Oral hygiene during treatment
How to brush and floss with braces, what tools help, and how to avoid the white marks that plaque leaves on enamel. CDZ Ortho, Johns Creek.
Why it matters more during treatment
Brackets and wires create surfaces that plaque collects around and that a toothbrush does not reach as easily.
Plaque left against enamel produces acid, which draws minerals out of the tooth surface. The result is a chalky white mark, called decalcification or a white spot lesion. Early marks can fade, and some can be improved by a dentist, but they often do not disappear completely. When the braces come off, the mark stays.
It is preventable with routine cleaning.
Brushing
Brush after every meal. Carry a toothbrush.
Use a soft-bristled brush and fluoride toothpaste. Angle the bristles down toward the gum above each bracket, then up toward the gum below it. Brush the chewing surfaces and the inside of each tooth as well.
Two minutes. An electric toothbrush with a timer makes this easier to actually do.
Cleaning between the teeth
Once a day, every day. Plaque between the teeth causes both decay and gum inflammation and a toothbrush does not reach it.
Floss threaders carry floss under the wire. Effective, and slow.
Orthodontic floss has a stiffened end that threads under the wire without a separate tool.
A water flosser directs a stream of water between the teeth and around the brackets. Faster than threading floss and most patients keep doing it, which matters more than which method is theoretically best.
Interdental brushes are small cone-shaped brushes that clean under the wire and around brackets.
Rinsing
An antimicrobial or fluoride rinse helps control the bacteria that cause gum inflammation.
Dr. Cen may recommend a higher-strength fluoride depending on your decay risk.
Signs something is wrong
Gums that bleed when you brush are inflamed, which is almost always caused by plaque at the gumline. The response is to clean that area more thoroughly, not to avoid it. Bleeding usually stops within a week or two of consistent cleaning.
Gums that are swollen enough to grow over the brackets need to be seen. Call the office.
Persistent bad breath usually means food and plaque are being retained somewhere.
Keep seeing your dentist
Continue with routine cleanings and check-ups throughout orthodontic treatment. Every six months, or more often if your dentist advises it.
Tell them you are in braces when you book so they can allow the extra time.
Good questions.
Clear answers.
How do I clean my teeth with braces?
Brush after every meal and clean between the teeth once a day. A water flosser is the fastest method for most people.
Will braces damage my enamel?
Decalcification is the main enamel risk and it is the one you control. Plaque left around brackets leaves white marks. Brushing after meals and cleaning between the teeth daily prevents it. Other risks, including slight shortening of tooth roots, are covered in your consent before treatment starts.