The American Dental Association (ADA) recommends that you brush your teeth twice a day for two minutes to get the most effective cleaning. That makes your toothbrush one of the most-used tools in your oral hygiene kit — which is why the ADA also advises swapping it every three to four months for better cleaning and oral health. 

But when was the last time you replaced your manual toothbrush or electric toothbrush head? If it’s been more than a few months, or you just can’t remember, now’s the time to make the swap — especially after you learn about all the gross germs and bacteria that could be living on those bristles. 

Fecal Matter and E. Coli

Yes, fecal matter might be on your toothbrush. Every time you flush the toilet and leave the lid up, aerosolized fecal matter or urine can travel up to 6 feet around the room and land on any surrounding items, such as faucets, hair brushes, toiletries, and, perhaps grossest of all, your toothbrush. 

Another harmful bacterium that can come from your toilet and end up on your toothbrush is E. coli. Exposure can cause an infection, triggering symptoms like diarrhea, stomach pain, and more. So make sure you shut the lid when you flush — it won’t totally contain the spray, according to experts, but it should help.

Blood

There may be traces of blood on your toothbrush, especially if you have oral health issues such as gum disease or mouth sores. If you’re noticing pink spots on your toothbrush or when spitting after brushing your teeth, it’s time to make an appointment with your dentist. 

Staphylococcus Aureus and Streptococcus Mutans

Staphylococcus aureus is a type of bacteria found on our skin and inside our noses — and that’s one reason it can end up on toothbrushes. But it may also get there via aerosolized droplets from the toilet; in fact, one study found that it wasn’t present on the bristles of toothbrushes kept in bathrooms without a toilet. Once in the air, S. aureus can settle on surfaces and proliferate fast, so touching a contaminated surface is another way it can end up on your toothbrush and in your mouth. While there’s not a huge risk of disease from exposure, you certainly don’t want to let it multiply  — if it gets into a break in your skin or gums, you could get an infection. 

Staphylococcus aureus isn’t the only staph bacteria you need to worry about: Streptococcus mutans is found in your mouth — primarily in the biofilms that form on your teeth — so it’s no surprise that it’s also on your toothbrush. Unfortunately, this bacterium causes tooth decay, and buildup such as dried toothpaste, calcium, and minerals from hard water can create hard deposits that trap the bacteria and increase your exposure. Studies have also shown that if you’ve recently had gum disease treatment, you have an increased risk of this type of bacteria in your mouth. 

Flu Virus

Did you know that flu viruses can live on toothbrushes for more than 72 hours? If you or a family member has been sick, it’s time to get a new toothbrush.  Experts say you should replace it within three to four days of feeling better.

Candida Fungus

Candida is a type of yeast that naturally lives on our skin, and an overgrowth of it can cause an infection. In the mouth, it can result in tongue thrush. Your toothbrush can contain this fungus as a result of toilet-flushing plumes if you had a previous infection, or if your toothbrush touches another one harboring candida. 

How To Keep Your Toothbrush Clean

After reading this list, you’ll probably want to keep your new toothbrush as clean as possible. Here are a few maintenance tips to keep in mind.

Thoroughly rinse it with hot water after every use. While this isn’t enough on its own, thorough rinsing can remove particles that accumulate with regular brushing.

Store your toothbrush in a dry, upright location away from the toilet. Keep it in your medicine cabinet or dresser drawer to limit exposure to harmful bacteria. 

Skip the toothbrush cap. It may sound contradictory, but that plastic toothbrush cover can create a moist environment that prevents your toothbrush from drying fully and allows bacteria to thrive.

Clean your toothbrush regularly. Once a week, mix one teaspoon of peroxide with one cup of water and let your toothbrush soak for about 15 minutes. Rinse with hot water thoroughly after.

Replace your toothbrush or toothbrush head every three to four months. Mark the calendar or set a reminder to swap out your brush. Do it sooner if you or a family member has been sick or if you notice damaged bristles.

Avoid using anyone else’s toothbrush. Sharing toothbrushes is a fast way to also share germs, so it’s best to use your own toothbrush. If you’re in a bind, just rinse your mouth thoroughly with water until you can pick up a new one.

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Most of us brush twice a day, and some of us floss at least once. You may even include a quick swish of mouthwash in your routine, whether it’s to freshen your breath after lunch or give your mouth that super-clean feeling at the end of the night. But what if your mouthwash is doing more harm than good? 

