Your night-time mouth care routine
The NHS advises brushing last thing before bed with fluoride toothpaste for about 2 minutes, then spitting, not rinsing. UK guidance also covers cleaning between teeth and avoiding sugary food and drink at bedtime.
On this page
You probably know you should brush before bed. What is less clear is what else belongs in a night-time routine, in what order, and which common tips are less settled than they sound.
Why brush last thing at night?
The NHS advises brushing for about 2 minutes twice a day with fluoride toothpaste: last thing before you go to bed, and on one other occasion. It says night-time brushing is important. The government’s oral health toolkit for dental teams gives the same timing, and says shift workers who sleep at another time of day can read “last thing at night” as “before bed”.
The toolkit also gives a reason to take care at bedtime. It says saliva production is stimulated at mealtimes and much reduced during sleep, and it advises avoiding sugary food and drink at bedtime. It is open about the limits. For gum health there is no high-quality evidence on which times of day are better for brushing, but it still suggests last thing at night and one other time, in line with its advice on decay.
A night-time routine, step by step
- Clean between your teeth. The NHS advises cleaning between your teeth every day, using floss or interdental brushes, and flossing before you brush. It says regular flossing may reduce gum disease, tooth decay and bad breath by removing plaque along the gum line. Interdental brushes, which should fit snugly, can replace floss, especially if you have gaps. Wooden toothpicks are not advised, because they may damage your gums. The toolkit, in its gum disease section, calls cleaning between teeth before brushing a habit-forming approach and good practice.
- Brush for about 2 minutes. Clean the inside, outside and chewing surfaces of every tooth. For adults, the NHS recommends a toothpaste with at least 1,350 parts per million (ppm) fluoride, which the packaging shows. Whether you need a higher strength is a conversation to have with your dentist.
- Spit out, and do not rinse. Rinsing straight after brushing washes away the concentrated fluoride left on your teeth, dilutes it and reduces its protective effect, so the NHS advises spitting out the excess and leaving the rest.
- Leave the sugar for earlier. The toolkit advises avoiding sugary food and drink at bedtime, when saliva flow is reduced.
The NHS says manual and electric toothbrushes are equally good if you clean every surface and use fluoride toothpaste. Our guide to plaque and how to remove it goes into the evidence, and fluoride and your teeth explains what the toothpaste is doing.
Where does mouthwash fit?
The NHS says a fluoride mouthwash can help prevent tooth decay. But it advises against any mouthwash, even a fluoride one, straight after brushing, because it would wash away the concentrated fluoride in the toothpaste left on your teeth. It suggests another time of day, such as after lunch, and says not to eat or drink for 30 minutes after using a fluoride mouthwash.
Food and drink before bed
The toolkit advises minimising the amount and frequency of sugary food and drink, and avoiding them at bedtime, when it says saliva flow is reduced. It explains that after you have sugar, bacteria in plaque turn it into acid, and that when sugar comes often, the gaps between acid dips are too short for the teeth to recover. Our guide to sugar and your teeth covers the daily limits and practical swaps.
For children, the toolkit cites a systematic review that found a consistent link between sugar around bedtime and decay risk across three age groups from 3 to 16, though it describes the certainty of the evidence as very low. It says avoiding sugar before bed rests on sound physiology and is good practice for everyone. Our guide to children’s dental health tips is written for parents.
Should you wait after eating before you brush?
UK sources differ on this. The Oral Health Foundation’s advice on dental erosion says to wait at least an hour after eating or drinking before brushing, so that the enamel can harden again. The government toolkit says there is no strong evidence that the timing of toothbrushing is of great importance for tooth wear, or that everyone should delay brushing until after meals with acidic food and drink. The NHS page on keeping teeth clean sets no waiting time.
Our guide to enamel erosion looks at acid wear in more detail, and your dentist can tell you what suits your teeth.
Dentures, grinding and a dry mouth at night
Three more things are worth sorting out before bed.
