Maintaining oral hygiene with braces is challenging because the brackets and wires create additional surfaces where food particles and plaque easily become trapped. This environment significantly increases the risk of developing cavities, gum inflammation, and permanent white spots on the enamel. A meticulous and adjusted cleaning routine is necessary to ensure teeth remain healthy beneath the hardware. This article provides clear steps for effectively cleaning teeth with orthodontic appliances.
The Recommended Brushing Duration
The standard recommendation for brushing time is two minutes, but with braces, this duration needs to be extended to at least two to three minutes for a thorough clean. This longer timeframe is necessary because the brackets and wires effectively increase the number of surfaces requiring attention. Brushing should ideally happen after every meal or snack, in addition to the mandatory session before bed, though a minimum of three times a day is advised.
Plaque, a sticky film of bacteria, starts forming almost immediately after eating, and braces provide many new hiding spots. If brushing immediately after a meal is not possible, rinsing the mouth vigorously with water helps dislodge larger food debris until a proper brushing session can occur. The nightly cleaning is important because the mouth produces less saliva during sleep, removing the natural rinsing effect that neutralizes acids and washes away bacteria.
Mastering the Technique for Braces
The technique used to clean around the orthodontic hardware is more important than the duration alone, requiring specific angles to reach all surfaces. Begin by holding a soft-bristled toothbrush at a 45-degree angle against the gumline, using small, gentle circular or back-and-forth motions to clean the gum margin. The bristles should be angled slightly toward the gum tissue to effectively clean the space where the tooth meets the gum, a common area for plaque accumulation.
Cleaning the bracket itself involves two distinct angles for each tooth. First, angle the toothbrush bristles from above the wire and bracket, pointing them downward, and use small circular motions to clean the top half and the area just above the wire. Next, angle the bristles from below the wire and bracket, pointing them upward, to clean the bottom half and the area closest to the gumline.
Clean each bracket individually, treating it as a separate tooth surface. After cleaning the front surfaces, remember to brush the chewing surfaces of the molars and the inner surfaces of all teeth with the same small, gentle movements. A systematic approach, moving from one section of the mouth to the next, ensures that no surface is missed during the cleaning process.
Specialized Tools for Effective Cleaning
A standard toothbrush cannot access every crevice created by the brackets and wires, making specialized tools necessary. Interdental brushes are small, cone-shaped brushes designed to fit easily under the archwire and between brackets. These tools are effective for removing trapped food particles and plaque from the tight spaces a regular toothbrush cannot reach.
Flossing requires specialized aids, such as floss threaders or orthodontic floss, to navigate the wire connecting the brackets. A floss threader is a stiff plastic loop that allows regular dental floss to be pulled underneath the archwire to clean the sides of the teeth and below the gumline. Orthodontic floss, like Super Floss, features a stiffened end that eliminates the need for a separate threader, simplifying the process of positioning the floss.
A water flosser is another tool that improves hygiene by delivering a pressurized stream of water to flush out debris. This jet of water is useful for dislodging food stuck deep within the brackets and wires, and it cleans around the entire appliance. While a water flosser is a powerful supplement, it does not replace the need for traditional flossing, which is necessary for scrubbing the surfaces between the teeth.
Finishing the Routine
Once thorough brushing and specialized cleaning with interdental brushes and floss are complete, the final steps protect the enamel. Rinsing the mouth with water washes away loosened plaque and food particles. However, some dental professionals recommend waiting to rinse immediately after brushing to allow the fluoride in the toothpaste to remain on the enamel longer.
Using a fluoride-containing mouthwash provides an extra layer of protection against demineralization, the process that leads to cavities and white spots around the brackets. Fluoride strengthens the tooth enamel, helping it resist acid attacks from bacteria and sugars. The final step should be a careful visual check in a mirror to confirm that all surfaces of the brackets and teeth are clean and shiny, with no lingering food debris.