Adjusting to proper oral hygiene with a smile full of brackets, including cleaning around bands and wires, is incredibly important. Effectively cleaning orthodontic appliances ensures that plaque is not allowed to build up around the braces. Typically, if a proper oral hygiene routine is not strictly adhered to, gum inflammation and tooth decay can occur.

The key to brushing and flossing effectively with orthodontic braces is learning the best technique. Though everyone has different preferences, here are some excellent tips on how to get started:

Brushing

Regular, proper brushing is especially important when braces have been applied to the teeth. If possible, brush teeth after every snack to eliminate plaque buildup. If this isn’t practical, aim to brush four times daily, including:    

• After breakfast

• After lunch

• After dinner

• Right before bedtime
  

It is important to choose an appropriate toothbrush and to inspect the bristles routinely for signs of wear. The orthodontic braces will wear and fray the bristles, so replacement brushes will be needed more often than usual.

A soft bristled toothbrush is best because it will not damage the archwire or brackets. Apply a small strip of toothpaste, preferably a brand with fluoride, to the brush. Keep in mind that every tooth has several sides that need to be thoroughly cleaned: the outside, the sides facing each other and the chewing side.

When brushing front-facing sides of the teeth, create a 45 degree angle between the brush and the gum line. Brush in gentle circular motions from the top of the tooth to the bottom and then from bottom to top. Try not to exert too much force on either the wire or the brackets. When brushing the inside angles of teeth, work methodically creating the same 45 degree angle with the brush. The back surfaces of the teeth should pose no additional problems and should be brushed in the regular way.

Next, use a specially-designed proxabrush (Christmas tree brush) to brush between two brackets at a time. Insert the proxabrush and use downward and upward motion. Continue until all the spaces between the braces are plaque-free. As a last step, use mouthwash to flush out remaining bacteria.

Flossing

Flossing is also of paramount importance. Plaque and food particles can quickly provide fuel for the formation of bacteria colonies that cause gum disease and tooth loss. Though flossing between braces can be more time-consuming, it should still be completed several times per day.

Floss threaders can be used or the floss can be wrapped around fingers in the standard method. First, thread a piece of floss underneath the archwire of the braces. Slide the floss in an up-and-down motion against the large surface of the tooth. Exercise great care around the bracket and archwire, as they can easily be damaged by excess pressure.

Next, guide the floss to the interdental area (between the teeth) and use gentle sawing motions to move down from the gum line toward the bottom of the tooth. Repeat this motion several times. Then, using the same sawing motion, work the floss from the bottom of the tooth toward the gum line several times.

In some cases, flossing around orthodontic braces can cause mild bleeding, which should go away. If this bleeding persists for several days, be sure to inform your oral health professional.

If you have any questions or concerns about brushing and flossing with braces, please contact your dental office.