Oral hygiene with braces

Orthodontic appliance hygiene does not have to be difficult or tedious. Although at first, the amount of new information and accessories may overwhelm both the little patient and his parents. What is worth changing in the daily care of teeth when braces appear in a child's life? What brush for the orthodontic appliance will not damage it and will permanently clean all nooks and crannies? In this post, we explain in detail how to care for oral hygiene during treatment with orthodontic appliances, both fixed and removable.

Child's braces: does the treatment process always look the same?

Beautiful, straight, and well-cared-for teeth are a calling card that stays with a child for life. Especially since they improve not only their well-being and appearance. Orthodontic braces that correct malocclusion are also an investment in their health. In the long term, they impact, among other things, eating comfort, correct pronunciation, and optimal shaping of the bones, ligaments, and muscles in the facial skeleton and related structures.

There are two basic types of orthodontic appliances:

• Movable, otherwise known as removable. The child, following the orthodontist's recommendations, wears such braces for a specific part of the day. The parts of the removable orthodontic appliance are: acrylic plate (often available in many colors to choose from), screws connected to the plate and wire elements (acting directly on the teeth). The braces are created individually for the child, affecting the malocclusion in a given period of time.
• Constant. They consist of locks glued to the teeth (usually made of metal), screws and wire elements, the so-called arches, the thickness and degree of tension of which are regulated by the orthodontist. Such braces work on the teeth around the clock, because the patient cannot remove them on his own (and should not try to do it, as it may end up damaging the teeth!).

Expert advises

It is the orthodontist who decides what type of braces will be used in a given child and how long the treatment process will take, taking into account: the type and complexity of the malocclusion, age and cooperation between the patient and the specialist. This last point - contrary to appearances - is crucial for the success of orthodontic treatment and in children should be carried out under the constant supervision of parents. Cooperation with an orthodontist includes not only regular check-ups, but also compliance with the received dietary recommendations and those regarding the proper hygiene of the orthodontic appliance and teeth.

Alicja Zawislak

Dentist, Orthodontist, Molecular Biologist, Acting Head of the Department of Maxillary Orthopedics and Orthodontics, Institute of Mother and Child

Food debris and plaque accumulate in the nooks and crannies of braces. Therefore, improper oral care during orthodontic treatment can result in, among other things, increased cavities, enamel discoloration, gingivitis, painful thrush, and unpleasant breath. Straight but neglected and "holey" teeth? A young patient can avoid this with the support of their parents and the orthodontist, who will demonstrate how to properly clean teeth with braces during the first visit.

Accessories useful for cleaning teeth with orthodontic braces

Before we discuss the oral cleaning process itself, we need to consider how to clean your teeth and braces. Which toothbrush is best for orthodontic braces? First of all, to thoroughly clean all the components of your braces and your teeth, one type of toothbrush is usually not enough. There are many products available on the market that help with proper orthodontic brace hygiene.

Examples of types of brushes for braces:

• Contoured, manual brush with soft bristles arranged in the shape of the letter "V". Especially recommended for fixed appliances. It helps to clean the entire surface of the apparatus from accumulated sediment and food debris. For some electric toothbrushes, you can also buy specially profiled heads for cleaning parts of the fixed orthodontic appliance.
• Interdental brush, the shape resembling a small brush (the one used for cleaning e.g. bottles). We use it to thoroughly clean hard-to-reach parts of an orthodontic appliance, tooth surfaces under wire arches or recesses around brackets. Interdental brushes have a profiled, easy-to-use handle and variable sizes of cleaning tips, which we adjust to the space between the appliance and the teeth (sometimes the size of the cleaning tip needs to be changed several times during a single wash to clean problem areas as well as possible).
• Single-tufted brush. It is a plastic handle with a bunch of soft fibers that allow you to gently and precisely clean every nook and cranny of the camera. It is perfect not only for cleaning parts of fixed orthodontic appliances, but also for the hygiene of removable appliances.
• Traditional toothbrush: manual, electric or sonic. Indispensable for cleaning the surface of the teeth without an orthodontic appliance (chewing, palatal and lingual parts of the teeth). It is suitable for treatment with fixed appliances and for cleaning teeth after removing removable appliances.

Additional accessories

Now you know which braces to choose for braces. However, apart from them, it is worth getting a few additional, very helpful accessories:

• Orthodontic, three-piece thread.In addition to the traditional part with floss (for cleaning the contact surface between the teeth), it also has a soft, sponge-covered part for thorough cleaning of the side surface of the brackets and a special, harder tip that allows easy "threading" under the arches of the braces.
• Irrigator. Equipment without which many people cannot imagine effective teeth cleaning with braces (it is also great for children and adults who do not wear braces). The electric irrigator, creating a stream of water under increased pressure, allows to "sweep" from the interdental spaces, gum pockets and recesses of the orthodontic appliance any food remnants and sediment that may have remained on the teeth and apparatus after brushing and flossing.
• Mouth rinses / washes.It is true that they will not replace the mechanical removal of plaque and food remains (brushing and flossing, above all!). However, they soothe irritations and show antibacterial properties, reducing the rate of plaque deposition.
• A special toothpaste for cleaning teeth with an orthodontic appliance. It is not essential. For oral hygiene, you can use the fluoride toothpaste used so far. Specialist toothpastes for orthodontic appliances, however, have a slightly more thin consistency and composition that may reduce the severity of the deposition of sediment on the appliance components;
• Denture brush. It has soft bristles and two specially profiled tips. They are perfect for the hygiene of removable orthodontic braces.

