Fixed orthodontic appliances, commonly known as braces, are highly effective tools for aligning teeth and improving the function of your bite. The complex structure of braces, consisting of brackets and archwires, provides numerous small surfaces and crevices where food debris and bacterial plaque can easily accumulate. Diligent and specialized cleaning practices are necessary during treatment to prevent issues like gingivitis, enamel decalcification, and permanent staining around the brackets.
Essential Tools for Orthodontic Hygiene
Maintaining a clean mouth with braces requires supplementing your standard oral care routine with several specialized instruments designed to navigate the wires and brackets. These tools form a comprehensive arsenal against plaque buildup:
- An orthodontic toothbrush, characterized by a “V” or “U” shaped trim in the bristles, allows the center to clean the bracket surface while outer bristles reach the adjacent tooth enamel.
- Interdental brushes, sometimes called proxabrushes, are tiny, cone-shaped brushes perfect for cleaning the small spaces directly under the archwire and between the individual brackets.
- A floss threader, resembling a small plastic loop, is used to manually guide dental floss underneath the main archwire.
- A water flosser is a supplementary tool that uses a pressurized stream of water to flush out debris and soft plaque from the hard-to-reach areas of the appliance.
Mastering the Brushing Technique
The mechanical action of brushing must be adapted to thoroughly clean the tooth surfaces and the hardware itself. Begin by rinsing your mouth with water to dislodge any large food particles before introducing the toothbrush and toothpaste.
The fundamental technique involves positioning the toothbrush bristles at two distinct 45-degree angles to effectively clean all sides of the brackets. First, angle the brush head 45 degrees downward toward the biting surface, applying gentle pressure to clean the top edge of the bracket and the area just below the archwire. After completing this motion across all teeth, reposition the brush 45 degrees upward toward the gumline. This second angle focuses on cleaning the bottom edge of the bracket and the enamel immediately beneath it, ensuring plaque is removed from the gum margin.
You must dedicate sufficient time to the cleaning process, brushing for a minimum of two minutes in total. A helpful strategy is to mentally divide the mouth into four quadrants—upper right, upper left, lower right, and lower left—and spend at least 30 seconds thoroughly cleaning each section. Additionally, the chewing surfaces and the inner surfaces of the teeth must be brushed using a regular back-and-forth motion.
Deep Cleaning and Interdental Care
Cleaning the spaces directly between the teeth, known as the interproximal spaces, requires specialized techniques to bypass the archwire. Since traditional flossing is impossible with fixed braces, the floss threader is necessary for manual interdental cleaning. To use it, feed one end of the threader under the archwire, pull the dental floss through the loop, and then gently guide the floss between the two adjacent teeth. Once the floss is in place, scrape the sides of both teeth to remove plaque from beneath the gumline before carefully pulling the floss out and repeating the process.
For those who find manual flossing time-consuming, a water flosser is an effective alternative or supplement, using a steady jet of water to flush away plaque and food from around the brackets and wires. The water flosser provides a gentle yet powerful clean, reaching areas that even a proxabrush might miss. Concluding the hygiene routine with a fluoride mouthwash or rinse is important for strengthening the enamel. These rinses contain fluoride ions that help remineralize the tooth surface, reducing the risk of developing “white spot lesions” or decalcification after the brackets are removed.