Last updated: May 2026. Sources: NHS, OHID Delivering Better Oral Health (Chapter 8), Oral Health Foundation, NICE.
TL;DR: Brush twice daily for two minutes with a fluoride toothpaste containing at least 1,350 ppm, angle the bristles at 45 degrees to the gum line, and spit, don't rinse, after brushing. Bedtime brushing matters most. Manual and electric toothbrushes are both effective when used with proper technique.
In England, 41% of adults now have visible tooth decay affecting at least one tooth, and that number has risen 13 percentage points since 2009 [5]. Most people do brush, but a 2024 Oral Health Foundation survey found that more than half of British adults skip toothbrushing at least once a week, and one in six skips at least three times a week [11]. The basics of brushing seem simple, but the way most of us were taught misses several rules that the NHS and the UK's evidence-based prevention toolkit have made clear.
This guide explains how to brush your teeth properly in 2026, based on the latest NHS guidance, the Office for Health Improvement and Disparities (OHID) toolkit, and the Oral Health Foundation. It covers technique, fluoride dose, the manual versus electric question, what to do for children, and the most common mistakes UK adults make.
The NHS rule: 2 minutes, twice a day
The headline guidance has not changed. The NHS recommends brushing your teeth twice a day for about two minutes each time [1]. One of those sessions should be the last thing before bed, because saliva flow drops overnight and the protection from fluoride toothpaste matters most when your mouth is least able to defend itself [1]. The second session can be at any other point in the day.
The OHID toolkit, which is the UK's senior evidence-based reference for dental prevention, agrees that a thorough cleaning takes at least two minutes [4]. Many electric toothbrushes have built-in two-minute timers that pulse every 30 seconds to prompt you to move to the next quadrant of your mouth.
Despite the simplicity of the rule, the OHID Adult Oral Health Survey 2021 found that 77% of adults with natural teeth brush at least twice a day [6]. That leaves around a quarter of UK adults brushing less often than the NHS recommends.
How to brush your teeth: step by step
There is no single technique that the UK's evidence base endorses by name. OHID Chapter 8 states explicitly: "no particular technique has been shown to be better than another" [4]. What matters is that you clean every surface of every tooth, systematically, without missing the gum line.
The Oral Health Foundation describes a method that fits NHS and OHID guidance: tilt the bristle tips to a 45-degree angle against the gum line and use small circular movements on every tooth surface [9]. The same approach works for both manual and electric brushes, although electric brushes do most of the motion for you.
A practical sequence:
- Wet the brush and apply a pea-sized amount of fluoride toothpaste.
- Angle the bristles at 45 degrees against the gum line.
- Brush the outer surfaces of each tooth, upper and lower, with small circular movements.
- Repeat on the inner surfaces.
- To clean the inside of your front teeth, tilt the brush vertically and use the front part of the brush head.
- Brush the chewing surfaces with a back-and-forth motion.
- Set a two-minute timer or follow your electric brush's pacing prompts to make sure no quadrant is shortchanged.
The NHS adds one important reminder: clean every surface of every tooth, including the inside surfaces, the outside surfaces, and the chewing surfaces [1]. The most commonly missed area is the inner surface of the lower front teeth, where the salivary glands sit and where tartar builds up fastest.
Spit, don't rinse: the most-skipped UK rule
The single rule most British adults break is rinsing with water after brushing. The NHS is unambiguous: "Don't rinse your mouth immediately after brushing, as it'll wash away the concentrated fluoride in the remaining toothpaste" [1]. OHID's senior toolkit gives the same guidance, telling clinicians to encourage patients to "spit out excess toothpaste, and not to rinse with water after brushing" [4].
The point of brushing with fluoride toothpaste is to leave a thin protective layer of fluoride on the tooth surface. Rinsing immediately washes that layer away. If you spit and walk away, the fluoride continues to remineralise the enamel for hours afterwards.
The same logic applies to mouthwash. The NHS specifically warns: "Don't use mouthwash (even a fluoride one) straight after brushing your teeth because it will wash away the concentrated fluoride in the toothpaste left on your teeth. Choose a different time to use mouthwash, such as after lunch" [1].
If you find the residual taste of toothpaste unpleasant, give it ten or fifteen minutes before drinking water. Better still, get used to it, the unfamiliar feel of toothpaste residue is the protective film doing its job.
Toothpaste: fluoride strength and how much to use
Adult toothpaste should contain at least 1,350 parts per million (ppm) fluoride [1]. The NHS and OHID both recommend a "family" or "standard" fluoride toothpaste in the 1,350 to 1,500 ppm range as suitable for everyone in the household [1] [4]. Most major supermarket and pharmacy brands sit in this range; check the back of the tube for the ppm figure if you are not sure.
