Braces create a complex environment in the mouth where food particles and plaque easily accumulate. Maintaining oral hygiene is challenging because brackets and wires obstruct the simple sweep of a manual toothbrush. An electric toothbrush offers a significant advantage due to its automated, high-speed bristle movement (oscillatory-rotating or sonic). This rapid action helps dislodge biofilm from the difficult-to-reach surfaces around the orthodontic hardware. Using an electric toothbrush makes thoroughly cleaning the entire tooth surface, especially areas adjacent to the brackets, substantially easier.
Essential Tools and Preparation
Selecting the appropriate equipment ensures the most effective and safest cleaning around the metalwork. Specialized orthodontic brush heads often feature a V-shaped pattern, with shorter center bristles to accommodate the bracket and longer edge bristles to clean the tooth surface. If a specialized head is unavailable, a standard small, compact brush head with soft bristles works well for maneuvering around individual teeth and brackets.
Use a model that includes a pressure sensor, which alerts the user to excessive force and helps prevent damage to brackets and gum irritation. Selecting a gentle cleaning mode, often labeled “sensitive” or “gum care,” is advisable to minimize discomfort, especially after an orthodontic adjustment. Fluoride toothpaste should be used to strengthen enamel, which is vulnerable to acid attack due to the plaque traps created by braces.
The electric toothbrush is the primary cleaning tool, but it cannot reach every area. Supplementary tools like interdental brushes and floss threaders are necessary components of a complete hygiene routine.
Mastering the Electric Toothbrush Technique
The core principle of brushing is to move slowly and systematically, allowing the mechanical action of the bristles to work instead of scrubbing vigorously. The technique must be adjusted to clean the three distinct surfaces created by the fixed appliance. Start by cleaning the tooth surface above the archwire and bracket, angling the brush head downward at a 45-degree angle toward the gum line. This positioning ensures the bristles reach the small margin of the tooth near the gum, where plaque commonly accumulates.
After cleaning the upper half, reposition the brush head to clean the surface below the archwire and bracket. Angle the brush head upward at a 45-degree angle, pointing toward the biting surface. Move the brush along the wire, pausing briefly on each tooth to allow the bristles to vibrate and dislodge debris. This methodical, tooth-by-tooth approach is more effective than sweeping across multiple teeth at once.
Finally, clean the chewing surfaces and the backs of the teeth using the standard technique, ensuring you spend the recommended two minutes for the entire process. Many electric toothbrushes include a built-in timer that prompts the user to move to a different section of the mouth every thirty seconds. This feature helps ensure all four quadrants receive equal attention, maintaining the deliberate pace required for effective cleaning.
Targeting Critical Areas Around Brackets and Wires
Certain areas require specific attention to prevent long-term damage like decalcification, which appears as white spot lesions after braces are removed. The base of the bracket, where it is bonded to the tooth, is a primary site for plaque accumulation. Use the small, concentrated head of the electric toothbrush to focus directly on this junction, resting the head on the bracket briefly to vibrate away the biofilm.
The spaces between the brackets and the gaps underneath the archwire are often inaccessible to the main toothbrush head. Interdental brushes (proxy brushes) are designed to slide into these small openings, allowing for mechanical removal of trapped food and plaque. Using these small, conical brushes to scrub under the archwire and around the sides of the brackets supplements the electric toothbrush.
The contact points between adjacent teeth are missed by brushing because the wire prevents bristles from reaching them. Daily flossing is non-negotiable for preventing decay and promoting gum health. Floss threaders or specialized orthodontic floss must be used to pull dental floss beneath the archwire and into the contact point. This final step ensures all surfaces are free of the plaque that harbors bacteria.