Chapters
Is There a Wrong Way to Brush?
[00:01:37 – 00:03:39]
Most people assume effort is what counts when brushing, but technique matters just as much. Scrubbing too hard, brushing in horizontal strokes, or missing the gum line entirely are among the most common mistakes — and they can cause real, lasting damage.
These habits abrade enamel, wear away gum tissue, and leave plaque undisturbed in exactly the spots where it causes most harm. Brushing harder or longer does not mean brushing better; correct brushing is gentle, controlled, and precise.
The Modified Bass Technique Explained
[00:03:46 – 00:06:01]
The modified Bass technique is the most widely recommended brushing method. The bristles are angled at approximately 45 degrees towards the gum, allowing them to slip gently under the gum margin in small, controlled vibrating motions.
This dislodges plaque at the gingival sulcus — the narrow space between tooth and gum — without traumatising the tissue. Random scrubbing never reaches this area, which is why some people brush frequently yet still experience bleeding gums and cavities.
A manual toothbrush with a square handle, such as a Curaprox, can help maintain the correct angle. With an electric toothbrush, the vibrations are done for you — you simply hold the brush at 45 degrees and guide it slowly along each tooth.
The Damage Caused by Scrubbing
[00:06:06 – 00:07:34]
Aggressive scrubbing feels productive, but it is biologically destructive. Enamel and dentine are not designed to withstand repetitive abrasive force, particularly when a medium or hard bristled brush is used.
Over time, this causes non-carious cervical lesions — wedge-shaped grooves near the gum line where the enamel is thinnest. These notches are sensitive to cold air and acidic drinks, and once the enamel is worn away, it cannot regenerate.
Research shows that brushing force is a stronger predictor of gum recession than brushing frequency. Gentle, precise technique is what preserves the gums over the long term.
The 45-Degree Angle and the Inside Surfaces
[00:07:40 – 00:10:11]
Angling the bristles towards the gum transforms brushing from a superficial clean into genuine disease prevention. When the brush is held flat against the tooth, bristles cannot reach under the gum margin, allowing plaque to accumulate and eventually cause inflammation and bone loss.
The inner surfaces of the lower front teeth present a particular challenge. Here, the brush should be held vertically and moved in short flicking strokes so the bristles can access those narrow spaces without applying excess pressure. This is also a common area for tartar build-up and gum disease.
Healthy gums benefit from gentle stimulation along the gum margin, which aids circulation and plaque control — but the goal is always stimulation and cleaning, never abrasion.
Timing, Technique and the Two-Minute Rule
[00:10:56 – 00:13:20]
Two minutes is the recommended minimum, yet studies consistently show that most people brush for less than a minute. A practical approach is to divide the mouth into quadrants and spend around 30 seconds on each — roughly one to two seconds per tooth.
The bedtime brush is the most important of the day and should be the most thorough. Many electric toothbrushes include a built-in timer that signals every 30 seconds when to move on. Alternatively, playing a two-minute song works just as well — just avoid anything as long as Radar Love.
Manual vs Electric Toothbrushes
[00:13:31 – 00:16:18]
The principles of good brushing apply equally to both brush types, but a quality electric toothbrush removes much of the technique burden. The user simply guides the brush slowly from tooth to tooth and lets the oscillation or sonic action do the work.
Electric brushes are particularly beneficial for people with limited dexterity, such as those with arthritis or elderly users who struggle to execute precise manual movements. Many modern models include a pressure sensor that alerts the user — or even pauses the brush — when too much force is applied.
A built-in app that tracks brushing coverage is available on premium models, though the basic version without the app cleans just as effectively. When purchasing an electric toothbrush, it is worth checking that replacement heads are affordably priced — and always opt for the softest bristle option available.
Spit, Don’t Rinse — and Know When to Replace Your Brush
[00:16:25 – 00:20:34]
Rinsing with water immediately after brushing washes away the fluoride that continues to protect enamel after the brush is put down. Those prone to cavities should spit thoroughly and leave the residual toothpaste on their teeth overnight. Products such as Tooth Mousse can provide additional fluoride protection when used in the same way.
