Dental Care in Braces: How to Maintain Good Oral Hygiene

This blog has been reviewed by a pediatric dentist. 

Braces are an exciting milestone for many children. Strong oral hygiene habits ensure the longevity of their smiles. Dental care in braces can be harder when it comes to keeping teeth clean and healthy. Braces often get in the way of proper oral hygiene. Dentists know that braces make flossing, removing plaque, and brushing along the gumline more difficult. 

That’s why we’ve compiled a list of tips and tricks to brush and floss more effectively in braces. 

Maintaining Good Oral Hygiene and Dental Care in Braces

1. Brush at least twice a day for two minutes each time. Brush after every meal if possible.
2. Use fluoride toothpaste to remineralize enamel and prevent cavities.
3. Try flossers and interdental cleaners to make sure flossing is effective. Floss after meals, or at least once per day. Use a “C” motion to get in between teeth and up along the gums when flossing
4. Water flossers can be added in addition to regular floss to help remove food particles that may get left behind after flossing, but should never replace regular flossing.
5. Electric toothbrushes help your child clean their teeth better than manual toothbrushes thanks to their smaller heads and vibrations.
6. Orthodontic toothbrushes are great for patients who want to brush manually, as they have V-shaped bristles to hug brackets. 

Master the 3-Angle Brushing Method 

Want your child to get the most out of brushing? Teach them the 3-Angle Brushing Method to get the most out of brushing while in braces. 

• The 45-Degree Downward Angle: Using a soft-bristled toothbrush, clean the upper edges of the brackets by placing the brush at a 45-degree downward angle. 
• The 45-Degree Upward Angle: Do the same, but at a 45-degree upward angle. 
• The Straight-On Circle: Finish by placing the bristles on top of the brackets, using gentle, circular motions.

Flossing Effectively: Tips and Tricks

• The Floss Threader Trick: Tie floss to a plastic floss threader so that the floss doesn’t slip out and is able to get between the wires. Watch this video to understand how to do it.
• Use Stiff-End Orthodontic Floss: Brands like Oral-B Super Floss have a built-in rigid plastic tip that allows your child to get the floss between their teeth.
• The Platypus Flosser: Platypus flossers are specialized orthodontic picks that have a spatula side made to go under the wires.
• Incorporate Interdental Brushes: These brushes can get into tight spaces around brackets. 

3 Common Mistakes When Brushing with Braces

1. Brushing too hard– Brushing too hard in braces doesn’t just damage gums and erode enamel; it can also damage brackets and wires.
2. Neglecting the spaces around brackets– Forgetting to angle the toothbrush to clean around the brackets means food and plaque build up, which increases cavity risk.
3. Rushing– A full two-minute brushing session every time ensures the teeth get clean. 

The Role of Orthodontists and Dentists

In simple terms, these are the main differences between the orthodontist and dentist: The orthodontist is focused on getting teeth into position, adjusting wires, and tracking jaw growth. The dentist cleans teeth, diagnoses and treats tooth decay, and applies protective fluoride treatments. 

Even though your child will have regular orthodontist visits every four to eight weeks, this does not replace going to their regular pediatric dentist. In fact, when your child is in braces, they will likely need to visit their regular pediatric dentist for cleanings more frequently (every 3-4 months). If your child’s gums bleed when they brush or look puffy and red, increase the frequency of regular dental care. The dentist can catch issues like gingivitis early to minimize the need for additional treatments.  

Why Braces Require Extra Professional Dental Care:

• Plaque Traps: Food particles hide in the spaces between brackets and wires. Plaque builds up quickly. 
• Decay Risk: Kids in braces are at higher risk of cavities due to the speed at which plaque builds up around metal. 
• White Spots: When brushing is less than optimal, permanent demineralization (white spots) forms around brackets. 
• Gum Inflammation: Trapped debris and less effective brushing at the gumline often trigger gingivitis and swollen gums.
• Hygiene Enforcement: Dentists firmly make it clear that patients must be vigilant about brushing and flossing. 

Dietary Adjustments While in Braces

Sticky, hard, and crunchy foods should be avoided while in braces. Candy and gum, especially, can stick to brackets or even pull them loose. Decreasing the amount of sugar your child consumes is also recommended to lower the risk of tooth decay. 

Poor Dental Hygiene With Braces: The Warning Signs

There are two common issues that need to be caught early to prevent permanent enamel changes and gum disease.

1. White spot lesions– These spots look chalky and opaque and typically form around brackets. They mean the enamel is demineralizing and needs professional dental intervention. 
2. Gingivitis– Bleeding, red, or swollen gums are symptoms of gingivitis. With improved brushing and flossing, gingivitis can be reversed. If allowed to progress into periodontal disease, risks like tooth loss arise. Contact your pediatric dentist if symptoms don’t improve within a week of better oral hygiene. 

Regular Dental Care Matters

If your child is in braces, they would benefit from increased dental cleanings. At a minimum, kids in braces with excellent oral hygiene should visit the dentist twice a year. At Children’s Dentistry of North Dallas, we provide professional dental cleanings to children in braces so that their smiles emerge from the process straight and cavity-free. 

Have questions about dental hygiene while in braces, or need to schedule a cleaning? Call us at 214-378-8868 or fill out this form to schedule. 

FAQs About Maintaining Oral Hygiene in Braces

Do I have to floss if I wear braces?

Yes, you absolutely need to floss. There are specialized floss options for those in braces that make it simple. 

What are the warning signs of poor oral hygiene in braces?

Chalky white spots on the teeth and gingivitis are the two main indicators that oral hygiene needs to be improved.

Should I be brushing more often while in braces?

Yes, if possible, you should brush and floss after each meal. At a minimum, brush twice a day for two minutes each time and floss daily. 

What are common mistakes people make while brushing in braces?

The three most common mistakes are brushing too hard, neglecting the brackets when brushing, and rushing through brushing. 

Why do braces require additional professional dental care?

Braces trap plaque, increase decay risk, increase gingivitis risk, and generally call for more frequent dental visits, both at the orthodontist and at the regular dentist. These professionals ensure everything looks healthy and is progressing as it should. The dentist can catch cavities early, monitor gingivitis, and provide more frequent dental cleanings to protect your smile.