than brushing after breakfast. If it is necessary to brush after breakfast, try to wait between 30 and 60 minutes before brushing. Brushing at any point in the morning is still better than skipping the step of brushing at all. Toothbrush A toothbrush is an instrument used to clean teeth, consisting of a small brush on a handle. Toothpaste, often containing fluoride, is commonly added to a toothbrush to aid in cleaning. Toothbrushes come in manual and electric varieties. Although there is conflicting evidence as to which is more effective, most evidence points to electric toothbrushes with an oscillatory motion being more effective than manual toothbrushes, with toothbrushes lacking an oscillatory motion being equivalent. A 2014 Cochrane review found moderate evidence that electric toothbrushes reduce plaque and gingivitis more than manual ones. Overall, both manual and electric toothbrushes are effective, however, and it is often recommended that people use whichever they feel comfortable with, determine is affordable for them, and will be more likely to regularly brush with. Toothpaste Toothpaste is a paste or gel dentifrice used to clean and improve the aesthetic appearance and health of teeth. It is almost always used in conjunction with a toothbrush. Toothpaste use can promote good oral hygiene: it can aid in the removal of dental plaque and food from the teeth, it can aid in the elimination and/or masking of halitosis when tonsil stones are not the cause, and it can deliver active ingredients such as fluoride to prevent tooth and gum (gingiva) disease. There is evidence that the addition of xylitol to fluoride-containing toothpastes reduces incidence of tooth decay by about 13%. Tooth powder (or 'toothpaste powder') is an alternative to toothpaste. It may be recommended for people with sensitive teeth. Tooth powder typically does not contain the chemical sodium lauryl sulphate, commonly used in toothpaste, which can be a skin irritant. The function of sodium lauryl sulphate is to form suds when teeth are brushed. Those with dentures may also use denture cleaner which can also come in powder form. Fluoride toothpaste use in young children When brushing teeth, using toothpaste that contains fluoride is recommended. There are different recommendations for the amount of toothpaste used based on age: For children under 3 years of age: use a small smear or rice grain amount of fluoridated toothpaste if the child is at high risk for cavities. For children 3 to