Toothbrushes and electric brush heads should be replaced every three months, or sooner if the bristles are visibly frayed. Worn bristles cannot clean effectively and may irritate the gums. A brush head that looks as though it has been used to polish shoes is well past its useful life.
When choosing an electric toothbrush, the Oclean Flow is a well-regarded option recommended at OptiSmile. For those who enjoy gadgetry, the Oclean Ultra 20S includes a pressure sensor and audio prompts. Whichever model you choose, always select the extra-soft bristle head.
Key Takeaways
[00:20:38 – 00:21:53]
Better brushing is not about brushing harder or longer. Angle, gentleness, and consistency are what protect your teeth and gums over a lifetime. Small adjustments to technique, made today, can prevent recession, sensitivity, and decay for decades to come.
Transcript
Eon Engelbrecht — E-Radio-SA (0:04 – 0:53)
Welcome back to Save Your Money, Save Your Teeth. Eon with you, and joined by Dr Clifford Yudelman
from OptiSmile. Today we’re doing something almost everyone thinks they’ve already mastered: brushing
your teeth. But here’s the surprise — most of us have been doing it wrong for years. And doing it wrong
doesn’t just leave plaque behind, it can actually wear away your enamel and your gums over time. So this is
the brushing masterclass. Dr Yudelman is going to walk us through the technique that the research actually
backs, the mistakes that quietly damage your teeth, and a few small changes that pay off for decades. Simple
stuff, but big rewards. Dr Yudelman, welcome back.
Dr Clifford Yudelman — OptiSmile (0:54 – 1:37)
Thanks, Eon. Thanks for having me back. A lot of great responses to some of our previous podcasts, and
we’ve gone all the way to number 117 and we’ve never really spoken about brushing. We’ve spoken about
fluoride toothpaste and things like that, but today is all about brushing. We’re going to take a deep dive —
and we’re not just going to brush over it, we’re going to get stuck in, so to speak. It will probably go a little bit
longer than the recommended two minutes that people recommend you brush your teeth for.
Eon Engelbrecht — E-Radio-SA (1:37 – 1:42)
Let’s do it. I want to start off by asking you: is there actually a wrong way to brush your teeth?
Dr Clifford Yudelman — OptiSmile (1:43 – 3:39)
Any way you brush your teeth is better than not brushing them, so let’s just start off with that. We don’t want
to scare anyone away from brushing, but there absolutely is a wrong way. It’s not just about the effort, or how
often you do it, or for how long. We’re going to speak a little bit about technique. Some people brush very
enthusiastically but they still get gum recession, they get sensitivity, and they get cavities, because they’re not
brushing properly. That’s a bit sad — very sad — because if you’re trying to look after something and it’s not
working, then learning the proper way can help. The most common mistakes are scrubbing too hard, or
brushing straight up and down horizontally like you’re polishing shoes. I haven’t seen anyone polishing shoes
for a while, but you know, when you take a brush to your army boots or your school shoes. And also missing
the gum line completely. These habits can abrade your enamel, they can wear away your gum tissue, giving
you recession. And worst of all, they can leave plaque undisturbed where the plaque is causing the most
problems. There’s a lot of evidence from periodontal research showing that improper brushing contributes
significantly to gum recession and wear at the gum line. There are abfractions, there are erosions, and then
there’s toothbrush abrasion. So brushing harder or longer doesn’t mean you’re brushing better. Correct
brushing is gentle, controlled and precise, and it protects your teeth for life rather than damaging them slowly.
Eon Engelbrecht — E-Radio-SA (3:40 – 3:46)
Can you tell us about the modified Bass technique, and why this is the gold standard?
Dr Clifford Yudelman — OptiSmile (3:46 – 6:01)
Yes. So Bass — it’s named after Dr Bass. I used to know the man’s first name. Modified Bass is not when you
use a normal electric guitar and only play on the bass strings — but this is Bass, that’s how I pronounce it.