How much to use? A pea-sized amount is enough for adults. More toothpaste does not mean more cleaning power. Fluoride works at the surface of the tooth at low concentrations, and the residue left after spitting is what continues to protect the enamel. A pea-sized blob produces the same protective film as a full strip across the brush head.
For children, the NHS publishes age-specific guidance on fluoride concentration and amount [2]:
| Age group | Fluoride level | Amount |
|---|---|---|
| Under 3 years | At least 1,000 ppm (or 1,350 to 1,500 ppm if recommended by a dentist) | A smear |
| 3 to 6 years | 1,000 to 1,500 ppm | A pea-sized amount |
| 7 and over | 1,350 to 1,500 ppm | A pea-sized amount |
A "smear" for an under-3 is a thin film no thicker than the width of the bristles, not a visible blob. That small amount is enough to provide fluoride protection without exceeding the safe daily intake for a small child who may swallow some of the paste.
Manual versus electric: what the evidence really says
The NHS view is straightforward: "It doesn't matter whether you use an electric or manual toothbrush. They're both equally good, as long as you clean all the surfaces of all your teeth and use fluoride toothpaste" [1]. If you brush properly, the type of brush is secondary.
The clinical evidence adds nuance. A 2014 Cochrane systematic review of 56 studies covering 5,068 participants found that powered toothbrushes reduced plaque by 11% in the short term and 21% in the long term compared with manual brushing, with similar reductions in gum inflammation [13]. OHID's Chapter 8 describes this as "moderate-certainty evidence to suggest that powered toothbrushes reduce plaque and gingivitis more than manual toothbrushing", but adds the practical conclusion: "teeth can be cleaned effectively with either type of toothbrush" [4].
The Cochrane authors add an important caveat: "the clinical importance of these findings remains unclear" [13]. A small percentage-point reduction in plaque is statistically significant in trial data, but whether it changes the long-term odds of cavities or gum disease for a person who already brushes adequately is less certain.
The practical advice:
- If you find a manual brush easy to use and your check-ups are clean, stick with what works.
- If you struggle to keep the technique going for a full two minutes, an electric brush with a built-in timer can help.
- If you have arthritis, dexterity issues, or a tendency to brush too hard, an electric brush with a pressure sensor takes the guesswork out.
- Look for a small head with a compact, angled arrangement of soft- to medium-bristle ends, regardless of whether the brush is manual or electric [1].
For a deeper comparison see our electric vs manual toothbrush guide.
How often to replace your toothbrush
Replace your toothbrush, or your electric toothbrush head, approximately every three months. The Oral Health Foundation works it out as roughly 180 uses, or six hours of brushing time, before the bristles deteriorate enough to lose effectiveness. If the bristles look frayed, splayed, or bent before three months, swap them out sooner.
Worn bristles do not clean as effectively. They also flick around erratically and can scrape gum tissue rather than sweep the tooth surface. After an illness, especially a sore-throat or stomach virus, replacing the brush head is a sensible precaution.
When NOT to brush: timing after acidic food and drink
Acidic food and drink, fizzy drinks, citrus, wine, fruit juice, vinegar-based dressings, can soften the surface of your enamel for a short period afterwards. Several NHS Trust patient-information pages, including North Tees and Hartlepool NHS Foundation Trust, advise waiting at least 30 minutes after acidic food or drink before brushing [7].
There is a caveat from the most senior evidence base. OHID's Chapter 8 notes: "there is no strong evidence to suggest that the timing of toothbrushing is of great importance in preventing tooth wear or that all patients should delay brushing until after meals involving erosive food and drinks" [4]. In other words, the 30-minute wait is a sensible precaution that most NHS clinicians teach, but the underlying evidence is not as strong as the rule sometimes implies.
The pragmatic position: if you have just finished a glass of orange juice or a fizzy drink, drinking water and waiting half an hour before brushing is unlikely to do any harm and may help. But if your only window to brush is right after breakfast and that is the only way you'll do it consistently, brushing is still better than not brushing.
Common brushing mistakes UK adults make
Brushing too hard
Pressing harder does not clean better, it damages enamel and gums. The Oral Health Foundation warns that brushing too hard can wear away enamel, cause sensitivity, damage gums, and lead to gum recession [9]. Enamel does not regenerate; once it is gone, teeth look more yellow because the underlying dentine shows through, and they feel more sensitive to hot and cold.
The fix: hold the brush like a pen rather than a fist, let the bristles do the work, and pick a soft- or medium-bristled brush. Many electric toothbrushes have a pressure sensor that lights up when you press too hard, which is a fast way to retrain the habit.
If your gums are already showing signs of recession or you have sensitive teeth, check with a dentist before assuming the cause is technique alone.
