When orthodontic appliances are placed, we offer detailed instructions regarding the care of the appliances. We also instruct our patients on the best way to ensure a clean and healthy smile--brushing and flossing. Braces themselves do not cause decay, but they act as a shelf and hold food and debris on the teeth until it is removed by brushing and flossing. Food particles that are allowed to accumulate on the teeth and braces will turn into plaque. Plaque that is left on the teeth will calcify and harden into calculus (tartar.) The bacteria that results from this accumulation of plaque/tartar can lead to gum disease, tooth decay, and even loss of teeth. It is also prudent to minimize the amount of sugar in the diet, especially during orthodontic treatment. When sugar mixes with the bacteria in plaque, it forms an organic acid that demineralizes or breaks down the enamel on the teeth. The result of the demineralization is a permanent white scar on the surface of the tooth known as decalcification. Allowed to continue, the enamel breakdown will eventually result in a cavity, potentially even on the visible surfaces of the front teeth. To avoid these problems while you are in orthodontic treatment, take special care of your braces, teeth, and gums to ensure you will have the best possible result. Each of our patients is given an appropriate home care kit at the start of treatment. As well, they are given detailed oral hygiene instructions involving the use of the items in their home care kit, with some items being specifically designed for orthodontic patients. It is of utmost importance that dental cleanings and check-ups are continued with your general dentist at least every 6 months during orthodontic treatment. In some cases, more frequent dental cleaning may be necessary.

BRUSHING

Use a toothbrush with soft bristles and a small strip of fluoride toothpaste. When you brush your teeth, move the brush in small, circular motions to reach food particles that may be under your gum line. Hold the toothbrush at an angle and brush slowly and carefully, covering all areas between teeth, between braces, and the surface of each tooth. It will take you several minutes to thoroughly brush your teeth. Brush up on the lower teeth, down on the upper teeth, brush the outside, inside and chewing surface of your front and back teeth. Also, brush your tongue and the roof of your mouth before you rinse.

Especially during orthodontic treatment, brush your teeth four times daily to avoid the accumulation of food particles in your teeth and braces:
  • In the morning after breakfast
  • After lunch or right after school
  • After supper
  • At bedtime

You will need to replace your toothbrush more often due to your appliances. As soon as the bristles start to wear down or fray, replace your toothbrush with a new one. It may be difficult for your toothbrush to reach some areas under your archwire. Do not swallow any toothpaste; rinse your mouth thoroughly with water after you finish brushing. It is important to floss and use an antibacterial mouthwash and fluoride treatment throughout your orthodontic treatment and beyond for optimal oral hygiene.


FLOSSING

For areas between the teeth that a toothbrush can’t reach, use dental floss to remove food particles and plaque. Flossing takes more time and patience when you are wearing braces, but it is important to floss your teeth every day.

Use either regular floss with a floss threader or Superfloss (floss with a built-in threader) to floss under your archwire daily. Guide the floss up and down along the side of each tooth to the gum line, pulling out food particles or plaque. Be sure to use a clean area of the floss for each tooth so as not to put bacteria and debris from the previous tooth back into your mouth. Use care around your archwire and do not floss too forcefully around it or put too much pressure on it. Floss behind all of your back teeth.

Floss at night to make sure your teeth are clean before you go to bed. When you first begin flossing around your braces, your gums may bleed a little. Although the bleeding is not uncommon, it is indicative of a bacterial infection below the gum line. Even the mildest infection can cause the gum tissue to swell and bleed during brushing and flossing. Although the natural response to the bleeding gum tissue may be to shy away from brushing and flossing, that is exactly the opposite of what is needed. Bleeding gums is a sure sign that more frequent and more effective brushing and flossing is necessary to maintain a healthy mouth. If the bleeding does not improve after several days of excellent brushing and flossing, inform a staff member at your next appointment.