Let’s go with Bass. We won’t be modifying any guitars today. It’s the most widely recommended brushing
method, and it targets plaque where it causes disease, along the gum line. The toothbrush bristles are angled
at approximately 45 degrees towards the gum. So instead of holding the brush level or parallel with the
ground and scrubbing up and down, if you’re doing your uppers you’re actually pointing the bristles at an
angle up towards the gums. And if you’re doing the lowers, you’re holding the brush towards the lower gums,
and you allow the bristles to gently slip under the gum margin in small, controlled vibrating motions, to
dislodge the plaque without hurting your gums. It’s very hard to actually do, to be honest, with a manual
toothbrush. Some of the brushes these days are difficult to control. There are some very nice Swiss brushes
called Curaprox that have a square handle and square head, so you know where the bristles are going. But it’s
quite hard to do. If you’re using an electric toothbrush this also stands — you just hold it at 45 degrees and the
toothbrush does those vibrations for you, which is why we actually much prefer those in many cases. These
techniques reduce gingivitis and plaque compared to random scrubbing. When you scrub up and down, the
bristles don’t go under the gums and get rid of the plaque. They don’t go between the teeth to prevent bleeding
gums and cavities. And it’s not about force, it’s about accessing it properly, looking in the mirror. When you
do it correctly, it protects the teeth and the gums over many, many years.
Eon Engelbrecht — E-Radio-SA (6:01 – 6:05)
So scrubbing is not a good thing then. What happens if we do?
Dr Clifford Yudelman — OptiSmile (6:06 – 7:34)
It feels productive. People love scrubbing their teeth. Even if I’m in a big hurry I put a bit of toothpaste on and
give a quick scrub up and down. As I say, it’s better than nothing — you’re getting the fluoride on your teeth
and you may be removing a little bit of plaque. So don’t get me wrong, it is better than nothing. But
biologically it’s destructive, especially if you’re not using an extra soft toothbrush. Your enamel and your
dentine are not designed to withstand this repetitive abrasive force. Over time it can cause what we call noncarious cervical lesions, which are wedge-shaped defects near the gum line. Those are the ones you can stick
your fingernail into, and they’re sensitive when you breathe air on them. They’re the ones that get most
sensitive when you drink gin and tonic or lemon water. You’ve made your gums recede, and you’ve caused a
little groove at the gum line, because that’s where your enamel is quite thin. And if you brush that away, it
doesn’t regenerate. The research has shown that brushing force is a strong predictor of recession — a lot more
of a predictor than how often you brush. Gentle, precise brushing is how you preserve your gums. Aggressive
brushing will mess them up.
Eon Engelbrecht — E-Radio-SA (7:34 – 7:40)
Okay. And can you tell us about the 45 degree angle rule?
Dr Clifford Yudelman — OptiSmile (7:40 – 8:59)
Yes. I jumped the gun a little bit on that question, but there are a few extra things I should say. The reason
you’re doing it, as I mentioned earlier, is to aim the bristles at what’s called the gingival sulcus — that’s where
the gum meets the tooth. There’s a little space between the tooth and the gum, and that is where plaque
accumulates. That is where plaque actually causes gingivitis, and in some cases cavities, except for the
cavities between the teeth, and we’ve spoken about flossing before. If you hold the brush flat against the
tooth, the bristles don’t go under the gum. Then you get inflammation, bleeding and eventually bone loss. So
just changing the angle transforms your brushing from a quick scrub with some toothpaste to freshen up your
mouth into a disease prevention method, where you’re actually preventing bleeding gums. So often we see
patients who brush three times a day and they tell me that, and I look and I believe them, and then their
bristles are all splayed or the brush is getting old, or they’re using a hard brush and brushing up and down —
but they’re not getting anywhere near where the plaque is actually sitting.
Eon Engelbrecht — E-Radio-SA (9:00 – 9:07)
Okay. And how do we brush the inside surfaces of the front teeth, or the side teeth — the so-called flick?
Dr Clifford Yudelman — OptiSmile (9:08 – 10:11)
It’s like when you’re brushing those lower front teeth and then your wife gives you a hard time because you
flick the toothpaste at the mirror. That happens to me a lot. The inside of the lower front teeth especially are
very hard to reach. So you actually hold the brush vertically and you’re going up and down, and the bristles
are flicking along the back of those teeth, because it’s quite hard to hold it at that 45 degree angle. That allows
the bristles to go into those narrow spaces without putting a lot of pressure on. That’s where a lot of people
get tartar formation, or calculus formation, and gum disease. And if you brush like I mentioned and you try
not to flick the mirror — and if you do, make sure you wipe it, if you want to stay happily married. Small
adjustments in the technique produce really big benefits. And the same goes for keeping your marriage
healthy.
