Oral hygiene - brushing with dental braces

Aims and Goals

Our aim is to get your teeth straight as soon as we can so that your braces will not be on for longer than they need to, and have your teeth and gums in a healthy condition at the end of your treatment. If this is your aim too, we will all need to work together, to make it happen. We will make sure we keep your teeth moving, by changing the modules and activating or changing the wires as required. You will need to help us by avoiding breakages, and by keeping your teeth and gums healthy.

How to brush effectively while you have your braces on

Brushing your teeth will take a lot longer now that you have braces on. Any brush with soft bristles and a small head that is comfortable to hold is fine. In the morning we understand that your time is limited, so just a quick but thorough brush with your regular toothbrush. Start at the back and work your way around your mouth, from one side to the other. That way no teeth will be missed.

Brushing Teeth

Hold the toothbrush not on top of the braces, but on the gums, wriggling in small circles. You can then push the bristles of the brush under the wires from above and below the braces to remove food and more importantly, plaque from under the wires. This will require placing the brush in one spot, then pushing the bristles. It won’t work if you are just scrubbing the under and top sides of the braces.

At lunchtime (at school), you don’t have to brush unless you want to. You will find though, that lots of food will get caught in your braces, so you’ll need to rinse thoroughly with water to get rid of it.

At night, or whenever you have more time, you should spend at least 5 minutes having a really good thorough brush. Start with the spiral brush. This is great for getting huge chunks of food out, but it is also essential for daily use to remove all the plaque from your teeth and gums. Bend the wire part of the brush so that it is at right angles to the handle. Direct the brush under the arch wire of your braces, going from the gums towards the biting edge of your teeth, then using long strokes, brush 15 strokes, from above one bracket, to above the other bracket.

Spiral left – That is five strokes from the left
Spiral middle – Five strokes straight up and down
Spiral right – And then 5 strokes from the right

Make sure the bristles of the brush are held firmly against your gum and the tooth above/below each bracket. If you pull against the arch wire with the brush, you will be holding the brush away from your gums, and this will be ineffective.
Once you have used the spiral between each of the brackets, then use your regular toothbrush in the same way discussed above. After brushing, have a good look and make sure everything looks clean and shiny. If anything looks dull or cloudy, there is still plaque there, and you need to brush again.

Extra protection for your teeth

While your braces are on, we recommend that you use a fluoride mouth rinse weekly. Fluoride is a mineral that can strengthen your teeth and make them more resistant to decay. Brush your teeth as normal, then after rinsing out all the toothpaste, take 5-10ml of Fluorocare in your mouth and swish vigorously for 30 seconds. Spit this out and then leave the residue sitting on your teeth for at least 30 minutes. It is best if this is done just before going to bed, then the fluoride will be working to strengthen your teeth all night. A helpful hint is to do this on the same night each week. Sunday nights can be your fluoride night! If you play contact sports we recommend the use of a re-mouldable mouthguard available form a chemist or sports store. Mouthguards help to protect your cheeks and lips from the braces if you get a hit to the face. Your braces will hold your teeth in position, but as you can imagine, all that metal being embedded into your cheeks would not be fun.

Caring for appliances other than braces

We use a number of different types of appliances other than the traditional fixed appliance most people refer to as “Braces”. The types of appliances we use can be categorised as either fixed or removable:

Fixed appliances

Fixed appliances are cemented into position in your mouth. They are usually made up of metal bands around at least two teeth, and a wire joining these bands.

Care of fixed appliances

Avoid eating all sticky foods, as they can cause the appliance to become loose. Eating sweets between meals should also be avoided, as there is a greater chance of decay while the appliance is in your mouth. Brush carefully around all of the wires and where the band meets your gum. If you are having difficulties getting into the small areas, please speak to our Dental Therapist, who will be able to advise you on brushing those hard to reach areas. Floss can be used under the wire. It needs to the threaded through under the wire and then used as normal.

Removable appliances – clear retainer

We use removable appliances to either hold the teeth in their new positions, or to make minor adjustments to form minor tooth movement. It is important that they are worn as instructed by your Orthodontist, and that you contact us if at any stage you are having problems with them.