Rinsing after brushing
Already covered above, but worth repeating because it is the single most-broken UK rule. Spit, don't rinse [1].
Skipping interdental cleaning
The Oral Health Foundation makes a useful point: brushing alone only cleans three of the five surfaces of every tooth [10]. The two contact surfaces between teeth, where decay and gum disease most often start, can only be cleaned with floss or interdental brushes.
The NHS recommends using floss or interdental brushes daily to remove food, debris, and plaque lodged between your teeth [3]. We cover the technique in detail in our flossing and interdental brushes guide.
Using too much toothpaste
The advertising-style "full strip across the brush head" is not necessary and may encourage children to swallow too much. A pea-sized amount for adults and over-7s, a pea-sized for 3-to-6-year-olds, and a smear for under-3s, is all you need [1] [2].
Using a worn-out brush
Bristles past three months stop sweeping and start scraping. Diary the replacement, or buy a multi-pack and swap on the first of every other month.
Beyond the brush: interdental cleaning, mouthwash, and tongue care
Interdental brushes versus floss
The UK position has shifted in recent years. The Oral Health Foundation reports that interdental brushes have stronger evidence for effectiveness than traditional floss, and a 2024 OHF survey found that 34% of British adults now use interdental brushes, overtaking the 31% who still use traditional floss [10]. The NHS endorses both: "You can use interdental brushes or single-tufted brushes instead of flossing, especially if there are gaps between your teeth" [1].
If you are flossing well and your gums are healthy, the OHF advises that there is no harm in continuing. Interdental brushes work better for gaps, around bridges and implants, and many adults find them easier to use than threading floss between tight contact points.
A 2019 Cochrane review of interdental cleaning devices noted that the evidence quality is low to very low, and that effect sizes "may not be clinically important". This does not mean interdental cleaning is unhelpful, only that the trials underpinning it are smaller and shorter than the trials of brushing itself. The pragmatic NHS and OHF advice still stands: clean between your teeth daily, with whichever tool you'll actually use.
Mouthwash
Fluoride mouthwash can be a useful addition for people at higher risk of decay, but timing matters. Don't use mouthwash straight after brushing, because it washes away the concentrated fluoride in the toothpaste residue [1]. Pick a different moment, after lunch is the NHS's example, and avoid eating or drinking for 30 minutes afterwards to let the fluoride work.
For most healthy adults, mouthwash is optional. If you choose to use one, our mouthwash guide explains what to look for and which ingredients to avoid.
Tongue cleaning
The main NHS guidance pages do not specifically recommend tongue brushing. NHS Trust patient information, including from Northumbria Healthcare NHS Foundation Trust, suggests that gently brushing the tongue removes bacteria and helps with bad breath [8]. It is a useful additional step rather than a non-negotiable, and a soft toothbrush is a reasonable tool for it.
If you have persistent bad breath that does not improve with regular brushing and interdental cleaning, see a dentist; the cause may be gum disease, decay, or another condition that needs treatment rather than tongue care.
Brushing children's teeth: a guide by age
The NHS recommends starting to brush as soon as the first milk tooth comes through, usually around six months [2]. The principle is the same as for adults, twice a day with a fluoride toothpaste, but the supervision and amount change with age.
| Age | Who brushes | Toothpaste | Notes |
|---|---|---|---|
| First tooth to 3 years | Parent or carer brushes | Smear of at least 1,000 ppm | Sit child on your lap or stand behind |
| 3 to 6 years | Child brushes, parent supervises | Pea-sized of 1,000 to 1,500 ppm | Help with technique, especially at night |
| 7 and over | Child brushes independently | Pea-sized of 1,350 to 1,500 ppm | Watch occasionally for two-minute duration and technique |
The NHS reminds parents to use small circular movements and to remember to gently brush gums and behind the teeth [2]. Children should also be taught to spit out the toothpaste and not rinse [2], the same rule as adults.
NICE guideline NG30, the official UK clinical guideline on oral health promotion, reinforces that "as soon as teeth erupt in the mouth, brush them twice daily with a fluoridated toothpaste, last thing at night and on one other occasion" [12]. The principle of twice-daily brushing, with bedtime as the priority, applies from the first tooth.
If your child resists brushing, a few practical workarounds: brush together so they copy you, let them choose a soft children's brush they like the look of, use a two-minute song or video, and praise the routine rather than threatening consequences. Most children settle into the habit by age four or five if it is part of daily life.
When to see a dentist
Brushing well is the foundation of preventive dental care, but it is not a substitute for regular check-ups. The NHS recommends seeing a dentist whenever a problem develops, and the recommended frequency of routine check-ups varies by individual risk, between 12 and 24 months for most adults.
