Congratulations on getting your braces. You will be flashing a confident, healthy, and beautiful smile in no time. But with braces comes great responsibility! Not only do you need to eat tooth-friendly foods, but you also need to ensure optimal oral hygiene – to prevent dental problems such as teeth cavities and periodontal inflammation that may require extensive dental treatment – sometimes requiring dental treatment using sleep dentistry. Besides, many braces’ wearers often have difficulty brushing their teeth properly.
While orthodontic treatment will help you achieve a beautiful smile and perfectly aligned teeth, failing to maintain optimal oral hygiene during your treatment can lead to severe problems like teeth cavities, gum problems, and bad breath. If you are also one of those people who find it challenging to clean their teeth with braces, this article is for you. Continue reading to find out how you can maintain optimal oral hygiene while wearing braces.
Brushing Teeth with Braces: Why is it so difficult?
Dentists attach braces or brackets to the teeth to fix tooth misalignment and bite problems. Each dental bracket contains a slot through which an orthodontic wire passes and connects all the teeth. Orthodontic wires are connected to the teeth using elastic ties. Since a significant area of the front surface of the tooth is covered by the bracket, together with the orthodontic wire and the elastic ties, the bristles of the toothbrush are often unable to penetrate the tight spaces between the teeth – leading to plaque and tartar buildup that can cause teeth cavities and periodontal problems due to food impaction and plaque buildup. That is why the American Association of Orthodontists recommends braces wearers take good care of their oral hygiene, cleaning their teeth multiple times a day.
What Happens if Teeth are not Cleaned Properly While Wearing Braces?
If optimal oral hygiene is not maintained during orthodontic treatment, food particles begin to adhere to the teeth and the dental brackets. As a result, a thin layer consisting of food debris forms on our teeth called dental plaque. Over time, this plaque hardens to become dental calculus, also called tartar. Both plaque and calculus provide an excellent environment for harmful bacteria to grow. These harmful bacteria utilize the sugars in the plaque and release toxins during metabolism.
These bacterial toxins are extremely harmful to the gums, resulting in the destruction of the fibers that attach our gums and jawbone to the teeth. Consequently, the gums start to recede from their position, exposing the underlying roots – causing tooth sensitivity and root caries. Not only this, but gum recession also leads to the formation of “pockets” between the teeth and gums, further promoting food impaction, bacterial metabolism, and toxin release. At the same time, these toxins make the oral environment acidic. This results in the accelerated loss of minerals from the teeth and bones, leaving them weak and vulnerable.
If this condition is not treated timely, there is widespread destruction of the gum tissues and jawbone. At this stage, the amount of new bone formation is lesser than that is destroyed due to the bacterial toxins. As a result, not only do the jawbones become weak and porous, but there is also insufficient bone tissue in the sockets to hold the teeth in position. Ultimately, the teeth become so loose that they fall off.
Besides, if periodontal disease is not treated timely, there are chances that the inflammation may spread to other body organs through the blood and cause severe, even life-threatening complications.
Another big problem associated with insufficient teeth cleaning while wearing braces is bad breath. Bad breath, also known as halitosis, is a condition that is primarily caused by the release of metabolic products by harmful bacteria inside the oral cavity. Food particles tend to adhere to the elastic ties and brackets, promoting plaque and tartar deposition and bacterial colonization – causing halitosis.
All these problems can be easily avoided – through regular oral hygiene maintenance. However, braces wearers need to undertake extra measures to ensure that their teeth and gums remain clean and healthy.
So, How to Brush Teeth Properly with Braces?
Whether you are wearing traditional metal braces, ceramic or lingual braces, the key to preventing dental problems is to ensure meticulous oral hygiene through brushing and flossing. According to the American Dental Association, regular brushing and flossing removes the plaque layer from the teeth and prevents tooth decay and gum problems. Here’s how you can brush your teeth with braces like a pro:
- Selecting the Right Armamentarium
Using the right tools for the job goes a long way in ensuring its success. You should select a toothbrush having a suitable handle length and a head size that can be easily inserted and removed from the mouth while brushing.
The type of bristles of a toothbrush can have a direct impact on the effectiveness of plaque removal. A research review concluded that toothbrushes having angled or multi-level bristles are more effective in cleaning teeth than the ones with flat-trimmed bristles.
Another important aspect, which is often ignored is the softness of the toothbrush bristles. Many people think that using a hard-bristled toothbrush may offer superior dental cleaning. This is not the case; instead, the hard bristles can lead to gum recession and tooth wear. That is why the American Dental Association always recommends using a soft-bristled toothbrush that contains ADA’s seal of approval.
- The Brushing Technique
- Take out any removable orthodontic accessories, such as bands and elastics, before brushing, if possible. This will allow you to clean your teeth more effectively.
- The American Dental Association recommends fluoride-containing toothpaste for braces wearers as it minimizes the risk of teeth cavities and kills disease-causing bacteria residing in the plaque and tartar. Apply only a pea-sized dab of fluoride paste on the toothbrush. Make sure that you don’t ingest the toothpaste while brushing it; spit it out once you are done.
- Holding your toothbrush head at a 45-degree angle to the tooth surface, start brushing at the gum line, moving it in an up-and-down fashion.
- Next, angle the toothbrush on top of the brackets and thoroughly clean the area. Repeat the same procedure for the tooth surface below the brackets.
