The answer to whether you can brush your teeth with braces is a definite yes, but the process must change completely. Brackets and wires create numerous new surfaces and tight crevices where food particles and plaque can become trapped instantly. Maintaining an adapted oral hygiene routine is necessary to prevent dental decay or permanent white marks, known as decalcification, on the enamel surrounding the hardware. These white spots occur when acids from plaque strip minerals from the tooth surface, leaving a visible and irreversible contrast once the braces are removed. Therefore, the daily cleaning routine must be far more diligent and extensive than before orthodontic treatment began.
Modifying Your Brushing Technique
The presence of brackets and archwires means the standard flat brush angle must be broken down into three distinct positions to reach all surfaces effectively.
Begin by focusing on cleaning the area directly above the brackets and the wire itself. Angle the toothbrush bristles downward at a 45-degree angle toward the biting surface of the tooth, using small, gentle circular motions. This downward angle allows the bristles to sweep underneath the archwire and clean the top portion of the bracket.
Next, shift the brush to clean the area immediately below the brackets and the wire. Angle the bristles upward at a 45-degree angle toward the gumline. This movement targets the lower half of the bracket and the tooth surface nearer to the gums. Treat each tooth surface individually, spending a few seconds on each tooth before moving on.
After cleaning the areas surrounding the orthodontic hardware, clean the main front surface of the tooth. Position the brush flat against the tooth and use a light, circular or vibrating motion to clean the remaining enamel and gumline. Finally, use the standard technique to brush the chewing and inner surfaces of all teeth for a minimum duration of two to three minutes. The pressure applied should always be gentle to avoid damaging the brackets or irritating the gums.
Essential Tools for Deep Cleaning
While mastering the manual brushing technique is fundamental, specialized manual tools are required to mechanically clean areas inaccessible to a standard brush head.
Interdental Brushes
Interdental brushes, often called proxabrushes, feature small, cone-shaped heads designed to maneuver beneath the archwire and into the tight spaces between brackets. These devices must be inserted gently and moved back and forth to dislodge plaque and food debris. Selecting the correct size is necessary, as a brush that is too small will not clean effectively, and one that is too large can be difficult to insert or potentially bend a wire.
Flossing Techniques
Cleaning between the teeth, known as interproximal cleaning, requires the use of floss threaders or specialized orthodontic floss. A floss threader is a small, flexible plastic loop that acts like a needle to guide a piece of regular dental floss underneath the archwire. Once the floss is threaded, it can be worked gently down the side of each tooth to the gumline to disrupt plaque buildup. Specialized orthodontic floss is also available with a stiffened end that eliminates the need for a separate threader, allowing the user to simply push the stiff end under the wire.
After the mechanical cleaning is complete, a fluoride or antiseptic mouthwash can be used as a supplementary rinse. This rinse helps deliver fluoride to the parts of the tooth surface that are hard to reach, strengthening the enamel. It should never be considered a replacement for the physical removal of plaque by brushing and flossing.
Navigating Electric Toothbrushes and Oral Irrigators
Many individuals find that electric toothbrushes offer a distinct advantage over manual brushing when navigating the complex surfaces created by braces. Models with oscillating-rotating or high-frequency sonic movements are effective at reaching around brackets and wires to dislodge plaque. When choosing a device, look for models that offer a sensitive mode or an orthodontic-specific brush head, which features softer bristles and a design tailored to fit around the metal hardware.
A valuable feature on many electric devices is a built-in pressure sensor. This sensor automatically alerts the user if they are pressing too hard against the teeth or braces. Applying excessive force can damage the brackets or cause gum recession, so this sensor helps maintain the gentle touch necessary during the cleaning process. Most electric toothbrushes also include an integrated timer to ensure the user brushes for the recommended two minutes, promoting consistent cleaning.
Oral irrigators, commonly referred to as water flossers, use a fine, pulsating stream of pressurized water to cleanse the mouth. These devices are highly effective at flushing out loose food particles and debris trapped between the wires, brackets, and teeth, performing this task much faster than traditional flossing. While excellent at rinsing and flushing, they are considered a supplement to, rather than a replacement for, the mechanical plaque removal achieved by brushing and flossing.