Brushing Technique: How to Actually Clean the Gum Line
How to brush your teeth properly at the gum line, for adults and parents: the bristle angle, pressure, timing, electric or manual, and spitting not rinsing. The core takeaway from NHS and Delivering Better Oral Health guidance: clean every surface and the gum line for about 2 minutes, twice a day, with fluoride toothpaste, then spit, don't rinse.
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Clinically reviewed by Dr Ibraheem Ijaz, dentist · GDC 301711
Medical disclaimer: This page is for general information only. It does not replace an examination or treatment by a dentist.
This page is reviewed by Dr Ibraheem Ijaz, the practice's principal dentist and a General Dental Practitioner (GDC 301711). His qualifications are BDS, BSc (Hons), MSc (Leeds), PG Dip Implant Dentistry and PG Cert Restorative and Aesthetic Dentistry.
Where does plaque actually sit?
Plaque builds up on the teeth and at the gum line, where gum inflammation starts, a Leeds Teaching Hospitals NHS Trust leaflet explains. The NHS calls plaque a film of bacteria that contributes to gum disease and tooth decay.
Delivering Better Oral Health (DBOH), the UK prevention toolkit, says early gum inflammation, gingivitis, can be reversed by reducing plaque at and below the gum margin (gingival margin). It advises cleaning the junction between gum and tooth carefully, and notes that your usual way of brushing may need changing to clean every surface systematically. The NHS advises getting gum disease checked by a dentist.
How do you angle the brush at the gum line?
Tilt the bristles towards the gum to clean below the gum line, Leeds Teaching Hospitals' leaflet advises, brushing 2 or 3 teeth at a time.
Angling into the gum line is also the basis of the Bass technique. A 2024 systematic review in PLoS One quotes Bass's description, bristles directed into the gum crevice at about 45 degrees to the long axis of the tooth, with short back-and-forth strokes; modified Bass adds a sweep from the gum towards the tip of the tooth. DBOH says no technique has been shown to be better than another, and the review found limited evidence for any.
The Leeds leaflet, DBOH and the NHS give these steps for a manual brush:
- Use a small-headed, medium-bristled brush, as DBOH advises, and fluoride toothpaste.
- Place the bristles along the gum line, angled towards the gum.
- Make small back-and-forward strokes over 2 or 3 teeth at a time.
- Roll or flick the brush away from the gum to lift plaque from below the gum line.
- Work round in order: outside, inside and chewing surfaces of every tooth.
How hard should you brush your teeth?
Avoid brushing aggressively: DBOH lists it as a possible cause of abrasion, a form of tooth wear, and advises a soft or medium brush.
DBOH's advice on aggressive brushing comes from its guidance for people at high risk of tooth wear and rests on low-quality evidence. It also reports low-certainty evidence that soft and medium bristles are less likely than hard ones to injure the gums, and notes that many brushes now have sensors that show when you are brushing too hard.
Is an electric toothbrush better than a manual one?
Both work: the NHS says electric and manual brushes are equally good if you clean every surface of every tooth with fluoride toothpaste.
DBOH reports moderate-certainty evidence that powered brushes reduce plaque and gingivitis more than manual ones, though the clinical relevance is unclear and no powered action, such as oscillating-rotating or sonic, is shown to be superior. DBOH stresses that teeth can be cleaned effectively with either type. Leeds Teaching Hospitals' leaflet advises cleaning one tooth at a time with an electric brush.
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How long and how often should you brush?
Brush for about 2 minutes, twice a day, last thing before bed and at one other time, the NHS advises.
DBOH explains that 2 minutes allows time to clean every surface and that a timer can help. For children, DBOH says parents or carers should brush from the first tooth, and children need an adult's help and supervision until at least age 7.
Why should you spit and not rinse after brushing?
Spit out the excess toothpaste but do not rinse straight away, because rinsing washes away the concentrated fluoride left on your teeth, the NHS explains.
DBOH gives the same advice from age 3 to adulthood. The NHS adds: do not use mouthwash straight after brushing; use it at another time, such as after lunch.
DBOH's prevention tables also set toothpaste fluoride strength and amount by age.
What brushing mistakes should you avoid?
NHS, DBOH and Leeds guidance points to four habits to avoid.
- Missing the gum line. DBOH says disclosing agents can show the areas you are missing.
- Brushing for less than about 2 minutes (NHS, DBOH).
- Rinsing with water or mouthwash straight after brushing (NHS).
- Stopping because your gums bleed. Leeds Teaching Hospitals' leaflet says bleeding from inflamed gums comes from the inflammation, not damage, and reduces if you keep cleaning; the NHS advises seeing a dentist if your gums bleed when you brush.
For cleaning between the teeth, mouthwash and tartar, you can browse the gum disease prevention section.
When should you speak to a dentist?
See a dentist if your gums bleed when you brush; NHS guidance also sets out when to get urgent help.
If you do not have a dentist or cannot get an emergency appointment, call 111 or visit 111 online. NHS guidance gives these actions:
- Gums that bleed when you brush or eat hard foods, or that are painful and swollen: see a dentist.
- Gum disease with very sore and swollen gums, teeth becoming loose or falling out, ulcers or red patches in your mouth, or a lump in your mouth or on your lip: ask for an urgent dentist appointment.
- Toothache that lasts more than 2 days, does not go away with painkillers, or comes with a high temperature, pain when you bite, red gums, a bad taste or a swollen cheek or jaw: see a dentist.
- Swelling around your eye or neck, or swelling in your mouth or neck that makes it difficult to breathe, swallow or speak: go to A&E or call 999 for an ambulance, and do not drive yourself.
Frequently asked questions
Should you brush straight after eating?
UK guidance differs on this. Delivering Better Oral Health finds no strong evidence that the timing of brushing matters for preventing tooth wear, and does not advise everyone to wait after acidic food and drink. Leeds Teaching Hospitals' leaflet suggests allowing at least 30 minutes after eating where possible.
Should you clean between your teeth before or after brushing?
Clean between your teeth before brushing. Delivering Better Oral Health calls this good practice that helps build the habit, and the NHS advises flossing before brushing. Delivering Better Oral Health also advises adults to clean between the teeth daily, to below the gum line, using an interdental brush where there is space and floss or tape for small gaps.
How often should you replace your toothbrush?
Replace it every 3 months, or sooner if the bristles are worn and splayed, Leeds Teaching Hospitals' leaflet advises. Some brands have dye indicators that show when a head needs changing. For most adults, the NHS says, a small head with a compact, angled arrangement of long and short round-end bristles is fine.
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Hygiene appointments can be booked directly with our dental therapist, without seeing a dentist first or registering as a patient. The practice, at 334 Manchester Road, Deepcar, Sheffield, S36 2RH, has free parking directly outside. Patients describe their visits in our patient reviews.
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Deepcar, Sheffield S36 2RH
0114 288 2121
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