A common fear is that orthodontic braces cause teeth to turn yellow, but the appliance itself does not inherently change the color of the tooth structure. Braces do not contain chemicals that stain enamel, nor do they physically abrade the tooth surface. However, the brackets and wires create an environment where discoloration is significantly more likely if meticulous oral hygiene is not maintained. The orthodontic hardware makes cleaning difficult, allowing plaque to accumulate and lead to two distinct types of color change. This article explains the science behind this discoloration and how to prevent and correct it.
Why Teeth Appear Yellow During and After Braces
The primary cause of long-term discoloration is demineralization, which results in White Spot Lesions (WSLs). Fixed orthodontic appliances complicate the removal of plaque, a sticky film of bacteria that produces acid as it consumes sugars and starches. This acid attacks the enamel surrounding the brackets, stripping away essential minerals like calcium and phosphate.
The demineralized enamel appears chalky white and opaque because the change in mineral density alters how light reflects off the tooth surface. When the braces are removed, these chalky white spots stand in stark contrast to the healthy enamel underneath the bracket. This visual difference makes the surrounding tooth surface seem more discolored than it truly is, creating an uneven, mottled look.
The other cause of yellowing is extrinsic staining, a more superficial issue. Poor hygiene allows plaque and tartar to build up on all exposed tooth surfaces. This buildup is often yellowish or brownish, and it is easily stained by pigmented foods and drinks like coffee, tea, or berries. This type of yellowing is not permanent damage to the enamel and can be addressed more simply than demineralization spots.
Essential Hygiene Strategies for Prevention
Preventing discoloration while wearing braces requires a significantly elevated oral care routine. It is recommended to brush after every meal and snack, rather than just twice a day, to remove food debris trapped by the brackets. Using a fluoride toothpaste is highly recommended, as fluoride helps strengthen the enamel and encourages remineralization, reversing early-stage demineralization.
Specialized tools are needed to navigate the brackets and wires effectively. Orthodontic toothbrushes have a V-shaped trim to better clean the tooth and bracket surface simultaneously. Interdental brushes can clean beneath the archwire and between the brackets. Flossing should be performed daily using a floss threader or a water flosser to clean the sides of the teeth that a brush cannot reach.
In addition to diligent at-home care, regular professional dental cleanings must be maintained, typically every four to six months. Hygienists use specialized instruments to remove hardened plaque and tartar that brushing cannot clear. Limiting the consumption of highly acidic or sugary foods and drinks, which feed the acid-producing bacteria, also significantly reduces the risk of decalcification.
Post-Treatment Solutions for Existing Stains
For general yellowing and surface stains remaining after braces are removed, professional teeth whitening is a highly effective treatment. Whitening treatments use a peroxide-based gel to bleach the tooth structure, successfully lightening the enamel’s color.
Treatment for Milder WSLs
White Spot Lesions (WSLs) require specific treatment because they are structural changes to the enamel. For milder cases, a dentist may recommend continued use of high-concentration fluoride or prescription remineralization pastes. These treatments help the lesions blend with the surrounding enamel over time.
Advanced WSL Treatments
For more noticeable spots, microabrasion is a technique that gently polishes and removes a minuscule surface layer of the enamel. Alternatively, resin infiltration is a minimally invasive procedure. A resin material is applied to the porous lesion, filling the damaged area and making the white spot appear transparent and blend with the rest of the tooth.