Orthodontic treatment involves fixed hardware, such as wires and brackets, that trap food particles and encourage the rapid accumulation of bacterial plaque. This hardware significantly complicates daily cleaning. Maintaining proper oral hygiene is necessary for a healthy result, as poor maintenance can compromise the outcome and the health of the enamel. Therefore, the standard two-times-a-day brushing routine is often insufficient during treatment.
Optimal Brushing Schedule with Braces
The recommended frequency for brushing with fixed orthodontic appliances is after every meal or snack, with a minimum goal of three times per day. This schedule directly addresses the increased risk of plaque buildup that occurs when food is caught in the brackets and wires. When sugars and starches are trapped, the oral bacteria rapidly metabolize them and produce acid. This acidic environment begins to demineralize the tooth enamel almost immediately.
Brushing after eating removes food particles before bacteria can create acid and cause damage. If immediate brushing is not possible, a vigorous rinse with water helps dislodge larger debris until a proper session can be performed. This increased frequency is a necessary protective measure during treatment.
Mastering the Brushing Technique
Cleaning around fixed braces requires a systematic and gentle approach that differs from standard brushing. The goal is to clean the tooth surface, the bracket surface, and the archwire effectively. A soft-bristled toothbrush or an electric toothbrush with an orthodontic head is recommended to avoid damaging the appliance or irritating the gums.
To clean the areas above the brackets, position the toothbrush bristles at a 45-degree angle pointing downward toward the wire and the chewing surface of the tooth. Use a gentle, circular, or short back-and-forth vibrating motion over the top of the bracket and the wire. This angle allows the bristles to sweep underneath the archwire.
Next, clean the surfaces below the brackets by angling the bristles at 45 degrees pointing upward toward the gum line. Use the same small, gentle motions to ensure the bristles can reach beneath the wire from the bottom. This dual-angle technique is essential because the brackets create two distinct ledges that harbor plaque.
Finally, clean the brackets themselves and the chewing surfaces of the teeth using a straight-on approach with a gentle scrubbing motion. Be sure to spend adequate time on the back surface of every tooth, which is often overlooked. Each cleaning session should last for a minimum of two minutes to ensure every area is addressed thoroughly.
Specialized Cleaning Equipment
Brushing alone cannot reach all areas where plaque and food debris accumulate, making supplemental tools necessary. Interdental brushes, or proxabrushes, are small, tapered brushes designed to fit into tight spaces. They are used to clean underneath the archwire and in between the brackets where food often gets trapped.
Flossing must be performed daily to clean surfaces between the teeth and under the gum line. Traditional string floss requires a floss threader to guide the floss under the archwire. Alternatively, orthodontic floss, which has a stiffened end, can navigate this space without a separate tool.
Water flossers, or oral irrigators, provide a pressurized stream of water to dislodge debris and plaque in hard-to-reach areas. While effective at flushing material from around the brackets and wires, they are not a substitute for mechanical brushing and flossing. They are a beneficial addition to the routine, especially for those with limited dexterity or sensitive gums.
Protecting Teeth from Damage
Poor oral hygiene during orthodontic treatment can lead to permanent damage. The most common risk is decalcification, which presents as permanent white spots on the enamel surface once braces are removed. This occurs when acid from prolonged plaque accumulation leaches minerals from the enamel around the bracket’s edges. Plaque buildup along the gum line can also quickly lead to gingivitis, characterized by gum inflammation, redness, and bleeding.
If left untreated, this condition can progress and potentially delay treatment time. Strict adherence to the recommended schedule ensures the final result is a straight smile with healthy, intact enamel.