- Once the front surfaces of all the teeth have been cleaned, brush the inner (lingual) surfaces of your teeth, making sure to remove food debris from beneath the gum line.
- Once all the tooth surfaces have been cleaned, rinse your mouth and reattach the orthodontic elastics or bands that you may have removed while brushing.
Dental professionals recommend brushing your teeth for at least two minutes – 30 seconds for each quadrant. Also, while brushing, make sure not to use excessive brushing force, as it may lead to dislodgement of the brackets or the orthodontic wire. Besides excessive brushing force can also lead to tooth wear and sensitivity.
Electric or Manual Toothbrush: Which is Better?
According to the American Dental Association, both electric and manual toothbrushes offer sufficient teeth cleaning, provided they are used correctly. So, this is a matter of your preference and convenience. Your orthodontist can give advice regarding the type of toothbrush that best suits your dental needs. A Research study published in the international journal of dental hygiene has shown that both powered and manual toothbrushes offer comparable tooth cleaning efficacy. It’s all about your brushing technique.
Specially designed powered toothbrushes are available these days for individuals who wear braces. Another benefit of powered toothbrushes is that most of them are connected with apps that help you keep track of your brushing time. Besides, modern electric toothbrushes also warn you if you are applying excessive force while brushing.
Using Additional Oral Hygiene Products to Up your Oral Health Game with Braces
When it comes to your oral health – especially while undergoing orthodontic treatment – you can never be too careful. Here are a few additional oral hygiene products you can add to your routine to keep your teeth squeaky clean while wearing braces:
- Interdental Toothbrush – Traditional toothbrushes are often not sufficient to optimally clean teeth having braces. That is why it is recommended to use an interdental brush. This toothbrush contains rounded, finer bristles that can easily penetrate the tight spaces between the teeth and remove plaque and tartar deposits. Interdental toothbrushes come in a variety of shapes and sizes. You should consult your orthodontist regarding an interdental brush type that best suits your dental needs.
- Flossing – more than 500 species of bacteria exist on our teeth and gums – some are beneficial/harmless, while others are disease-causing. According to the American Dental Association, flossing should be an integral part of everyone’s oral hygiene routine, especially the ones who are undergoing orthodontic treatment. Flossing at least once a day is one of the most effective methods to prevent dental problems during orthodontic treatment. Depending on your preference, you may use the conventional thread floss or one with small multi-angled bristles.
- Waterpik or Water Flosser – if you do not like to use dental floss, you may use a Waterpik. The Waterpik generates a pressurized stream of water that removes food debris from interdental spaces. A research study published in the journal of clinical dentistry showed that the combination of Waterpik and a manual toothbrush was more effective in removing interdental plaque than the combined usage of a manual toothbrush and string floss. Another study showed that the Waterpik was two times more effective in removing interdental plaque than the conventional string floss.
- Fluoride or Medicated Mouthwash – a fluoride mouthwash is effective in killing bacteria that cause teeth cavities and gum inflammation. Besides, fluoride has also been shown to make our teeth stronger and more resistant to tooth cavities. Adding a mouthwash approved by the ADA can go a long way in keeping your teeth and gums healthy during orthodontic treatment. Sometimes, your orthodontist may also recommend using a medicated mouthwash to minimize the chances of periodontal inflammation.
- Tooth-Friendly Diet – Besides, eating a tooth-friendly diet rich in nutrients, minerals, and proteins will make your teeth stronger and resistant to decay. Dentists also ask braces wearers to avoid fizzy and sugary drinks as they can cause tooth decay. A fiber-rich diet containing green vegetables and fruits provides a cleansing action that helps remove plaque and tartar deposits and prevents tooth staining.
While it is important to clean your teeth thoroughly after a meal, the Oral Health Foundation recommends brushing your teeth at least after one hour of eating. This is because the food attached to your teeth may serve as an erosive, making the outer surface of your teeth temporarily soft. If you brush your teeth immediately after a meal, this layer will be removed through the mechanical brushing action and may lead to tooth sensitivity.
Besides meticulous oral hygiene maintenance, regular visits to your dentist or hygienist can go a long way in maintaining good oral health. This is because some dental issues can arise even if you brush and floss regularly. These problems are not visible to the naked eye, especially during their early stages. Only your dentist or orthodontist can detect them, using specialized equipment. In this way, your dentist or orthodontist can diagnose dental problems in their initial stages, before they cause permanent damage, thereby saving you from investing time and money in seeking treatment for avoidable dental problems.
This is why it is imperative that you never miss an appointment with your orthodontist. Regular visits to your dentist or orthodontist are not only essential for your orthodontic treatment but also to ensure that you retain a pearly white smile during – and even after – your orthodontic treatment.
To sum up, you simply have to take extra care of your teeth during orthodontic treatment. If you do that, you won’t have to worry about problems like yellow teeth, cavities, bad breath, and bleeding gums.
Dr. Mehmood Asghar is a dentist, an educator and a researcher in dental biomaterials. He is currently working as an Assistant Professor in Dental Biomaterials at the National University of Medical Sciences, Pakistan, in addition to pursuing a Ph.D. in Dental Biomaterials. Apart from his professional activities, Dr. Asghar loves reading, writing, and working out.