Is Mouthwash Bad for You?

There are two main categories of mouthwashes: cosmetic and therapeutic. Cosmetic mouthwashes briefly relieve bad breath, while therapeutic mouthwashes address concerns such as halitosis (chronic bad breath), gum disease, or tooth decay. You may even have a prescription for a therapeutic mouthwash from your dentist, though they’re also available over the counter. 

Problems with mouthwash typically arise from the ingredients and their effects on your mouth. Here are some signs you may want to set your mouthwash aside.

It Irritates or Burns Your Mouth

Ever notice a slight burning sensation after using mouthwash? Some mouthwash formulas can contain an ingredient known as sodium lauryl sulfate (SLS). It’s why toothpaste and soap foam when they interact with water. SLS can irritate your mouth and in some small studies has been associated with triggering canker sores or irritating existing sores. It’s especially aggravating if you’re undergoing cancer treatment — not because SLS is a carcinogen (it’s not), but because treatments for cancer can make the skin more sensitive. If you’ve experienced this problem, check your mouthwash for the ingredient and look for an alternative that doesn’t include it.

It Triggers Dry Mouth

Saliva helps our mouths stay healthy: It removes food particles from the teeth and around the gums, and it aids digestion. Regular use of an alcohol-based mouthwash can lead to dry mouth, a condition in which your salivary glands don’t produce as much saliva. Choose an alcohol-free mouthwash to help minimize the risk of this condition.

It Minimizes Good Bacteria

Most of us think of bacteria as harmful. Your mouth has all kinds of bacteria — some bad, but also some good. Adding an alcohol-based mouthwash or a chlorhexidine mouthwash (which helps reduce gum disease) to your regular oral hygiene routine can eliminate both harmful and beneficial bacteria. Ask your dentist about the risks of prolonged use of your mouthwash and their recommendation for the best option to protect your oral (and overall) health.

What Are the Benefits of Mouthwash?

Despite the risks, there can be some benefits to mouthwash. Studies have shown it can reduce plaque in your mouth and your risk for gum disease. Your dentist may even have recommended that you include it in your oral care routine. To make the most of mouthwash without overdoing it, make sure to:

• Choose one with minimal synthetic ingredients, and avoid alcohol-based options.
• Use a mouthwash that includes fluoride, an ingredient known to help reduce the risk of cavities.
• Skip mouthwashes including artificial sweeteners, but look for ones with the sugar alternative xylitol.
• Use any prescription mouthwash as directed, but no more than the recommended use.
• Look for ones with the seal of approval by the ADA (American Dental Association).

Most importantly, talk to your dentist about your mouthwash. You should mention any concerns you have about your oral health during your next checkup. You can also bring your mouthwash with you, or take a photograph of it and its ingredients, to confirm it’s safe for regular use, especially if it hasn’t been prescribed or recommended by your regular dentist. And be sure to follow any guidance intended specifically for you, as everyone’s oral health needs are unique.

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You want to keep your teeth healthy for as long as possible, and that requires practicing good oral habits. Most of us know the basics: Brush twice a day, floss at least once, and visit your dentist for regular checkups. But there are certain things that put our pearly whites at risk, from what we’re not doing (flossing, ahem) to dangerous DIY hacks. We spoke with Dr. Ann Nguyen-Chung, dentist and founder of the dental and body care brand Hippotanicals, and cosmetic dentist Dr. Bill Dorfman about what they wish their patients wouldn’t do to keep their teeth in good condition.

Sipping All Day Long

We all have our beverages of choice, but before you pour a glass, beware: All-day sipping on anything other than plain water can expose your teeth to harmful acids that erode your enamel, the hard outer shell of your tooth. “Whether it’s soda, sports drinks, energy drinks, sweetened coffee, or even fruit juice, frequent exposure gives cavity-causing bacteria and acids more opportunities to damage teeth,” Dr. Nguyen-Chung says. “If you’re going to enjoy these beverages, it’s better to have them with a meal rather than continuously sipping for hours.”

Hard Brushing

It may sound contradictory, but brushing aggressively can harm your teeth. “Many people think scrubbing harder will clean their teeth better,” Dr. Nguyen-Chung says. “But it can actually wear away enamel and contribute to gum recession and enamel loss over time.”

