Fixed orthodontic appliances, commonly known as braces, challenge oral health maintenance despite improving dental alignment. The brackets and wires create numerous surfaces and tight spaces where food particles and plaque easily become trapped. This environment increases the risk of enamel demineralization, appearing as visible white spot lesions once the braces are removed. Because the cleaning process is more complex and time-consuming, a diligent approach is necessary for a successful outcome resulting in straight and healthy teeth.
Specific Brushing Techniques for Braces
Brushing requires a modified approach to effectively clean tooth surfaces and orthodontic hardware. Use a soft-bristled toothbrush, perhaps an orthodontic-specific brush with a V-shaped trim, to prevent damage to the brackets and gums. The recommended duration for a thorough cleaning session is at least two to three minutes, ensuring all surfaces are addressed.
The brushing technique involves a two-part cleaning method for each tooth. First, position the brush at a 45-degree angle toward the gumline, using small, gentle circular motions to clean the area above the archwire and the gingival margins. This angle allows the bristles to reach slightly under the wire and gently massage the gums where plaque accumulates.
Next, reposition the toothbrush to clean the area beneath the archwire and the bracket bases. Angle the brush 45 degrees toward the chewing surface (or incisal edge), employing small, circular movements. This action effectively sweeps debris and plaque away from the base of the bracket and the wire. Clean the back and chewing surfaces of the teeth as well, just as in a standard routine.
Mastering Flossing with Orthodontic Hardware
Interdental cleaning, or flossing, is particularly challenging with braces because the archwire physically blocks the path between the teeth. To navigate this hardware, a floss threader or a specialized product like Superfloss is necessary to guide the cleaning material under the wire. The floss threader acts like a plastic needle, through which standard dental floss is threaded before being guided beneath the main archwire.
Once the floss is successfully passed through, wrap the ends around your fingers and gently slide the floss down between the two adjacent teeth. Form a “C” shape with the floss, hugging the side of one tooth, and move it vertically up and down to scrape away plaque, extending slightly below the gumline. Repeat this process on the adjacent tooth surface before carefully pulling the floss out from under the archwire.
An alternative is Superfloss, which features a stiffened end that eliminates the need for a separate threader. This stiff end is inserted directly under the archwire, followed by a spongy section effective for cleaning larger gaps, and a regular floss section for interproximal cleaning. Although time-consuming, performing this thorough interdental cleaning once daily is required to prevent decay between teeth.
Supplementary Cleaning Tools and Routine Frequency
To complement manual brushing and traditional flossing, several supplementary tools can significantly enhance debris removal and overall hygiene. A water flosser, or oral irrigator, utilizes a pressurized stream of water to dislodge food particles and rinse away loose plaque from around the brackets and wires. The pulsating water stream is highly effective for reaching areas specialized brushes may miss, and it provides a final rinse to the entire appliance.
Another useful tool is the interdental brush, sometimes called a proxabrush, which resembles a small, cylindrical bottle brush. These are designed to fit into the small spaces directly under the archwire and around the individual bracket components for targeted spot cleaning. These brushes are used with a gentle in-and-out motion to manually clear away any stubborn debris remaining after main brushing.
The required frequency for the oral hygiene routine is significantly increased while wearing fixed appliances. It is recommended to brush the teeth after every meal and snack to prevent the rapid accumulation of plaque. Flossing with a threader or Superfloss should be performed at least once a day, preferably in the evening. Following the mechanical cleaning, rinsing with a fluoride mouthwash helps strengthen the enamel and reduce the bacterial load.