The use of all these accessories only at the beginning seems problematic and time-consuming, but over time, the little patient (with the help of his parents) will develop a routine that will allow for efficient dental and orthodontic hygiene.

Teeth cleaning with fixed orthodontic braces

First and foremost, we try to brush our teeth after every meal, so carrying a toothbrush and toothpaste with us is a very good idea. If, for some reason, brushing your teeth with braces isn't possible that often, it's a good idea to rinse your mouth with water after each meal. This significantly minimizes the risk of tooth decay and periodontal disease.

How to clean teeth with fixed braces?

1. Remove any movable parts of the orthodontic appliance such as pulleys.
2. With the use of toothpaste, we thoroughly brush the surface of the apparatus, using a specially profiled manual or electric toothbrush (bristles at a 90-degree angle to the apparatus). Then we set the brush at a 45-degree angle, with a circular sweeping motion, cleaning the surface of the teeth to which the braces are attached.
3. Using an interdental brush and / or a single-tuft brush, we clean the spaces between the teeth and the arches of the braces, and all nooks and crannies of the brackets. Cleaning is carried out carefully so as not to damage parts of an orthodontic appliance.
4. With a traditional, flat brush, we clean the surface of the teeth to which the braces are not attached (palatal and lingual - unless the child has a fixed lingual appliance attached to the inside of the teeth) and the chewing part of the teeth.
5. Using orthodontic thread, we clean the spaces between the teeth and hard-to-reach places of the braces. We guide the thread carefully so as not to damage the elements of the fixed braces. When working on new teeth, we make sure that you always use a clean, unused part of the thread.
6. We use an irrigator / mouth rinse.

How to clean your teeth with braces removable?

When it comes to removable braces, there's one key rule: only place clean braces on clean teeth. Never brush your teeth with removable braces in place: always remove them before beginning oral hygiene, cleaning your teeth and braces separately. Brush your teeth traditionally using fluoride toothpaste , a toothbrush, dental floss, and a mouthwash and/or rinse.

More parents and children have problems with proper hygiene of removable orthodontic appliances – how to clean them properly?

1. Before each insertion into the mouth, the apparatus should be rinsed under running water and washed: what brush for braces removable? Traditional brushes with very soft bristles that do not scratch the acrylic surface of the camera work very well. You can also purchase a delicate but precise toothbrush for dentures, which will help you reach hard-to-reach nooks and crannies. For cleaning, we use a preparation for dentures, water with a little soap or a special paste for orthodontic appliances. Ordinary paste may scratch the surface of the camera too quickly. When cleaning the removable appliance, hold it by the acrylic part (a grip on the wire elements may damage them).
2. Use a single-tuft brush to clean hard-to-reach ones parts of an orthodontic appliance.
3. Rinse the appliance thoroughly and put it in your mouth (after brushing your teeth!) Or store it in a ventilated, dry place until the next use. The orthodontist usually supplies the patient with a special container for storing a clean appliance.

Expert advises

To get rid of sediment and limescale, which are often deposited on the braces, it is worth cleaning the braces once every two weeks with special tablets (e.g. for cleaning dentures). According to the manufacturer's instructions, it is usually enough to dissolve the specificity in a glass of water in which the removable apparatus is immersed for a certain amount of time.

Alicja Zawislak

Dentist, Orthodontist, Molecular Biologist, Acting Head of the Department of Maxillary Orthopedics and Orthodontics, Institute of Mother and Child

Oral hygiene with braces: what else is worth knowing?

Especially at the beginning, it's worth helping your child become familiar with the new orthodontic appliances before they become proficient in using them themselves. Talk to your child frequently about the importance of regular dental and brace care. A child won't consistently keep their braces and mouth clean if they don't understand why. Daily parental supervision is also essential, especially if the child is under 12 years of age. However, older teenagers should also be regularly reminded about proper brace hygiene.

Despite regular orthodontic visits and home hygiene, it's important to visit the dentist . These should occur at least every six months. If your child wears removable braces, bring them with you to the appointment. The dentist will check the oral health of your child with braces. If necessary, they will treat any cavities and perform dental hygiene (tartar removal and fluoride application).

Author

Alicja Zawislak

Dentist, Orthodontist, Molecular Biologist, Acting Head of the Department of Maxillary Orthopedics and Orthodontics, Institute of Mother and Child