Comparative efficacy of a hydroxyapatite and a fluoride toothpaste for prevention and remineralization of dental caries in children. BDJ Open, 5, 18.
- American Dental Association. (n.d.). 8 bad brushing habits to break in 2022. https://www.mouthhealthy.org/en/brushing-mistakes-slideshow
- American Dental Association. (n.d.). Cavities: What are they and how do we prevent them? https://www.mouthhealthy.org/en/dental-care-concerns/how-do-we-prevent-cavities
- American Dental Association. (n.d.). Chewing gum to prevent cavities. https://www.mouthhealthy.org/en/az-topics/c/chewing-gum#:~:text=Look%20for%20chewing%20gum%20with,%2C%20xylitol%2C%20sorbitol%20or%20mannitol
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- American Dental Association. (n.d.). Fluoride: Topical and systemic supplements. https://www.ada.org/resources/research/science-and-research-institute/oral-health-topics/fluoride-topical-and-systemic-supplements
- American Dental Association. (n.d.). Nutrition and oral health. https://www.ada.org/resources/research/science-and-research-institute/oral-health-topics/nutrition-and-oral-health
- American Dental Association. (n.d.). The truth about sugary drinks and your smile. https://www.mouthhealthy.org/en/nutrition/food-tips/sugary-drinks
- American Heart Association. (2021). Good dental health may help prevent heart infection from mouth bacteria. https://newsroom.heart.org/news/good-dental-health-may-help-prevent-heart-infection-from-mouth-bacteria
- Centers for Disease Control and Prevention. (2019). Pregnancy and oral health. https://www.cdc.gov/oralhealth/publications/features/pregnancy-and-oral-health.html
- Centers for Disease Control and Prevention. (2020). Adult oral health. https://www.cdc.gov/oralhealth/basics/adult-oral-health/index.html
- Centers for Disease Control and Prevention. (2020). Oral health conditions. https://www.cdc.gov/oralhealth/conditions/index.html
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- Kheradpisheh, Z., Mirzaei, M., Mahvi, A. H., Mokhtari, M., Azizi, R., Fallahzadeh, H., & Ehrampoush, M. H. (2018). Impact of drinking water fluoride on human thyroid hormones: A case-control study. Scientific Reports, 8(1), 2674. https://doi.org/10.1038/s41598-018-20696-4
- Marchesan, J. T., Byrd, K. M., Moss, K., Preisser, J. S., Morelli, T., Zandona, A. F., Jiao, Y., & Beck, J. (2020). Flossing is associated with improved oral health in older adults. Journal of Dental Research, 99(9), 1047–1053.
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- Math, M., & Balasubramaniam, P. (2009). Water swishing. British Dental Journal, 207, 304.
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- Mickenautsch, S., Leal, S. C., Yengopal, V., Bezerra, A. C., & Cruvinel, V. (2007). Sugar-free chewing gum and dental caries: A systematic review. Journal of Applied Oral Science: Revista FOB, 15(2), 83–88.
- National Institute of Dental and Craniofacial Research. (2020). Oral hygiene. https://www.nidcr.nih.gov/health-info/oral-hygiene
- National Institute of Dental and Craniofacial Research. (2021). Periodontal disease in adults (age 30 or older). https://www.nidcr.nih.gov/research/data-statistics/periodontal-disease/adults
- National Institute on Aging. (2020). Taking care of your teeth and mouth. https://www.nia.nih.gov/health/taking-care-your-teeth-and-mouth
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