When fixed braces are placed on the teeth, the brackets and archwires create numerous new surfaces and tight spaces that trap food debris and plaque. This complexity immediately increases the risk of oral health issues, requiring a specialized cleaning routine. Consistent plaque presence can lead to decalcification, which appears as permanent white spots on the enamel after braces are removed. Neglecting hygiene also promotes gingivitis, causing gums to swell and potentially prolonging orthodontic treatment time.
Essential Tools and Supplies
Maintaining oral health with braces requires acquiring specific tools designed to navigate the appliance hardware. An orthodontic toothbrush, often featuring a “V-trim” bristle pattern, is shaped to clean the tooth surface and the bracket simultaneously. For accessing tight spots, interdental brushes (proxibrushes) are small, tapered brushes that resemble tiny pipe cleaners. Flossing requires assistance from either floss threaders or Superfloss, which features a stiffened end for easy threading beneath the archwire. Fluoride toothpaste and a fluoride mouthwash are also important for strengthening enamel and preventing decay in hard-to-reach areas.
Step-by-Step Brushing Technique
The standard brushing method must be modified to ensure all tooth surfaces are reached around the fixed appliance. Begin by focusing on the area above the archwire, angling the V-trim toothbrush bristles downward toward the wire at a 45-degree angle. Use a gentle, circular or vibrating motion across the surfaces of the brackets and the enamel in this upper section, treating each tooth individually. This technique sweeps plaque away from the gumline and the top of the bracket.
Next, reposition the toothbrush to clean the area below the archwire, angling the bristles upward from the biting surface toward the wire. Use a light, circular motion to clean the lower half of the bracket and the tooth surface beneath the wire. This dual-angle approach is necessary because the archwire physically blocks a straight-on cleaning motion. After cleaning the front of the teeth, ensure the chewing surfaces and the inside surfaces of all teeth are brushed thoroughly, as these areas are often neglected.
Interdental and Wire Cleaning
Once the main tooth surfaces and bracket faces are clean, clearing debris from beneath the archwire and between the teeth is necessary. Use a floss threader by inserting the stiff end under the archwire and pulling floss through the gap between two teeth. Once positioned, gently slide the floss up and down the side of each adjacent tooth, extending slightly below the gumline to remove trapped plaque. Repeat this process for every space between the teeth, as this is the only way to clean areas a regular toothbrush cannot reach.
Interdental brushes are then used to meticulously clean around each individual bracket and the archwire. Gently slide the brush under the wire and around the sides of the bracket, moving it back and forth to dislodge remaining food particles and plaque. Select an interdental brush size that fits comfortably without forcing it, as using too large a size can damage the brackets or wires. These brushes are particularly effective at cleaning the small spaces between the bracket and the tooth surface where plaque accumulates most densely.
Post-Cleaning Care and Dietary Considerations
After completing the mechanical cleaning, rinsing the mouth helps wash away loosened debris and residual plaque. Using a fluoride mouthwash provides an additional layer of protection, as the fluoride ion helps remineralize enamel surfaces weakened by acid exposure. It is recommended to use the mouthwash at a different time than brushing to maximize fluoride exposure to the teeth. After cleaning, visually inspect the braces in a mirror to ensure no wires are loose or brackets are detached.
The cleaning effort must be supported by thoughtful dietary choices to prevent appliance damage and maintain hygiene. Hard foods, such as nuts, popcorn, and ice, can easily break off a bracket or bend an archwire, requiring an unscheduled repair appointment. Sticky or chewy foods, including caramel, taffy, and chewing gum, adhere tightly to the brackets and wires, making their complete removal nearly impossible. Consuming these items leaves food material trapped against the teeth, increasing the risk of cavities and gum inflammation.