Oral hygiene routines are all a matter of habits. Some people like to take their time with them, brushing, flossing and using mouthwash at their own speed. For others, its often an afterthought, and the last thing to do before leaving the house for work or school.
When clinicians encourage patients to make effective changes to their routine (whether this is cleaning more often, or adding a new step) it’s important to consider that this changing an existing habit, or creating a new one entirely.
With New Year’s resolutions around the corner, there is no better time to speak to patients about their habits, and encourage them to develop healthier behaviours where necessary.
Current behaviours
Good habits for oral hygiene include regular toothbrushing, interdental cleaning, tongue cleaning, and an awareness to seek support from dental professionals when needed. This is typically supported by mechanical cleaning performed by a dental professional in the practice.
The adult oral health survey for 2021 (latest available data) from the Office for Health Improvement & Disparities found that 77% of adults in England with natural teeth brushed twice a day, which is a promising figure.[i] However, this also notes that many people aren’t keeping to the official guidance.[ii]
A smaller number of people use interdental cleaning solutions; just 30% utilised dental floss in their routine, and 21% used interdental brushes, whilst 11% used interdens, toothpicks or woodsticks.[iii] Interdental cleaning, completed properly, has many known benefits, including the reduction of periodontal disease and dental decay, which in turn are linked to general health conditions such as diabetes, strokes, cardiovascular disease, and more.[iv]
The data shows that efforts are still needed to encourage patients to take up these oral hygiene habits. Understanding some of the psychology behind habit formation could help clinicians advise simple changes that make a significant difference.
How to form a habit
Habits are repetitive enactments of behaviours within a consistent context, which eventually become near enough automatic and effortless.[v] It takes time for these actions to become habitual. One idea in popular culture stems back to the 1960 text Psycho-Cybernetics by Maxwell Maltz, which suggests that new habits need just 21 days of repetition. This is heavily disputed, with many questioning variables such as the difficulty or value of the targeted behaviour as well as the attitudes of an individual trying to develop a new routine.v
A 2021 study[vi] found it took a median of 59 days for successful habit formation, reflecting a similar finding of 66 days in a prominent 2010 study.[vii] Participants with successful habit formation were more likely to have chosen a behaviour which felt intrinsically more rewarding. Both of these studies worked on the concept of behaviour in response to a cue, for example, drinking a glass of water when watching the news. Clinicians should encourage patients to try and pair oral hygiene routines with generic, everyday behaviours. Patients could clean interdentally after styling their hair for the day or following a shower, in effect typing the actions together mentally.
To ensure a habit is formed, consistency in repetition is required.vii In turn, patients need self-control for a significant period of time before the automaticity of the routine sets in, allowing the behaviour to be performed without exceptional thought.
Inspired by reward
Telling patients about the eventual rewards of good oral hygiene and interdental cleaning may help them establish an end goal, which can drive motivation and encourage self-control. This is inspired by the thought that successful habit formation is linked to behaviours that feel more rewarding.vi
In personal oral hygiene routines, the reward of regular interdental cleaning includes improved periodontal health, reduced risk of caries, and increased success of restorations by minimising treatment-related infection.[viii] This not only reduces the need for future treatment, but improves aesthetics by reducing inflammation.
Reward may also be felt through using a known effective and comfortable solution, like the Cordless Advanced water flosser from Waterpik™, the #1 water flosser brand recommended by dental professionals.[ix] The solution removes up to 99.9% of plaque from treated areas, including between teeth and below the gumline.[x] It is 2x as effective for improving gingival health when compared to string floss,[xi] and includes 3 different pressure settings for a personalised, simple flossing experience.
With patients having one eye on the new year, suggesting improved oral hygiene routines with interdental cleaning could influence their upcoming resolutions. With benefits for their oral health, aesthetics, and potentially confidence in everyday life, using new solutions to form healthier habits may be the best way to enter 2026.
For more information on WaterpikTM water flosser products visit www.waterpik.co.uk. WaterpikTM products are available from Amazon, Costco UK, Argos, Boots and Tesco online and in stores across the UK
Author: Rachel Bennett
Rachel Bennett is a dental hygienist working at Bupa Dental Care Leeds and Churchview Dental Care, where she offers high-quality care to her patients. She has been a professional educator for Waterpik™ for years, and will talk about the importance of water flossing and her experience with Waterpik™ solutions.
[i] Office for Health Improvement & Disparities, (2024). Adult oral health survey 2021: report summary. GOV.UK. (Online) Available at: https://www.gov.uk/government/statistics/adult-oral-health-survey-2021/adult-oral-health-survey-2021-report-summary [Accessed August 2025]
[ii] Office for Health Improvement & Disparities, Department of Health & Social Care, NHS England, NHS Improvement, (2021). Guidance, Chapter 8: Oral hygiene. GOV.UK. (Online) Available at: https://www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-prevention/chapter-8-oral-hygiene [Accessed August 2025]
[iii] Office for Health Improvement & Disparities, (2024). Accredited official statistics, Adult oral health survey 2021: health-related behaviours. GOV.UK. (Online) Available at: https://www.gov.uk/government/statistics/adult-oral-health-survey-2021/adult-oral-health-survey-2021-health-related-behaviours [Accessed August 2025]
[iv] Oral Health Foundation, (2016). Flossophy: Interdental cleaning is important to our oral health. (Online) Available at: https://www.dentalhealth.org/news/flossophy-interdental-cleaning-is-important-to-our-oral-health [Accessed August 2025]
[v] Singh, B., Murphy, A., Maher, C., & Smith, A. E. (2024, January). Time to form a habit: a systematic review and meta-analysis of health behaviour habit formation and its determinants. In Healthcare (Vol. 12, No. 23, p. 2488). Multidisciplinary Digital Publishing Institute.
[vi] Keller, J., Kwasnicka, D., Klaiber, P., Sichert, L., Lally, P., & Fleig, L. (2021). Habit formation following routine‐based versus time‐based cue planning: A randomized controlled trial. British Journal of Health Psychology, 26(3), 807-824.
[vii] Lally, P., Van Jaarsveld, C. H., Potts, H. W., & Wardle, J. (2010). How are habits formed: Modelling habit formation in the real world. European journal of social psychology, 40(6), 998-1009.
[viii] Ng, E., & Lim, L. P. (2019). An overview of different interdental cleaning aids and their effectiveness. Dentistry journal, 7(2), 56.
[ix] Based on 2025 independent survey of Dental Professionals; among those who recommended branded water flossers.
[x] Gorur, A., Lyle, D. M., Schaudinn, C., & Costerton, J. W. (2009). Biofilm removal with a dental water jet. Compendium of continuing education in dentistry (Jamesburg, NJ: 1995), 30, 1-6.
[xi] Rosema, N. A., Hennequin-Hoenderdos, N. L., Berchier, C. E., Slot, D. E., Lyle, D. M., & van der Weijden, G. A. (2011). The effect of different interdental cleaning devices on gingival bleeding. J Int Acad Periodontol, 13(1), 2-10.