Eon Engelbrecht — E-Radio-SA (10:13 – 10:16)
Should we brush the gums, or just the teeth?
Dr Clifford Yudelman — OptiSmile (10:17 – 10:51)
You should be brushing the gums, but that’s because of the angle of the brush. Very gently, though, not
aggressively. Healthy gums like a bit of gentle stimulation, which improves the circulation and the plaque
control. But don’t brush your gums directly with force. You let the bristles massage the gum margin very
lightly while you’re focusing on plaque removal. You can reduce inflammation there without causing
recession. The goal is stimulation and cleaning, not abrasion.
Eon Engelbrecht — E-Radio-SA (10:51 – 10:56)
So it sounds like two minutes is the sweet spot. Do you think we need a timer?
Dr Clifford Yudelman — OptiSmile (10:56 – 12:17)
Two minutes is much longer than people realise. In all the studies they’ve done — people get paid to actually
do this, they put in a secret video camera or whatever and they time people — most people brush for less than
a minute. And like I said, it’s still better than nothing. The last brush before you go to bed needs to be very
thorough. I would time it. If you’ve got an electric toothbrush it’s got a built-in timer, and it sometimes tells
you every 30 seconds when it’s time to move on. So you’ve done the uppers on the outside for 30 seconds,
then the uppers on the inside for 30 seconds. The tops of the teeth don’t need a lot of brushing, to be honest.
And then you jump to the bottom for 30 seconds on the outside. It’s basically 15 seconds per quadrant, and
there are anywhere from six to eight teeth in each quadrant, so each tooth is only getting one or two seconds,
really. It’s not a lot. You can play your favourite song that’s two minutes long. Don’t play Radar Love — that’s
about six minutes long. You’re over, for people who remember Radar Love.
Eon Engelbrecht — E-Radio-SA (12:17 – 12:18)
Golden Earring.
Dr Clifford Yudelman — OptiSmile (12:18 – 12:21)
I won’t sing it. Yes, Golden Earring, that’s it.
Eon Engelbrecht — E-Radio-SA (12:21 – 12:23)
Yes, I know it’s a long song.
Dr Clifford Yudelman — OptiSmile (12:23 – 12:28)
Maybe you can listen to Joe Cocker — You Can Keep Your Hat On. But maybe take it off when you’re
brushing.
Eon Engelbrecht — E-Radio-SA (12:30 – 12:39)
That song’s also longer than two minutes. I think if you like Elvis Presley, most of his songs are two minutes
or two minutes thirty. Yeah, that should do.
Dr Clifford Yudelman — OptiSmile (12:39 – 12:43)
Yes, or maybe a good old James Brown.
Eon Engelbrecht — E-Radio-SA (12:43 – 12:48)
Yeah, all the old songs were quite short. Nowadays they’re like three to four minutes.
Dr Clifford Yudelman — OptiSmile (12:49 – 13:05)
You would know, hey, that’s your game. If you can go to the bathroom quickly while that song’s playing — or
if it’s going to end while you’re still going, that’s very short. That’s when you put on Radar Love.
Eon Engelbrecht — E-Radio-SA (13:05 – 13:09)
Or Queen — Radio Ga Ga, or Bohemian Rhapsody.
Dr Clifford Yudelman — OptiSmile (13:09 – 13:10)
Oh, yes.
Eon Engelbrecht — E-Radio-SA (13:10 – 13:12)
Those are quite long songs.
Dr Clifford Yudelman — OptiSmile (13:13 – 13:20)
I think we’re ready for doing a music video podcast next week.
Eon Engelbrecht — E-Radio-SA (13:22 – 13:31)
Imagine. I also want to ask you: when it comes to manual versus electric toothbrushes, does the technique
actually change?
Dr Clifford Yudelman — OptiSmile (13:31 – 15:01)
The principles are the same, but a good electric toothbrush takes a lot of the technique out of it. The whole
thing is to guide the toothbrush and let the brush do the work. Whether it’s an Oral-B with a little round head
that rotates, or a Sonicare, or one of the other really good sonic ones now available, you move them slowly
from tooth to tooth and you let the brush do the work. For most people, electric brushes are actually better.
