The question of whether you can brush your teeth with braces is simple: brushing is not only possible but mandatory. Braces introduce a network of brackets and wires that create numerous surfaces and traps for plaque and food debris. The orthodontic hardware makes it considerably more difficult to remove the bacterial film, which elevates the risk of dental decay and gum irritation. Because of this added challenge, your cleaning routine must adapt to ensure that all surfaces of the tooth and the hardware itself are meticulously cleaned.
The Essential Tools and Supplies
Successfully managing oral hygiene with braces requires specific equipment beyond a standard toothbrush and paste. A soft-bristled toothbrush is recommended to protect the brackets and gums from damage during the rigorous cleaning required. Many people find that an electric toothbrush with a specialized orthodontic brush head can reach the difficult crevices more effectively than a manual brush.
The foundation of your routine remains fluoride toothpaste, which helps to strengthen tooth enamel against acid attacks from trapped bacteria. For targeting the space between the archwire and the tooth surface, small specialized tools are necessary. These tools include interdental brushes, sometimes called proxabrushes, which have tiny, cone-shaped bristles designed to slip under the wire and around the bracket.
Specialized Brushing Techniques
The mechanical process of brushing with braces requires a methodical, three-part approach to ensure comprehensive cleaning. Rinsing your mouth with water can dislodge larger food particles, making the brushing process more effective. You should aim to brush for a minimum of two to three minutes, ideally after every meal, to prevent plaque from hardening around the brackets.
The first step is to position the toothbrush at a 45-degree angle pointing downward toward the biting surface, cleaning the area above the bracket and the archwire. Use a gentle, circular, or short-sweeping motion across the entire surface. Next, reposition the brush so it angles 45 degrees upward toward the gumline, cleaning the area below the bracket and the gum margin.
Finally, clean the bracket itself and the surrounding tooth surface directly. Use the specialized interdental brush to clean the areas between the brackets and the archwire, where a standard brush cannot reach. This meticulous attention to the three zones—above, below, and on the bracket—is necessary to remove the sticky bacterial film.
Essential Steps Beyond Brushing
Even the most rigorous brushing cannot reach the contact points between teeth, making interdental cleaning a necessary daily practice with braces. Flossing is particularly challenging because the archwire blocks the path, requiring the use of specialized tools to thread the floss through.
Flossing Tools
Floss threaders are flexible plastic loops that act like a needle, allowing you to pull a piece of regular floss under the main archwire. An alternative is to use Superfloss, which features a stiffened end that can be inserted under the wire, followed by a spongy section to clean around the brackets. Once the floss is threaded under the wire, gently slide it up and down against each tooth surface, including slightly below the gumline. This process must be repeated for every space between the teeth.
Supplemental Cleaning
A water flosser can be a beneficial supplement. This device delivers a pressurized stream of water that can help flush out food particles and loose plaque from around the brackets and wires. Finishing your routine with a therapeutic mouthwash, such as one containing fluoride or an antimicrobial agent, can provide an extra layer of protection by reaching areas the brush and floss may have missed.
Long-Term Monitoring and Care
Inadequate oral hygiene during orthodontic treatment can lead to two primary and lasting issues: decalcification and gingivitis.
Decalcification and Gingivitis
Decalcification occurs when the plaque around the brackets releases acid, causing a loss of minerals from the tooth enamel. This results in permanent white spots on the teeth that become visible only after the braces are removed. Gingivitis, or gum inflammation, is also common due to the increased plaque accumulation along the gumline. Symptoms include redness, swelling, and bleeding of the gums. While reversible with improved hygiene, gingivitis may otherwise prolong the overall treatment time.
Professional Oversight
Professional oversight is important to monitor and address these risks. Most patients with braces are advised to maintain regular dental cleanings more frequently than the standard schedule. Instead of the typical six-month interval, a cleaning every three to four months is often recommended to allow a professional to remove hardened plaque and tartar buildup. This proactive approach, combined with diligent at-home care, ensures that the teeth and gums remain healthy throughout the entire duration of the orthodontic treatment.