The Truth on How Long You Should Brush Your Teeth

Hand written by Dr David Chen, an actively practicing dentist and avid writer. #doctorswrite

According to the American Dental Association (ADA), you should brush for two minutes twice a day with a soft toothbrush.

cartoon girl brushing teeth

The end…

Yeah right, did you really think that was everything we had to say? Of course not, things are never as simple as they seem. There is more to it than simply brushing your teeth for two minutes, once in the morning and once at nighttime.

So, what more is there? Well since you’ve asked so kindly, we will oblige.

Is TWO minutes the optimal brushing time?

As a matter of fact, two minutes is actually NOT the most optimal amount of time to be brushing your teeth. Research shows that three minutes is more effective at removing plaque than the mere two minutes that you’re using.

This was clearly demonstrated in a study from the Journal of Dental Hygiene where they compared brushing time with the amount of plaque removed.

  • There was no difference in plaque removal for 45 vs 60 seconds of brushing.
  • 120 seconds of brushing removed 26% more plaque than 45 seconds of brushing.
  • 180 seconds of brushing removed 55% more plaque than 45 seconds of brushing.

The conclusion was that oral health care professionals should encourage patients to brush longer. They should attempt to persuade patients to brush longer than 45 seconds and reach the two minute consensus.

Despite the study’s authors recommending a brushing time of 2 minutes, their results clearly indicated that 3 minutes was superior. However, the ADA also said to do it for two minutes as well.

Aren’t you curious as to why it should be for two minutes when the three minutes removed 29% more plaque?! We don’t even need to hear your response because that made us more curious than curious george himself.

curious george

Where did the two minutes timer come from?

Unfortunately there is no mention of where the recommendation for two minutes of brushing came from. It wasn’t as if there was a conference and all of the dentists came together and decided that two was the number.

What we’re sure of is that the ADA recommends it and so does the australian dental association as well as the NHK. The ADA even has a video showing you how to brush as well.

That specific number just seems to come up in a lot of studies and simply referenced to as “the recommended time”.

An example would be this randomized controlled trial which compared 2 minutes of brushing with 40 seconds.

  • Fluoride levels were no different between the two different times.
  • There was a significant change in plaque biofilm at the 5, 15, 30, and 60 minutes mark.

However we did find a semi-contradictory study about electric powered brushes and their brushing time. Apparently there were negligible benefits after brushing beyond the two minute point with a powered brush.

According to another author, that study may have led to the birth of the two minute timer for electric toothbrushes. That makes sense since if brushing for longer than two minutes yielded no additional benefits, the timer would be set at two.

Perhaps the recommended brushing duration was a result of this one study which was meant for electric powered brushes.

The average brushing time for Americans

Despite the recommendation for two minutes by all dental associations across the board, what we actually see is completely different. Studies have consistently shown that the average brushing time for most Americans was a measly 45 seconds.

The average brushing time is less than half of the recommended time! What a far cry from what actually transpires!

To make matters worse, a study about Socio-Behavioral Determinants of Oral Hygiene Practices Among USA Ethnic and Age Groups showed grimmer results. Apparently study participants knew how long they were supposed to brush but they all felt that 3 minutes was “too long”.

That’s right, brushing for three minutes is too long and takes up too much time in their life. Therefore, most people only brush for less than half of the recommended time.

Don’t even mention the three minutes because the average person can’t even make it halfway to two minutes. That brings us to the next point, which is about compromising and practicality.

The two minutes is a practical compromise

The consensus of settling on two minutes as the recommended brushing time is a practical compromise.

  • Three minutes of brushing may be a tough sell for the general public.
  • Electric powered brushes showed no additional benefits beyond two minutes.
  • Two minutes is still better than 45 seconds.

When people are left to their own decisions, they choose to brush for only 45 seconds when they know that they should be brushing for longer. Asking people to do it for 3 minutes is a lot more difficult than doing it for 2 so we should take what we can get.

Since studies have shown that for electric powered toothbrushes, two minutes was sufficient there is no need to recommend three minutes. Perhaps it was to keep it consistent across the board and apply the same duration for manual toothbrushes. It is more difficult to get a point across when there are too many instructions so it is best to keep it simple.

Studies have also shown that two minutes of brushing was significantly more effective than 45 seconds. Despite not reaching the maximum benefit of plaque removal of 3 minutes, the 2 is still a solid choice.

Can you brush for longer than 2-3 minutes?

You can absolutely brush for longer than both of the touted times above as long as you do it safely. What we mean by that is to make sure that you’re either using a soft toothbrush or an electric one with a pressure sensor on it.

The reason for that is to prevent you from brushing too hard and causing your gums to recede. Overzealous brushing can cause gingival abrasions and make your gums shrink.

Studies have shown that a medium toothbrush is more effective at removing plaque than a soft one. But it also increases the chance of gingival abrasion.

Therefore if you’re using a manual one, you must purchase a soft or very soft bristled brush. If you’re using an electric, try to get one with a pressure sensor that beeps at you if you’re brushing too hard or one that’ll stop spinning if you do.

As long as you’re not cleaning your teeth aggressively, it shouldn’t damage your gums.

Last but not least, make sure that your whitening toothpaste isn’t too abrasive either. Most toothpastes have a RDA value which stands for relative dentin abrasivity. If the value is very high, it may erode your tooth by too much brushing. Therefore you should try to pick one with a low RDA value if you were to brush more frequently and also for longer. That way you’re being as gentle on your teeth and gums as possible.

Toothpaste RDA chart

How long would we brush for?

In our opinion, the most optimal brushing time is still two minutes. The reason is that we believe everyone should be using an electric powered toothbrush.

Yes, it does help that there is objective scientific evidence saying that the maximum brushing benefit for a powered brush is two minutes. However that isn’t the determining factor for our decision.

We believe the most powerful aspect of a powered brush is the built in two minute timer. Your toothbrush won’t stop vibrating until it reaches the full two minutes. That prevents you from brushing less than that because if we left you to brush manually, you’d probably stop at 45 seconds.

However if you choose to use a manual toothbrush, we would recommend that you increase the brushing time to three minutes from the two. For manual brushing, there is more benefit to be had beyond the two minute mark so why not take advantage of it.

If you think that takes too long then you should just switch to an electric powered one!

Takeaway

You should brush for at least two minutes twice a day. That recommendation is a sound one and it comes straight from the ADA so we can’t disagree with that.

We wholly agree with that duration of time but at the end of the day you should use your common sense. How long you should really be brushing for is however long it takes to get your teeth clean.

If you were brushing your teeth and the two minutes up but you still see some plaque… Do you stop right then and there? No, obviously you keep going until everything is clean. Also don’t forget to rinse afterwards!

If it takes you longer than two minutes then you should spend more than two minutes. The perfect example would be if you had braces. Due to the brackets and wires, two minutes is often NOT enough to keep all of your teeth. So keep brushing!

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