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Tooth Brushing Before or After Breakfast?: European Archives of Paediatric Dentistry

Brushing teeth before or after breakfast is an academic debate without clear clinical evidence either way. Brushing before breakfast removes plaque and provides fluoride when it is most effective, while brushing after may cause additional enamel loss from abrasion if the pH is still low from food acids. However, personal preferences and habits are also important factors. The real issue is promoting regular twice daily brushing, including before school/work and before bed, with parental supervision for children. Public health campaigns could help remind high risk groups to brush at bedtime.

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Randy Fernandes
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126 views1 page

Tooth Brushing Before or After Breakfast?: European Archives of Paediatric Dentistry

Brushing teeth before or after breakfast is an academic debate without clear clinical evidence either way. Brushing before breakfast removes plaque and provides fluoride when it is most effective, while brushing after may cause additional enamel loss from abrasion if the pH is still low from food acids. However, personal preferences and habits are also important factors. The real issue is promoting regular twice daily brushing, including before school/work and before bed, with parental supervision for children. Public health campaigns could help remind high risk groups to brush at bedtime.

Uploaded by

Randy Fernandes
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

European Archives of Paediatric Dentistry

Tooth brushing before or after breakfast?


Should we advise our patients to brush their teeth
before or after breakfast? Is there any clinical significance or is this simply an academic issue?

Let us consider each of these in turn. Fluoride has


been proven to prevent dental caries by preventing
demineralisation of tooth mineral and promotion of
remineralisation. If we brush our teeth before breakfast then we remove the build up of dental plaque
thereby minimising the acidogenic response of the
oral bacteria present to the foods eaten. We also
provide intra-oral fluoride at the time it is needed
most of all which will prevent demineralisation and
promote remineralisation of dental enamel and
dentine.
However, if we brush after breakfast the acidogenic
response has already occurred and the tooth tissues
have been softened by the drop in intra-oral pH to
below the critical pH of about 5.5, or even lower,
depending on the food constituents ingested. Tooth
brushing at this time will lead to further tooth mineral loss by the abrasion of tooth brushing which
will be in addition to any loss caused by the erosive
food products eaten during breakfast. The fluoride
now provided will not be as effective in limiting
demineralisation and promoting remineralisation.
However, there are other factors to consider such as
personal preferences and brushing routines/habits
and the effects of tooth brushing either before or
after breakfast on the subsequent taste of the food
ingested during the meal.
Following an acidogenic challenge such as occurs
following mealtimes it is advisable to wait for the

saliva to buffer the drop in intra-oral pH before tooth


brushing to minimise tooth mineral loss. Some
authorities recommend that tooth brushing should
not occur for a period of between 20-60 minutes
after eating whilst others recommend brushing
before and rinsing after breakfast.
Is there any evidence to help in making a decision as
to whether to tooth brush before or after breakfast?
There is some in vitro evidence showing that there
is less tooth mineral loss when brushing before an
acidogenic challenge rather than after the challenge. However, the clinical evidence from in vivo or
even in situ studies is lacking or inconclusive.
In reality this is more an academic discussion and
the real issue is to promote regular effective tooth
brushing by our patients. A simple message is to
brush teeth twice daily, first thing in the morning
(either before or after breakfast) and last thing at
night immediately before bedtime. For children this
means getting the parents to take responsibility for
supervising their children when tooth brushing.
Nowadays modern children are more concerned
with extending their television or games console
time immediately prior to bedtime rather than concentrating on their nightly oral hygiene regimes.
It would certainly help to have TV commercials
promoting bedtime tooth brushing at key times for
young children and at later times for teenagers and
adolescents. This will be especially beneficial for
high caries-risk groups and act as a reminder.

Jack Toumba

European Archives of Paediatric Dentistry

107

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