Professional cleanings are essential for maintaining oral health during orthodontic treatment. Fixed appliances complicate daily hygiene, making regular dental visits more important. These appointments thoroughly remove plaque and tartar buildup, which cannot be fully managed by at-home care alone. Professional cleaning, including scaling and polishing, safeguards the enamel and gums throughout treatment.
The Impact of Braces on Professional Cleaning
Braces fundamentally change the oral environment by creating new surfaces and retention sites where food debris and plaque accumulate. Brackets, wires, and bands form microscopic niches that harbor bacteria, complicating the cleaning process for both the patient and the hygienist. This mechanical obstruction prevents the natural cleansing action of the mouth from reaching all tooth surfaces effectively.
Debris accumulation elevates the risk for specific dental issues, primarily gingivitis and enamel decalcification. Gingivitis, the initial stage of gum disease, presents as inflammation, redness, and bleeding of the gum tissue adjacent to the appliance. Acidic byproducts of plaque bacteria can rapidly leach minerals from the enamel, leading to permanent white spot lesions, which are visible signs of decay. These obstacles require the dental professional to employ a modified and meticulous approach to cleaning.
The Professional Cleaning Procedure
A professional cleaning with fixed appliances is similar to a standard cleaning but requires specialized tools and greater attention. The process begins with the removal of hardened plaque (calculus or tartar) from the tooth surfaces and around the brackets. Hygienists use a combination of hand instruments, such as sickle scalers, and power-driven ultrasonic scalers.
When using an ultrasonic scaler (employing high-frequency vibrations and a water stream), the hygienist maintains a low power setting and avoids prolonged contact with the bracket’s bonded area to prevent dislodging. Cleaning focuses on the exposed enamel and the area beneath the archwire and at the gumline, where plaque often collects.
After scaling, the teeth are polished using a specialized prophy angle, often featuring a pointed tip or tapered brush designed to maneuver around the wires and brackets. This removes surface stains and residual soft plaque. The final step involves applying a concentrated professional fluoride treatment (varnish or gel) to the exposed enamel surfaces. This preventive measure strengthens the enamel and increases resistance to acids that cause decalcification.
Essential At-Home Oral Care During Treatment
Due to the challenges posed by orthodontic hardware, patients must adopt a diligent home care routine between professional visits. Brushing technique must be modified to effectively clean the tooth structure surrounding the appliances. Patients should angle a soft-bristled toothbrush at 45 degrees, brushing above the brackets (closer to the gumline) and then angling the brush downward to clean below the brackets.
Interdental cleaning is challenging and requires specialized tools to navigate the archwire. Patients must use floss threaders or pre-cut orthodontic floss, featuring a stiffened end to pass the floss underneath the main archwire. Interdental brushes (proxabrushes) are effective small, tapered brushes used to clean tight spaces around the bracket. Water flossers (oral irrigators) are a helpful supplement, using a pulsating stream of water to flush out food particles and plaque.