Orthodontic treatment often raises questions about the security of appliances, particularly the brackets adhered to the tooth surface. These brackets anchor the wires that guide teeth into alignment, making their security a valid concern. Proper oral hygiene is necessary to prevent decay, but brushing introduces mechanical force near the adhesive bond. This leads many patients to wonder if cleaning their teeth could damage their braces.
The Likelihood of Brushing Causing Damage
The likelihood of standard, proper brushing causing a bracket to detach is extremely low. Modern orthodontic technology uses specialized composite resin adhesives engineered to create a strong, stable bond with the tooth enamel. These materials are designed to withstand the normal, daily forces encountered during routine eating, speaking, and cleaning.
However, an existing bond may be compromised by an overly aggressive technique or improper tools. Brushing with excessive force or using hard-bristled toothbrushes exerts damaging shear forces onto the bracket-to-enamel interface. While the adhesive is robust, continuous, forceful scrubbing can weaken the bond over time, especially if the bracket was not placed on perfect enamel or if the adhesive has been eroded.
Essential Brushing Techniques for Braces
A modified brushing technique is required to ensure both cleanliness and security when wearing braces. Patients should use a soft-bristled toothbrush or one specifically designed for orthodontic use, often featuring a V-shaped trim. Gentle, circular motions should replace aggressive back-and-forth scrubbing, focusing on cleaning one or two teeth at a time.
The technique involves a two-part approach for each tooth, cleaning both above and below the wire and bracket. First, angle the bristles down toward the tooth surface at a 45-degree angle to the gumline, focusing on the area above the bracket and the wire. Next, reposition the brush to angle the bristles upward at a 45-degree angle, cleaning the area below the bracket and near the gumline.
Electric toothbrushes with small, rounded heads can be effective, provided they are used carefully and ideally feature a pressure sensor. Supplemental tools are necessary to reach inaccessible areas. Interdental brushes (proxabrushes) clean horizontally between the archwire and the bracket wings to dislodge trapped food debris. Floss threaders or water irrigators should be used daily to clean between the teeth and around the gumline, as a standard brush cannot effectively reach these tight spaces.
Primary Reasons Brackets Detach
Other factors are far more likely to cause a bracket to detach than a proper hygiene routine. The most frequent cause of bracket failure involves consuming foods that are hard, sticky, or crunchy. Biting into these items places extreme pressure on the bracket, exceeding the adhesive’s shear strength.
- Ice
- Nuts
- Popcorn
- Hard candy
- Certain raw vegetables
Habitual behaviors, such as chewing on non-food items like pen caps, pencils, or fingernails, also generate forces that compromise the bracket bond. External trauma, such as a bump to the mouth or a sports injury, can easily dislodge appliances, which is why mouthguards are recommended for contact sports.
The bond strength may also be weakened from the start due to the tooth’s condition. Brackets adhere best to healthy, intact enamel, and their strength is reduced if placed on teeth with existing dental restorations, such as fillings or crowns. Issues during the initial bonding process, like insufficient enamel preparation, may also result in a weaker bond susceptible to detachment.
Immediate Steps Following Bracket Damage
If a bracket feels loose or detaches, remain calm, as this is not generally considered an emergency. First, assess the damage and determine if the bracket is still attached to the archwire. If it is loose but still on the wire, gently attempt to slide it back to the center of the tooth.
A detached bracket or a protruding wire end can cause irritation to the cheek or gums. To prevent discomfort, place a small amount of orthodontic wax over the sharp or irritating surface. If the bracket comes completely off the wire, save it and bring it to the orthodontist. Patients should contact their orthodontist promptly to schedule a repair, as a loose bracket is no longer moving the tooth correctly and can prolong the overall treatment time.