The journey toward a straighter smile requires careful preparation. Before the process of moving teeth can begin, a healthy foundation within the mouth must be established. This preparation phase is crucial because the environment created by braces introduces unique challenges to maintaining oral hygiene. Establishing optimal dental health beforehand helps ensure that the entire treatment period is safe, efficient, and ultimately successful.
The Mandatory Pre-Braces Dental Clearance
The clear answer to whether existing cavities must be filled is yes; all necessary restorative work is required before an orthodontist will place brackets and wires. This requirement is formalized through “dental clearance,” where your general dentist confirms your teeth are free of decay and gum disease. The process begins with a comprehensive dental examination, X-rays, and a thorough cleaning to remove plaque and tartar buildup. Existing tooth decay must be addressed, typically with dental fillings. Teeth must be structurally sound and free from active infection to withstand the consistent forces exerted by orthodontic appliances. If teeth are weakened by decay, the pressure from the braces could lead to greater structural damage, such as fractures.
Why Starting Braces With Untreated Decay Is Risky
Ignoring existing tooth decay before starting orthodontic treatment significantly increases the risk of complications. Brackets and wires create numerous small spaces where food particles and bacteria can easily become trapped. This environment makes thorough brushing and flossing more difficult, providing an ideal condition for existing decay to progress rapidly. A small cavity that was manageable before braces can quickly become a large lesion under the appliances. As decay progresses, it can reach the tooth’s pulp, leading to a painful infection or abscess that necessitates a root canal procedure. Furthermore, the decayed tooth surface is not a stable base for the orthodontic bonding agent, which can compromise the adhesion of the bracket.
Managing Decay That Occurs During Orthodontic Treatment
Even with the best oral hygiene, a new cavity might still develop after braces have been placed. When this occurs, the general dentist and the orthodontist must work together to treat the decay. If the cavity is in an easily accessible location, the dentist may be able to perform the filling without any interference from the appliances. For decay that develops in a harder-to-reach area, such as between teeth or near the archwire, the orthodontist may need to temporarily remove the wire. In some instances, the nearest bracket must be removed to give the dentist clear access. After the filling is complete, the orthodontist will reattach the bracket and wire, often requiring closely scheduled appointments to minimize disruption to tooth movement. Maintaining excellent, consistent oral hygiene and continuing regular checkups with your general dentist are the best defenses against this mid-treatment complication.