The introduction of fixed orthodontic appliances, commonly known as braces, significantly alters the mouth. Brackets, wires, and bands create numerous new surfaces and tight spaces where food debris, sugars, and starches become easily trapped. This environment allows oral bacteria to rapidly accumulate and form plaque, making a standard twice-daily brushing routine insufficient for maintaining dental health during treatment.
The Necessity of Post-Meal Brushing
Orthodontists strongly advise patients to brush or perform a thorough cleaning of the teeth and braces after every meal and snack. The presence of components complicates the mouth’s natural self-cleaning mechanisms, such as saliva flow, making manual debris removal mandatory. Food particles lodged against the enamel are quickly metabolized by oral bacteria, leading to the release of acidic byproducts within minutes.
This immediate and frequent acid exposure necessitates the removal of food and plaque multiple times a day. Relying on the standard twice-daily cleaning schedule permits prolonged acid attacks on the tooth surface surrounding the brackets. For patients with fixed appliances, clearing the trapped debris is the priority to minimize the time plaque resides against the enamel and gum tissue.
Understanding the Risks of Trapped Food
Failing to consistently remove trapped food and plaque can lead to several specific and permanent forms of dental damage. One common consequence is decalcification, which manifests as permanent white spots on the enamel after the braces are removed. This occurs because the acids produced by bacteria demineralize the tooth surface directly adjacent to the brackets, creating a distinct etched pattern.
Plaque accumulation along the gumline also rapidly causes gingivitis, an inflammation resulting in swollen, red, and bleeding gums. If not managed, the persistent presence of bacteria increases the risk of tooth decay, or cavities, which can accelerate beneath the wires and brackets. In severe cases, damage may require the premature removal of the braces to treat the resulting dental decay.
Essential Tools and Brushing Techniques
A full cleaning routine requires three to five minutes to ensure every surface is addressed thoroughly. The proper technique begins with a specialized orthodontic toothbrush, which features a V-shaped or “ortho” trim designed to straddle the wire and brackets. This design helps the bristles make direct contact with both the tooth surface and the appliance simultaneously.
The most effective method involves a two-angle approach for each tooth. First, angle the brush toward the gumline (downward for the upper teeth, upward for the lower) to clean the area above the bracket. Next, angle the brush toward the biting surface to clean the area below the bracket and the archwire. This ensures that the bristles reach the edges of the bracket and the surrounding enamel.
Cleaning under the archwire and between the teeth requires specialized accessories beyond a standard toothbrush. Interdental brushes, often called proxy brushes, are small, tapered tools used to meticulously clean the tight spaces between brackets and underneath the main wire. Flossing is best accomplished using floss threaders, which are stiff plastic loops that guide regular floss beneath the archwire, or by using products like Superfloss, which have a stiffened end for easy threading.
Quick Cleaning Options When Brushing Is Impossible
While a full brush and floss routine is the ideal practice, there are times when a thorough cleaning is not possible, such as at school or work. The best immediate solution is a vigorous rinse with plain water. Swishing water forcefully helps to dislodge larger food particles caught in the wires and flush away loose debris.
Another helpful option is chewing sugar-free gum, particularly those containing Xylitol. Chewing stimulates saliva production, which helps neutralize acids and wash away food remnants. Carrying a compact interdental brush or a small floss pick designed for braces allows for the quick removal of noticeable food traps. These methods are temporary and should always be followed by a complete cleaning at the earliest opportunity.