The question of whether an orthodontist cleans teeth during treatment is common, arising from the specialized nature of dental care. An orthodontist is a dental specialist who focuses on the diagnosis, prevention, and treatment of dental and facial irregularities, particularly the alignment of teeth and jaws. Their specialized training involves a deep understanding of biomechanics and the movement of teeth, which is distinct from the general dental focus on restorative and preventative care. This article clarifies the professional boundaries regarding routine teeth cleaning and explains the necessary hygiene practices during orthodontic treatment.
The Scope of Practice for Orthodontists and General Dentists
Orthodontists do not perform routine, comprehensive teeth cleanings, which are medically known as prophylaxis. This procedure, which involves the thorough removal of plaque, tartar, and stains from the tooth surfaces, is the exclusive domain of the general dentist or a registered dental hygienist. The training and scope of practice for the two professions are distinctly separate after dental school.
General dentists complete a Doctor of Dental Surgery (DDS) or Doctor of Dental Medicine (DMD) degree and focus on a broad range of dental health issues, including restorative work, disease prevention, and routine cleaning. Orthodontists complete an additional two to three years of specialized, post-doctoral training concentrated specifically on correcting malocclusions and aligning teeth. The two practitioners work in tandem; the general dentist maintains the health of the teeth and gums, while the orthodontist focuses on the position of the teeth.
Oral Hygiene Challenges During Orthodontic Treatment
Maintaining cleanliness becomes significantly more difficult for patients once fixed appliances, such as braces, are bonded to the teeth. The brackets, bands, and archwires create numerous new surfaces, nooks, and crannies where food particles and plaque—a sticky film of bacteria—can easily accumulate. This environment is highly conducive to bacterial growth and makes the mechanical removal of debris challenging, even with diligent home care.
The increased plaque accumulation raises the risk of several common dental issues. One significant concern is decalcification, which presents as white spots on the teeth where the enamel has begun to demineralize due to acid exposure near the bracket edges. Patients are also more prone to developing gingivitis, an early stage of gum disease characterized by inflammation, redness, and swelling of the gum tissue. Because of these heightened risks, patients undergoing treatment often need professional cleanings more frequently than the standard six-month interval, with many dental providers recommending visits every three to four months.
Specific Hygiene Procedures Performed by the Orthodontist
While orthodontists do not perform a full cleaning, they execute certain limited, specialized procedures that relate to cleanliness and oral health. During routine adjustment appointments, the orthodontist or their assistant will closely monitor the patient’s oral hygiene. They often visually check for signs of excessive plaque buildup, gingival inflammation, or early decalcification.
These specialists are also responsible for managing the hardware itself, which includes removing excess bonding cement that may have squeezed out from beneath the bracket during placement. This small amount of adhesive can create a rough surface that attracts plaque, so its removal is a form of localized cleaning. Furthermore, upon the completion of treatment, the orthodontist performs a detailed process called de-bonding, where they remove the brackets and any remaining dental cement from the tooth surface. The final step is to polish the teeth to smooth the enamel, which is a necessary, albeit limited, hygiene procedure incidental to the end of treatment. The orthodontist’s primary role in hygiene is providing instruction on specialized tools, such as water flossers or interdental brushes, to help the patient manage the daily cleaning difficulties at home.