Orthodontics and Dental Hygiene

Healthy vs unhealthy.

You already know that maintaining good oral hygiene is important for everyone — but when you're having orthodontic treatment, it's even more critical. Why? Because, while the appliances (such as braces or clear aligners) you may need to wear during treatment are very effective in correcting misaligned teeth, they can also trap food particles easily. Keeping your teeth (and your appliances) clean is a little harder — but you can do it! Here's a look at why good oral hygiene is so important during orthodontic treatment, and some tips on how you can keep it up.

The major enemy of oral health is plaque. Food that becomes trapped near tooth surfaces can lead to the formation of plaque — a thin coating of microorganisms and organic debris (biofilm) containing potentially harmful bacteria. Braces or other appliances make it harder to remove plaque. The bacteria in plaque digest the sugars in food, producing acids which may erode teeth and irritate gums. This can cause cavities, white spots on teeth, gum disease and bad breath.

Keeping plaque under control is one of the most effective means of maintaining strong, healthy teeth and gums. There are three general ways to do it: through diet, daily maintenance, and regular professional care. Taken all together, they're your teeth's best defense.

Diet and Decay

Controlling your diet involves avoiding foods that could increase your risk of developing tooth decay. That means cutting down or eliminating foods with an excess of sugar, like soda, sweets, and ice cream. It also means avoiding foods that could easily become stuck in your braces, like toffee, gum, licorice and caramels.

Foods that are very hard or extremely sticky can also cause physical damage to orthodontic appliances. Certainly braces or retainers with broken wires or loose brackets aren't working to straighten your teeth! You should avoid foods like hard candies or nuts, beef jerky and hard pizza crust. Keep eating healthy foods like carrots and apples — but cut them into bite-sized pieces first! And don't chew on ice, pencils, or your nails: these habits can cause damage to your appliances, and even result in chipped teeth!

Daily Maintenance

You know how important brushing and flossing are for keeping a healthy smile — especially now that you're in orthodontic treatment. But sometimes it's harder to clean your teeth effectively around an appliance's brackets and wires. Here are some tools and tips you can try for better tooth cleaning.

Either a soft-bristle or a bi-level toothbrush (one with longer bristles on the edges and shorter ones in the middle) can be effective in plaque removal — even with braces. An electric toothbrush can also be used, on a moderate setting. For hard-to-clean areas, try an interdental brush, or proxabrush. The small bristles of this special tooth-cleaning aid, which is shaped like a pipe cleaner, can get in between wires, brackets and teeth. With gentle and persistent effort, it's possible to reach into the smallest nooks and crannies, and control plaque buildup.

You should floss at least once a day during orthodontic treatment. While it's a little harder to do with braces, there are some special products available — including floss threaders and particular kinds of floss — that can help you get the floss between wires and gum line. Our staff will review proper brushing and flossing techniques with you when your braces are put on — but if you ever have questions, don't hesitate to ask!

Depending on your situation, we may recommend an in-office or at-home supplemental fluoride treatment to boost your cavity resistance. An antiseptic rinse may also be recommended, to ease minor gum inflammation or irritation.

If you have a retainer, it should be brushed daily, the same way you brush your teeth. We may also recommend using a cleaning solution — but never put hot water on your retainer, because it can distort the soft plastic and make it unusable! And always keep it in a case when it's not in your mouth.

Professional Care

Even though you're seeing an orthodontist regularly, that doesn't mean you don't need to see your regular dentist — in fact, it's just as important as ever! While we're focused on improving your bite and alignment, your dentist will make sure your teeth stay healthy with thorough examinations, cleanings and preventive care. Your orthodontic treatment is a team effort where everyone — our office, you, and your family dentist — has an important role to play. And the team has just one goal: giving you a winning smile.

Brushing with braces.

You know how important it is to brush and floss properly when you're wearing braces — but what's the best way to do that? Let's start with the basic brushing tools: Either a soft-bristle brush or a bi-level brush (one that has shorter bristles in the middle and longer bristles at the edges) can be effective. Used carefully, an electric toothbrush can work just as well. But be sure the electric brush is set to a moderate power level, and don't let its vibrations cause the back of the brush to hit brackets or braces!

You should brush with a fluoride toothpaste at least two times per day (preferably after meals), for at least two minutes each time. Remember to brush all of the tooth surfaces: the outside, the inside, and the chewing surfaces as well. Be especially careful to clean the areas between wires and teeth, and between brackets and gums — that's where food particles can easily become trapped.

Here's a suggested brushing technique: Beginning at the outside surfaces, place the tips of the bristles flat against your teeth, and use small circular motions to gently polish them clean. For areas between braces and gums, tilt the brush toward the gum line (down for the bottom teeth, up for the top) while keeping up the circular motions. Next, move on to the chewing surfaces of upper and lower teeth, using a firm back-and-forth motion. Finally, finish up by carefully brushing the inside surfaces of the teeth the same way you did the outside surfaces.

Special Brushing Tools

Interdental toothbrush.

If you're having trouble cleaning the areas near brackets and wires, there are some special tools that may help. One is the interdental toothbrush, or proxabrush. It has a small tuft of bristles that stick up all around, like a pipe cleaner. Use it gently and carefully to clean the tiny spaces under wires and around bands and brackets.

Another special cleaning tool is the oral irrigator or "water pick." This device shoots a small stream of pressurized water at your teeth, which can help dislodge bits of food that become trapped in nooks and crannies. While it's easy to use, an oral irrigator isn't a substitute for a toothbrush or dental floss — but when used along with proper brushing and flossing techniques, it can be very effective.

Floss Fundamentals

Floss threader.

To keep your teeth and gums clean and healthy, you need to floss at least once per day. But how do you get floss under the archwire of your braces? It's not so hard with the help of a floss threader. Using this device is somewhat like threading a needle: You pull one end of floss through the threader, and then push the threader — carrying with it the free end of the floss — under the archwire. Now grasp the floss on each end and slide it up and down the sides of both teeth, and all the way under the gums until you hear a squeaky sound. Finally, pull it out and use a new section of floss for the next area.

Full Disclosure

Ever wonder how effective your tooth-cleaning techniques really are? There's an accurate way to tell, using special vegetable dyes called "disclosing solutions" or "disclosing tablets." As they dissolve in the mouth, these dyes highlight plaque and food debris that brushing has missed. You can then easily remove the dyed spots — and you'll know for sure if your oral hygiene methods need a little "brushing up."

Keeping your teeth and gums healthy now is an investment in your future. It enables you to get the best results from your orthodontic treatment, and starts you toward a brighter smile that can last for a lifetime.

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