Plaque buildup is a common concern for individuals undergoing orthodontic treatment. The complex surfaces created by brackets and wires provide hiding spots where food particles and bacteria can easily become trapped. If not removed thoroughly, plaque can lead to tooth decay, gum inflammation, and permanent white spots on the enamel once the braces are removed. A diligent at-home cleaning routine is necessary to ensure teeth remain healthy throughout the treatment period.
Essential Tools for Cleaning with Braces
Standard toothbrushes and dental floss are often insufficient for navigating the hardware of braces. An orthodontic toothbrush, which may feature V-trimmed bristles designed to contour around the brackets, is used for surface cleaning. Many people find that an electric toothbrush with an orthodontic brush head offers superior efficiency in reaching difficult spots and removing debris.
Interdental brushes resemble tiny pipe cleaners and are excellent for targeted cleaning. These small brushes remove trapped food and plaque from directly around the brackets and under the archwire. For cleaning between the teeth, traditional string floss requires a floss threader, a flexible plastic loop used to guide the floss under the archwire. A water flosser, or oral irrigator, is a valuable device that uses a pressurized stream of water to flush out material from tight spaces.
Step-by-Step Brushing Technique
Start by rinsing the mouth vigorously with water to dislodge any loose food particles caught in the braces. Using a pea-sized amount of fluoride toothpaste, the first step involves cleaning the gumline and the area above the brackets.
The toothbrush bristles should be angled at approximately 45 degrees toward the gumline, using short, gentle circular or vibratory strokes. This angle ensures the bristles clean both the tooth surface and the edge of the gum tissue, where plaque often accumulates. Next, the toothbrush is angled downward to clean the top surface of the brackets and the wire running over them, again with short, careful strokes. Finally, angle the brush upward from below to clean the lower surface of the brackets and the wire.
Specialized Cleaning for Interdental Spaces and Wires
After the main tooth surfaces are clean, the focus must shift to the spaces between the teeth and under the archwire. One method involves using a floss threader, which acts like a needle to pull a segment of regular floss underneath the archwire.
Once the floss is threaded under the wire between two teeth, gently slide it up and down the sides of both teeth, cleaning just below the gumline. A convenient alternative is Superfloss, which features a stiffened end for insertion under the wire, followed by a spongy section for cleaning wider gaps.
The water flosser offers a highly effective alternative, using a pulsating jet of water to flush out food and plaque from around the brackets and under the wire. The water flosser is less technique-sensitive and can clean areas that string floss may miss. Targeting the stream of water at the bracket and the gumline at a 90-degree angle ensures maximum cleaning power. The water flosser should be used once daily, in addition to brushing. While it is effective at removing loose debris and disrupting plaque, some orthodontists recommend supplementing it with traditional flossing to physically scrape plaque from the tight contact points between the teeth.
Supplementary Rinses and Dietary Adjustments
Rinsing with a fluoride mouthwash strengthens the tooth enamel against the acids produced by plaque bacteria. Fluoride helps remineralize areas of the tooth susceptible to decay or the development of white spot lesions around the brackets.
An alcohol-free antimicrobial mouthwash may also be used to control the overall bacterial population and reduce gum inflammation. Avoid mouthwashes containing alcohol, as this ingredient can be drying and irritating to oral tissues. Modifying the diet limits the fuel source for plaque. Limiting the consumption of sugary and starchy foods reduces the amount of fermentable carbohydrates available to the bacteria. Avoiding hard, sticky, and chewy foods protects the brackets and wires from damage.