Especially older people, or people who don’t have good dexterity — people with arthritis, or elderly people,
or some people who just don’t have the best control, whose hands don’t do what their mind wants them to.
They’re just not very good at brushing. You can show them over and over, and then it’s a case of, why don’t
you get an electric toothbrush, because I think you’ll do much better. And some of the amazing new electric
toothbrushes will actually warn you. A red light comes on when you’re pushing too hard. Mine does that all
the time. Then it almost stops — the brush stops if you’re pushing too hard. And it’s also got a little voice. If
you’re going too fast it says brushing too fast, like a tiny little voice that comes out of the toothbrush.
Eon Engelbrecht — E-Radio-SA (15:01 – 15:01)
What?
Dr Clifford Yudelman — OptiSmile (15:01 – 15:07)
I don’t even know where the speaker is. But yes, those are really cool.
Eon Engelbrecht — E-Radio-SA (15:07 – 15:10)
What does it say? Brushing too fast?
Dr Clifford Yudelman — OptiSmile (15:10 – 15:17)
Yes. And then if you stop brushing and it’s less than two minutes, it says, hey, where are you going?
Eon Engelbrecht — E-Radio-SA (15:18 – 15:34)
No, you’re joking. So it’s always like that woman you sometimes hear on those cheap devices where she says
Bluetooth connected. Oh, I love it, man. I would actually start laughing if my toothbrush was speaking to me.
I think that’s hilarious.
Dr Clifford Yudelman — OptiSmile (15:36 – 16:14)
Look, this one I’ve got has a fancy app as well that tells you if you missed a spot. It’s got a built-in sensor. If
you brush only the uppers on the outside and you don’t brush the rest, it knows the position of the brush and
how long you were in that area and whether you’re moving up and down. But I don’t look at the app any
more. It’s just too much information. People ask and they want to buy the top of the line one — it’s a couple
of grand extra. I was like, no, the cheap one without the app works the same way, it just doesn’t have the app.
So don’t buy the one with the app unless you’re a person who likes your toothbrush talking to you.
Eon Engelbrecht — E-Radio-SA (16:15 – 16:17)
Maybe you just like your gadgets, you know?
Dr Clifford Yudelman — OptiSmile (16:17 – 16:18)
Yes, exactly.
Eon Engelbrecht — E-Radio-SA (16:19 – 16:24)
And then I want to ask you: why should we spit but not rinse after brushing?
Dr Clifford Yudelman — OptiSmile (16:25 – 17:45)
It also depends on your cavity rate and whether you’ve had lots of cavities in the past. Anybody who has
struggled with cavities — usually people who eat a lot of sweets, haven’t been flossing for years, have socalled soft teeth that they got from their parents, and all those other things that are sometimes just excuses that
we hear. Basically eating a packet of Maltesers or a Whispers while you’re lying in bed, and you fall asleep,
and you wash it down with a Coca-Cola. Those are the people who should brush with a fluoride toothpaste
and just spit, and leave the fluoride on their teeth. Spit as much as you can — you don’t want to leave too
much in your mouth because you don’t want to swallow all of that. But leaving fluoride toothpaste on your
teeth can make your teeth much, much stronger long term. There’s also other stuff you can get called Tooth
Mousse, which has a tiny bit of fluoride in it, and you swish it around for a couple of minutes and then you
spit, spit, spit, and you don’t rinse with water afterwards. But if you haven’t had a cavity in years and you
don’t want to walk around or go to bed with a whole lot of toothpaste on your teeth, then I’ll give you
permission, you can have a little bit of a rinse. But try to keep a little bit of toothpaste in there.
Eon Engelbrecht — E-Radio-SA (17:45 – 17:54)
Okay. And now we come to the final question, and this is the burning question: how often should we really be
changing our toothbrush?
