Brush thoroughly, clean between teeth daily and seek care for missing teeth

Cost: The source estimates tens of yuan yearly for floss or interdental brushes, one or two hundred yuan for a professional cleaning, and two or three additional minutes daily. Making interdental cleaning a habit is the difficult part. A powered brush costs several hundred yuan and needs replacement heads.

In plain language: The source reports associations between interdental cleaning and lower mortality, and between missing teeth and higher mortality. These observational associations do not establish that brushing or replacing teeth changes mortality. Powered brushes remove more plaque and reduce gingivitis somewhat compared with manual brushes, but the importance of those differences for health remains uncertain.

Findings reported by the source: A Japanese study followed 9,676 people for six years. Interdental-cleaning-tool use was associated with a hazard ratio of 0.89 for mortality, and tongue-cleaning-tool use with 0.77. A synthesis of studies in community-dwelling older adults reported mortality odds ratios of 1.87 (95% CI 1.35–2.59) for having no teeth and 2.04 (95% CI 1.67–2.49) for having fewer than 20 teeth. In 51 randomized trials comparing powered and manual brushes, powered brushes reduced plaque by around 11% at one to three months and 21% beyond three months; gingivitis reductions were around 6% and 11%, respectively. The review authors stated that the clinical importance of these differences remained unclear.

Source author's evidence grade: B; not site verification or professional approval.

Notes and dispute: The mortality studies followed and recorded people rather than proving causation. Poor oral health can coexist with poorer general health and economic circumstances; the direction of causation is uncertain. The source emphasizes low costs and the direct effect of periodontal disease and missing teeth on eating. Oscillating-rotating round powered-brush heads have the largest trial base in the cited comparison with manual brushing. An independent review did not establish the best powered-brush type because there were too few trials. For implant prices and insurance coverage, see chapter 24, entry 12 on asking for the complete quoted price before an implant.

Original source bibliography (titles retained as supplied): Wang K, Matsuyama Y, Kiuchi S, et al. (2026). Routine oral health practices and all-cause mortality. Journal of Dentistry. https://doi.org/10.1016/j.jdent.2026.106789；Ko MJ, Seo S, So JS, et al. (2026). Deteriorated oral health and function as risk factors for physical disability and mortality in community-dwelling older adults: a systematic review and meta-analysis. European Geriatric Medicine. https://doi.org/10.1007/s41999-025-01319-4；Yaacob M, Worthington HV, Deacon SA, et al. (2014). Powered versus manual toothbrushing for oral health. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD002281.pub3；Deacon SA, Glenny AM, Deery C, et al. (2010). Different powered toothbrushes for plaque control and gingival health. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD004971.pub2