Having braces is an effective way to achieve a straight, healthy smile, but the hardware necessary for tooth movement introduces new challenges for maintaining oral health. The addition of brackets, wires, and bands creates numerous small, sheltered areas where plaque can easily accumulate and thrive. If not meticulously managed, this trapped plaque and the resulting acid attacks significantly increase the risk of tooth decay. Preventing cavities during this period requires a dedicated, multi-faceted approach that goes beyond a standard hygiene routine.
Understanding the Increased Cavity Risk
Traditional braces provide bacteria with many new surfaces and crevices where they can hide, making thorough cleaning difficult compared to smooth tooth surfaces. Plaque, a sticky film of bacteria, produces acids when it metabolizes sugars from food. These acids dissolve the tooth enamel, the hard outer layer protecting the tooth.
The initial sign of this dissolution, known as demineralization, often appears as white spots on the teeth, usually around the bracket base and along the gum line. While the bonding material attaching the bracket creates an airtight seal, the area directly surrounding it is vulnerable to plaque accumulation. If left untreated, this decalcification progresses into full cavities. The orthodontic hardware complicates the removal of the plaque responsible for these changes.
Specialized Mechanical Cleaning Techniques
A simple routine is insufficient when navigating the complex hardware of braces, requiring a precise mechanical cleaning regimen after every meal and snack. Start by rinsing the mouth with water to dislodge loose food particles trapped in the wires. When brushing, hold the soft-bristled toothbrush at a 45-degree angle to the gum line and use small, gentle, circular motions.
The technique must specifically target the areas above and below the brackets, ensuring all surfaces of the tooth and hardware are cleaned for at least two minutes. Interdental brushes, which resemble tiny pipe cleaners, are helpful for cleaning the small spaces directly beneath the archwire and around the brackets. These specialized tools remove debris and plaque from hard-to-reach areas that a regular toothbrush cannot access.
Flossing requires the use of a floss threader, a flexible device used to pull the floss underneath the main archwire. Once threaded, gently move the floss up and down the sides of each tooth and slightly beneath the gum line to remove plaque and food particles. Alternatively, a water flosser, or oral irrigator, can be highly effective as a supplementary tool for dislodging debris with a pressurized stream of water. While it does not replace brushing or traditional flossing, it is helpful for flushing out particles trapped around the wires and brackets.
Dietary Adjustments for Orthodontic Patients
The types of foods consumed play a significant role in cavity prevention because braces prolong the contact time between food particles and the teeth. Patients must limit sticky and chewy foods, such as caramel, dried fruits, and gummy candies, as these easily become trapped in the brackets and are difficult to clean. Hard or crunchy items, including nuts, popcorn kernels, and hard candies, should also be avoided because they pose a risk of breaking or bending the orthodontic hardware.
The second category of concern involves foods and drinks high in sugar or acid content, which fuel the bacteria that attack enamel. Sugary beverages, including soda and sports drinks, should be minimized, as the sugar triggers acid production, leading to a prolonged acid attack on the enamel. Acidic foods like citrus fruits, vinegar-based products, and tomato sauces also weaken tooth enamel, making the teeth more susceptible to decay. Minimizing snacking between meals limits the frequency of acid attacks on the teeth.
Chemical Protection and Professional Monitoring
Beyond diligent mechanical cleaning, chemical aids provide protection against enamel demineralization. Fluoride, a mineral that strengthens enamel, can be applied through over-the-counter or prescription-strength toothpaste and rinses. Fluoride mouth rinses help remineralize enamel weakened by acid attacks and inhibit the growth of harmful oral bacteria. These rinses deliver concentrated fluoride to the teeth, which is especially beneficial in vulnerable areas around the brackets.
Maintaining regular appointments with both the orthodontist and the general dentist is necessary for cavity prevention during treatment. While the orthodontist monitors the appliance, the general dentist provides professional cleanings and checks for early signs of decay. Patients with braces are often advised to schedule professional cleanings every three to four months, rather than the standard six-month interval. This increased frequency allows the dental team to remove plaque and tartar buildup that at-home efforts may miss, ensuring the teeth remain healthy throughout the entire orthodontic process.