Dr Clifford Yudelman — OptiSmile (17:54 – 20:34)
It varies from brand to brand and depends on what your toothbrush looks like. They say every three months is
a general guideline, or sooner if your bristles are getting frayed. If the bristles are worn out and going all over
the place, they can traumatise your gums and they also don’t clean as well. They’ve also shown that you get a
lot of bacteria building up in your brush the longer you keep it. Having said that, with these fancy electric
toothbrushes, the replacement heads are around R350 for two heads. But I think I’ve used the exact same head
— not the one that comes with it, I got an extra soft head, which you must always make sure of: if you’re
using an electric toothbrush, get the softest bristles possible. This particular brush, the extra soft brush, is such
high quality that I think I’ve been using the same head for about a year and it’s still doing a great job. So it
depends. The ones I see are those electric toothbrushes people buy, these Oral-B ones that have blue ink built
in, and the harder you push and the more you use it, the blue disappears. When it’s halfway down you’re
supposed to get a new one. A lot of the time when I see patients with a lot of plaque on their teeth I say, what
kind of brush do you use? And they say, I use an Oral-B electric. And I say, when you get home, why don’t
you just send me a picture of the bristles? And you can’t believe it — it looks like they’ve been polishing their
army boots with it. But I can understand it, because those replacement heads are sometimes more than the
brushes. So when you do buy an electric toothbrush, make sure that it’s affordable for you to be able to
change the bristles, and maybe your dentist or hygienist can recommend one. I would recommend buying an
electric toothbrush from a dental practice, if the practice is like ours where they’ve paid a lot of attention and
all the dentists have tried different brushes out and recommend the ones they use themselves. I’m actually at
the practice, so I’m going to have a quick look, because we do love this brush and I can’t remember the name.
The name of the brush is Oclean — just O and then the word C-L-E-A-N. They’ve got different models. We
love the Oclean Flow. The Ultra 20S is the one with all the bells and whistles and the little voice and all of
that. So if you like gadgets, that’s the one to get.
Eon Engelbrecht — E-Radio-SA (20:35 – 20:37)
Okay, sounds good.
Dr Clifford Yudelman — OptiSmile (20:37 – 20:38)
I hope that answered your question.
Eon Engelbrecht — E-Radio-SA (20:38 – 21:04)
It really did. And I think this was a wonderful brushing masterclass today. Thank you, Dr Yudelman. I also
think the big takeaway for our listeners is that brushing better isn’t about brushing harder or longer. It’s all
about angle, gentleness and consistency. And those small changes actually protect your teeth for life. Are you
in agreement, Dr Yudelman?
Dr Clifford Yudelman — OptiSmile (21:04 – 21:07)
Yes, 100 per cent. Very much so.
Eon Engelbrecht — E-Radio-SA (21:07 – 21:27)
Fantastic. So thanks again to you. And that’s our episode for today. If you’ve got a dental question that you’d
like us to tackle on the show, you’re always welcome to get in touch. But right now it’s time to say goodbye
until next week. And next week we’re talking about the psychology of the smile. That sounds interesting,
doctor.
Dr Clifford Yudelman — OptiSmile (21:27 – 21:45)
Yes, it’s actually a slightly different take from our fourth episode several years ago. We wanted to revisit it
because it’s a very important topic, and I wanted to touch on it again from a different angle. So looking
forward to speaking to you next week.
Eon Engelbrecht — E-Radio-SA (21:45 – 21:53)
Absolutely, likewise. And until next time, for our listeners, thanks for joining us. And remember to look after
your teeth and your wallet.
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Disclaimer: The content provided in this podcast, “Save Your Money Save Your Teeth” on Medical Mondays, is for informational and educational purposes only. It is not intended to serve as dental or medical advice. The insights and opinions expressed by Dr. Clifford Yudelman and any guests are designed to foster a better understanding of dental health, preventive measures, and general well-being, but should not be interpreted as professional dental or medical recommendations.Dr. Clifford Yudelman does not diagnose, treat, or offer prevention strategies for any health conditions directly through this podcast. This platform is not a substitute for the personalized care and advice provided by a licensed dental or healthcare professional. We strongly encourage our listeners to consult with their own dental care providers to address individual dental health needs and concerns.The information shared here aims to empower listeners with knowledge about dental health but must not be used as a basis for making health-related decisions without professional guidance. Your dental care provider is the best source of advice about your dental and overall health. Please always seek the advice of your dentist or other qualified health professionals regarding any questions or concerns about your dental health.
