Core Viewpoint - The article emphasizes the importance of brushing teeth at least twice a day to maintain oral health and prevent dental issues such as cavities and periodontal disease. Summary by Sections Importance of Brushing Twice Daily - Brushing twice a day is essential to combat the two main enemies of oral health: cavities and periodontal disease, which are caused by bacteria accumulating on teeth surfaces over time [1]. Stages of Plaque Formation - **Initial Attachment (0-2 hours)**: After brushing, a small number of loose bacteria begin to attach to the teeth using a saliva film [2]. - **Bacterial Attachment (2-12 hours)**: More bacteria attach to the teeth, becoming more firmly established [3]. - **Mature Plaque (12 hours)**: Attached bacteria start to reproduce and form a complex biofilm structure, making it harder to remove [4]. - **Fully Matured Plaque (24 hours)**: After 24 hours, plaque becomes a complex microbial community that poses a significant threat to oral health, leading to cavities and periodontal diseases [5]. Importance of Nighttime Brushing - Nighttime brushing is crucial as saliva production decreases significantly during sleep, reducing the natural cleaning effect of saliva [8]. - Food residues in the mouth can lead to an acidic environment that erodes tooth enamel, making nighttime brushing vital to remove these residues [9]. - Bacteria proliferate rapidly at night, and brushing before sleep helps to minimize plaque accumulation and reduce the risk of dental issues [10]. - Oral odor is often worse in the morning due to bacterial activity overnight; brushing at night helps to mitigate this issue [11]. - Oral health is linked to overall health, and nighttime brushing can reduce the risk of chronic diseases by lowering bacterial levels in the mouth [11]. Conclusion - Establishing a nighttime brushing routine is essential for both short-term and long-term oral health, and parents should encourage this habit in their children [11].