You should make an appointment sooner if you notice:
- Bleeding gums when brushing or flossing that does not improve in two weeks
- Persistent tooth sensitivity to hot, cold, or sweet
- Visible tooth wear, sharp edges, or chipped enamel
- Stained or discoloured teeth that brushing does not improve
- Bad breath that persists despite good oral hygiene
- A toothache, swelling, or any pain that lasts more than a day
If you do not currently have a dentist, the NHS access situation in the UK is genuinely difficult and worsening. Patient registration with NHS dental practices is no longer guaranteed, and many areas have long waiting lists. Search for a dentist near you on Dentists Closeby to find both NHS and private practices accepting new patients in your area.
Frequently Asked Questions
How long should you brush your teeth?
The NHS recommends brushing for about two minutes each session, twice a day [1]. Less than that and you are unlikely to clean every surface effectively. A practical method is to divide your mouth into four quadrants and spend roughly 30 seconds on each. Most electric toothbrushes pulse every 30 seconds to help with pacing.
Should you brush before or after breakfast?
The NHS recommends twice-daily brushing without specifying before or after breakfast [1]. What matters most is that you brush last thing at night. If you brush in the morning, NHS Trust guidance suggests waiting at least 30 minutes after acidic food or drink before brushing, since acid temporarily softens enamel [7].
Should you rinse with water after brushing?
No. The NHS advises against rinsing immediately after brushing because it washes away the concentrated fluoride left on your teeth from the toothpaste [1]. Spit out the excess toothpaste and leave the residue. The fluoride film continues to protect the enamel for hours afterwards if you don't disturb it.
How much toothpaste should adults use?
Adults should use a pea-sized amount of fluoride toothpaste containing at least 1,350 ppm fluoride, with 1,350 to 1,500 ppm being the standard NHS recommendation [1] [4]. More toothpaste is not more effective. The fluoride works at the tooth surface at relatively low concentrations, and the residue left after spitting is what continues to protect.
How long should a toothbrush last before replacing?
Approximately three months, or sooner if the bristles are visibly frayed [9]. The Oral Health Foundation works it out as around 180 brushing sessions, or six hours of cumulative use, before the bristles lose their cleaning effectiveness. Replace your toothbrush after a sore-throat or stomach virus as a sensible precaution.
Is electric better than manual?
The NHS says both are equally effective if used properly with fluoride toothpaste [1]. A 2014 Cochrane review found powered brushes reduced plaque by up to 21% more than manual over the long term, but the authors note the clinical importance is unclear [13]. Electric brushes can help if you struggle with technique or pressure.
Can you brush too hard?
Yes, and it is one of the most common UK mistakes. The Oral Health Foundation warns that brushing too hard wears away enamel, causes tooth sensitivity, and makes gums recede [9]. Once enamel is lost it does not regenerate. Use a soft- or medium-bristled brush, hold it lightly, and consider an electric brush with a pressure sensor.
Should you brush your tongue?
The main NHS guidance does not specifically recommend tongue brushing, but NHS Trust patient information advises that gently brushing the tongue helps remove bacteria and freshens breath [8]. It is a useful addition to your routine rather than a non-negotiable. A soft toothbrush is sufficient; specialist tongue scrapers are optional.
Find a dentist on Dentists Closeby
If you are due a check-up or you have a concern that brushing alone won't fix, search for a dentist near you. Dentists Closeby lists both NHS and private dental practices across the UK, with information on registered status with the General Dental Council, current availability, and what each practice offers.
Sources
- How to keep your teeth clean -- NHS, last updated 30 June 2025
- Taking care of children's teeth -- NHS, last updated 30 June 2025
- Take care of your teeth and gums -- NHS, last updated 17 February 2025
- Delivering better oral health: an evidence-based toolkit for prevention, Chapter 8 -- Office for Health Improvement and Disparities, GOV.UK, updated 10 September 2025
- Adult Oral Health Survey 2023: Clinical Oral Health -- OHID, GOV.UK, published 17 December 2025
- Adult Oral Health Survey 2021: Report Summary -- OHID, GOV.UK, published 25 January 2024
- A guide to toothbrushing -- North Tees and Hartlepool NHS Foundation Trust, last reviewed 30 March 2026
- Toothbrushing: am I doing it correctly? -- Northumbria Healthcare NHS Foundation Trust
- Brushing too hard -- Oral Health Foundation
- Interdental brushes vs floss: evidence review -- Oral Health Foundation
- Half skip toothbrushing once a week, finds charity census -- Oral Health Foundation, July 2024
- Oral health promotion: general dental practice (NG30) -- NICE, published 15 December 2015
- Powered versus manual toothbrushing for oral health (Yaacob et al., 2014) -- Cochrane Library, 2014