- Dentures. The NHS advises taking them out every night, unless your dentist recommends otherwise, and keeping them in water, a polythene bag with damp cotton wool, an overnight denture-cleaning solution or a denture bath. Its reasons are that trapped food raises the risk of gum infections and tooth decay, and that dentures left in during sleep carry a risk of choking. In the evening it also advises brushing your gums, tongue and any remaining teeth with fluoride toothpaste, and cleaning the dentures with soft soap or washing-up liquid, since toothpaste could damage them.
- Grinding your teeth. The NHS says grinding can happen while you are awake or asleep. A dentist may recommend a mouth guard or splint, worn at night to protect your teeth, made to fit over the upper or lower teeth. Our guide to teeth grinding has more.
- A dry mouth. The NHS lists breathing through your mouth at night, from a blocked nose or sleeping with your mouth open, among the causes of a dry mouth. It suggests keeping some water by your bed, and says you are more likely to get tooth decay if your mouth is dry, so brush twice a day and use an alcohol-free mouthwash, at a different time from brushing. It also says not to stop a prescribed medicine without medical advice, and that a pharmacist can suggest products. Our guide to dry mouth covers it in full.
When to see a dentist
Start with the signs that need an urgent appointment.
- you have gum disease and other symptoms such as very sore and swollen gums, loose teeth or teeth falling out, ulcers or red patches in your mouth, or a lump in your mouth or on your lip: the NHS says to ask for an urgent dentist appointment
In an emergency or out of hours, call your dentist first: if they are closed, an answerphone message may tell you what to do. The NHS says to call 111 if you do not have a dentist or cannot get an emergency appointment.
The NHS says to see a dentist if you have not had a check-up for 2 years, or 1 year if you are under 18, even when nothing seems wrong.
- your gums bleed when you brush your teeth or eat hard foods (dentist)
- your gums are painful and swollen, or you have bad breath (dentist)
- you grind your teeth and have tooth damage, sensitive teeth, or pain in your jaw, face or ear (dentist)
- your partner says you grind your teeth in your sleep (dentist)
- your dentures are causing pain, or they slip or no longer fit properly (dentist)
- you have a dry mouth that is still dry after a few weeks of home or pharmacy treatments, or you think a prescribed medicine is causing it (GP)
Our guide to bleeding gums explains what a dentist looks for.
What we would do
If you are not sure your routine is working, start with a new patient exam. We check your teeth, gums and soft tissues, including an oral cancer screening, and take small X-rays only where needed. Any options are explained in plain language.
A dental hygiene appointment starts with an assessment of your gum health, followed by a clean and scale to remove trapped plaque and a polish. It includes professional advice on your own brushing and flossing routine, and you can book an appointment at whichever of our five practices suits you. If you wear dentures, our dentures page answers questions about cleaning them and taking them out at night.
If your own routine differs from this, mention it at your next check-up. The NHS says dental professionals may give you more advice based on your own dental health and needs.
Want us to take a look?
Book an appointment at whichever of our five practices suits you. We will check what is going on and talk you through your options.
Questions this guide answers
Should I floss before or after brushing at night?
The NHS advises flossing before you brush. In its section on gum disease, the government oral health toolkit also describes cleaning between your teeth before brushing as good practice, as a way of building the habit.
Should I rinse my mouth after brushing at night?
The NHS says to spit out the excess toothpaste and not to rinse straight away. Rinsing washes away the concentrated fluoride left on your teeth, dilutes it and reduces its protective effect.
Is an electric toothbrush better than a manual one?
The NHS says they are equally good if you clean every surface of every tooth and use fluoride toothpaste, though some people find an electric brush easier to use thoroughly. The government toolkit says both kinds are effective for controlling plaque.
Do I need to wait after eating before I brush at night?
UK sources differ. The Oral Health Foundation advises waiting at least an hour after eating or drinking in its advice on dental erosion, while the government toolkit finds no strong evidence that waiting to brush after acidic food or drink makes much difference to tooth wear. The NHS gives no waiting time. Ask your dentist what suits you.
Should I take my dentures out at night?
The NHS advises taking dentures out every night and not wearing them overnight unless your dentist recommends it. It says trapped food raises the risk of gum infections and tooth decay.