Instead, she recommends using a soft-bristled toothbrush and gentle techniques. Hold the brush at a 45-degree angle and brush all surfaces of your teeth with circular motions. If you’re using an electric toothbrush, apply gentle pressure, glide the brush along your teeth, and let the bristles do the work. 

Using Your Teeth as Tools

If you’ve ever opened a bottle or a package with your teeth, you’ve put yourself at risk for a dental emergency. “I’ve seen many patients crack or fracture teeth this way,” Dr. Nguyen-Chung says. “In some cases, the damage extends into the nerve of the tooth, requiring root canal treatment and a crown to save [it].”

You can eliminate the temptation to use your pearly whites as a bottle opener or pair of scissors by keeping those utensils nearby — add a key-chain-sized bottle opener to your house keys and leave scissors throughout your home. “Our teeth are designed for chewing food, not for opening or breaking objects,” Dr. Nguyen-Chung says.

Skipping Flossing

A 2014 survey by Delta Dental found that only 41% of adults floss once daily, and 20% never floss at all. That means most of us are skipping this essential part of the dental routine, which is an issue, according to Dr. Nguyen-Chung. “Since a toothbrush can’t effectively clean between teeth, plaque and food debris can accumulate in those areas, increasing the risk of cavities and gum disease,” she says.

If you don’t like traditional flossing methods, consider using interdental proxabrushes or water flossers instead. They’re great for adults with dexterity issues or those who don’t feel comfortable using traditional dental floss.

Chewing Any Nonfood Items

Take note if you’re a nail-biter or an ice-cruncher: These habits do more harm than good. “Biting … destroys your nails, which grow back, and your teeth, which don’t grow back,” Dr. Dorfman says. “Ice is too hard for normal biting and often cracks teeth.” 

If you have a hard time quitting your nail-biting habit, cut your nails short. Ice-crunchers can chill their drinks in the fridge or by using a frosted glass. And if you just like the chewing sensation, opt for sugar-free gum when the temptation strikes.

DIY Dental Work

Visiting the dentist can come with a healthy dose of anxiety — we’re all worried that we’ll get terrible news about our teeth. Unfortunately, that can lead people to consider DIY dental procedures, one of which, Dr. Dorfman says, is teeth filing. “People who have not gone to dental school decide to reshape their teeth with a nail file,” he says. “The problem here is that, unlike hair, teeth don’t grow back.”

Dr. Dorfman has also seen an alarming trend where people get veneers from someone other than a dentist: “This can cause several problems,” he says, “from permanent tooth and gum damage to malocclusion [aka a bad bite] and TMJ problems with your jaw.”

DIY whitening is also a bad idea. (This doesn’t include whitening strips, which are safe for most people when used as directed.) “Teeth whitening with hydrogen peroxide, lemon juice, or baking soda … can cause chemical burns, severe tooth sensitivity, enamel erosion, and unpredictable results,” Dr. Dorfman says. Dr. Nguyen-Chung concurs: “While [brushing with charcoal or other viral home remedies] may sound natural or effective, they can wear away enamel over time. Since enamel doesn’t grow back, the damage can be permanent.”

Frequent Snacking

Like all-day sipping, regular snacking puts your teeth at risk. “Every time we eat, especially carbohydrate-rich foods, the bacteria in our mouths produce acids that can contribute to tooth decay,” Dr. Nguyen-Chung says. “Giving your mouth time between meals allows saliva to help neutralize acids and protect your teeth naturally.” 

Instead of setting out a bag of chips to nosh on, opt for a mindful snacking choice that cuts your hunger craving and restores energy. Consider grabbing a piece of fruit, some veggies, or a handful of nuts for healthy nourishment. (If your enamel is weak, you may want to cut your fruit and veggies into more manageable pieces and soak nuts to make them easier on your teeth.) Rinse your mouth with water to remove any lingering food particles, or wait 30 minutes after snacking to brush.

Taking Oral Health Advice From Social Media

Influencers can come across very confidently on social media, so it’s hard to resist a seemingly hot take or pro tip on dental health. But Dr. Nguyen-Chung warns against following anyone’s advice without consulting a dental professional first. “Not every viral trend is backed by science, and what’s safe for one person may not be appropriate for another,” she says. “When it comes to your teeth, prevention is often much easier and less expensive than trying to fix damage later.” If you’re curious whether a trend or life hack for your teeth is safe, ask your dentist to confirm.

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