Care of removable appliances:

Each time the appliance is taken out of the mouth, it should be rinsed with water to remove the saliva. This will keep the retainer from becoming slimy and hard to clean. Twice a day the appliance must be taken out of the mouth and scrubbed with toothpaste and a toothbrush. A hard toothbrush can be used on the appliance, but always use a soft one in the mouth. Do not use hot water as it can distort the appliance. Don’t forget to take your appliance out of your mouth to give your teeth and gums a thorough brush. Your appliance should be in its box at all times when it is not in your mouth. It should never be in a pocket or bag as it can be easily lost or broken. Wrapping a retainer up in a tissue will usually result in the whole thing being thrown out, so leave it in the mouth to eat if the box is not available. If a retainer is lost or broken, a new appointment will be needed to repair or replace it. Replacing retainers are costly mistakes, as a lab fee will need to be charged to your account. Your speech may be affected for the first few days. Don’t remove it though, if you need to speak clearly at first, or it will take longer to get used to. The only exception to this is for singing or playing a wind instrument.

Oral hygiene FAQs

Why do I have to brush my teeth?

Everybody has to clean their teeth daily to remove the plaque that collects on their teeth that causes dental diseases such as decay and gum disease.

What is plaque?

Plaque is a soft, colourless, sticky film of bacteria, which is difficult to see until the coating is quite thick. It forms in everybody’s mouth all the time, collecting on the surfaces of the teeth mainly next to the gums and between the teeth.

If plaque is not removed regularly, it can convert the foods we eat to acid. These acids eat away at the enamel of your teeth, eventually making holes in them. This is called decay.
Plaque is also the main cause of gum disease. The presence of plaque around the gums gradually causes the gum to loosen their hold on the teeth. Waste products from plaque then attack, and eventually destroy the bone supporting the teeth. The teeth become loose and may ultimately be lost. Remember – gum disease is the most common reason for tooth loss in adults.

So if I brush my teeth thoroughly, I won’t get decay?

Careful toothbrushing combined with good eating habits will give you the best chance to avoid decay. Remember that: plaque + sugar = acids = tooth decay! This doesn’t mean that you can’t eat any sugar for the rest of your life, but it is important to limit the number of times you eat sugar during the day. Sugary foods should be kept for mealtimes because then the other food you eat can reduce the amount of acid produced. For example, a small piece of cheese at the end of the meal can help to neutralise acid around the teeth. Remember – every time sugar comes into contact with plaque it causes at least a 30-minute acid attack on the teeth. So don’t eat sugar in between meals

But what if I want a snack in between meals?

If you have to eat something in between meals, make sure you choose ‘safe’ snacks e.g. wholemeal bread, cheese, fresh fruit and vegetables, nuts, diet drinks, milk. Always check the labels on foods to see if they contain sugar. The higher on the list of ingredients sugar appears, the higher the proportion there is of it.

How can I tell if I’ve got gum disease?

Your gums will bleed quite easily when brushing, they can also look red, rather than a healthy pink, and they will become swollen.

How do I make sure this doesn’t happen to me?

Regular, and most importantly – thorough tooth cleaning! You should clean your teeth and gums at least twice each day, morning and evening. Make sure that in the evening you get your mouth completely plaque-free. The time this takes will vary from person to person, but you should spend at least 2-3 minutes brushing.

What is the best way to clean my teeth?

Most plaque will form in the areas where the teeth meet the gums. It is particularly important to brush these areas thoroughly. To make sure you clean all of your teeth, concentrate on just one area at a time. Carefully brush the outside, inside and the top biting surfaces of the teeth until all areas have been thoroughly cleaned. The order in which the teeth are cleaned does not matter as much as the amount of time spent. Overall, tooth brushing (without orthodontic appliances) should last for about two minutes. Position the head of you toothbrush at an angle of 45 degrees to the teeth, allowing some of the brush bristles to overlap onto the gums. Make small circular strokes, pressing carefully, but firmly. You must brush every tooth and all the gum edges on the outside and the inside, not forgetting the biting surfaces. Develop a regular pattern of brushing to ensure that no tooth surface is missed. Use a good toothbrush with a small head, comfortable handle, and soft bristles. The amount of toothpaste about the size of a pea is all that is needed on your toothbrush.

  1. Start at the back, and carefully work your way around your mouth, making sure that you spend long enough on each tooth before moving onto the next one. Clean the outside of all upper teeth with small circular strokes, paying special attention to the areas where teeth and gums meet.
  2. Hold the toothbrush at a 45 degree angle to the teeth and gums, making sure that the bristles are touching both the gums and the teeth.
  3. Then move your brush to the inside of your upper teeth, clean the inside surface of all upper teeth with short gentle vibratory back and forth strokes.
  4. Repeat on the outside and then the inside surfaces of all the lower teeth.
  5. Cleaning the inside surfaces of the teeth can be made easier by tilting the brush.
  6. Brush the biting surfaces of both the upper and lower teeth with short gentle vibratory back and forth strokes.