Dental tartar, also known as calculus, is the hardened form of plaque that remains on the teeth after failing to be removed by regular brushing and flossing. This sticky, colorless film of bacteria mineralizes when exposed to calcium and phosphate in saliva, typically within 24 to 72 hours, becoming firmly bonded to the tooth surface. Braces introduce numerous complex surfaces, small spaces, and tight corners around the brackets and archwires. These areas trap food debris and bacteria, significantly accelerating the accumulation of plaque and the subsequent formation of dental calculus. Since hardened tartar cannot be removed with home care tools, professional intervention is necessary to prevent long-term damage like gum disease and decay.
Addressing Calculus Buildup While Wearing Braces
Dentists and dental hygienists are fully equipped to remove tartar even while orthodontic appliances are in place. Professional cleaning is a mandatory part of maintaining oral health throughout the treatment period. Because the hardware complicates access, most patients with braces are advised to increase the frequency of professional cleanings. Instead of the standard six-month interval, a cleaning every three to four months is often recommended to manage accelerated buildup.
The general dentist or hygienist is primarily responsible for scaling and polishing the teeth, while the orthodontist focuses on adjusting the wires and brackets. This collaborative approach ensures the teeth remain healthy as they are moved into alignment. Professionals can only clean accessible tooth surfaces, meaning the area directly beneath the bonded bracket base cannot be reached. However, removing calculus from all exposed surfaces is essential to prevent white spots, decay, and gingivitis around the hardware.
Specialized Techniques for Cleaning Around Orthodontics
Removing hardened deposits from around delicate brackets and wires requires specialized tools and careful technique to prevent damage to the appliances or the tooth enamel. Hand scaling remains a precise and frequently used method, often utilizing smaller, finer instruments like mini-bladed curettes. These instruments allow the hygienist to meticulously navigate the tight spaces between the brackets and beneath the archwire to fracture and lift the calculus deposits. The reduced size of the working ends provides the necessary dexterity to clean the tooth surface without snagging the orthodontic components.
Ultrasonic scalers are also employed, but they must be used with caution and often at lower power settings than a traditional cleaning. These devices use high-frequency vibrations to break apart calculus, but prolonged or high-power contact near the brackets can weaken the adhesive bond. The tip of the ultrasonic scaler is always kept moving and angled carefully to clean the tooth surface without directly bumping the bracket itself.
The final step of polishing is performed using air polishing systems, which are effective for patients with braces. This technique propels a fine spray of pressurized water and powder, such as sodium bicarbonate or glycine, onto the tooth surface. The fine mist can reach areas under the archwire and around the bracket bases that are inaccessible to traditional rubber-cup polishing. Air polishing effectively removes fine plaque, surface stains, and residual debris without risking damage to the appliance. In rare instances of severe calculus accumulation, the archwire may be temporarily removed by the orthodontist to grant the hygienist better access.
Essential Home Care and Prevention Strategies
Since professional cleaning is more challenging with braces, the daily home care routine is the most important defense against calculus formation. Patients should use an orthodontic toothbrush, which often features “V-trimmed” bristles, and must brush after every meal to remove food particles trapped in the hardware. The brush should be angled first from above the bracket and then from below at a 45-degree angle toward the gumline to clean all surfaces effectively.
Cleaning between the teeth and under the archwire is equally important and requires specialized aids. Floss threaders or specialized orthodontic floss must be used to carefully pull floss beneath the wire and between the teeth. Small interdental brushes, sometimes called proxabrushes, are excellent for scrubbing the spaces between brackets and the exposed tooth surface.
The routine should be completed with a fluoride mouth rinse or an antimicrobial rinse, if recommended by the dental professional. Fluoride helps strengthen the enamel, while antibacterial rinses reduce plaque-forming bacteria. Patients must also exercise dietary self-control, avoiding hard, sticky, or chewy foods that can damage the appliances or become lodged, encouraging early plaque and tartar development.