Oral Hygiene – The Basics
The objective of orthodontic treatment is straightening of the teeth and correcting the bite. If the health of the teeth is ignored along the way, the treatment result can be significantly compromised. Therefore, effective brushing and flossing is one of the most critical actions needed from patients during Orthodontic treatment. Regular visits to the general dentist for check -ups and cleaning are also vital.
Inadequate oral hygiene leads to decalcification (white, yellow or brown spots/marks), gingivitis (inflammation of the gums), and periodontal disease (damage to the tooth supporting tissues leading to bone loss).
A common misconception is that the braces themselves cause marks on the teeth. The reality is that the plaque left around the braces causes decalcification. Fortunately, decalcification is preventable by thorough brushing and flossing, along with regular visits to the general dentist and hygienist.
Brushing
In order to prevent decalcification, a regular and effective brushing technique is required. Each tooth needs to be cleaned including a surrounded gum. Notice that only a couple of teeth at a time are brushed. This helps concentrate on specific areas around the braces and along the gum line. The angle of the brush is important in order to properly clean all sides of the teeth and under the wire. Using a battery operated toothbrush can make brushing easier and therefore more effective.
Flossing
Using floss between the teeth is also very helpful during braces. The space between the teeth is unreachable by a brush, so regular flossing will help to prevent plaque build-up in these areas. With braces, the wires will prevent the usual technique for flossing. Therefore, the floss can first be threaded underneath the wire by hand. The best floss for thhe job is Superfloss by Oral B.
Interdental brushes
TePe brushes are quite useful to insert in between the brakcets under the wire. Use them to clean the side edges of the brackets that are hard to reach with a toothbrush.
Mouthrinse
In addition to proper brushing and flossing, daily use of a fluoride rinse will help reduce the chance of developing cavities and white spots on the teeth. The best way to a mouthrinse is to check the label the bottle. It should indicate that it contains Fluoride. Antibacterial mouth rinse such as Corsodyl should only be used under the instruction of the Orthodontist.
Additional brushing instructions to keep in mind.
Frequent visits with a general dentist for examination and cleaning are critical to prevention. Most people see their dentist every 6 months. Some patients may need more frequent visits. Talk to the orthodontist and dentist about their recommendations.
Also, it is important that the teeth are brushed after every meal. Food can collect very easily around the braces and therefore needs to be removed on a regular basis. It has been proven that it takes 24 hours for a plaque to become “sticky” and start to adhere to tooth surface.
Furthermore, avoid trying to brush all the teeth at once. It helps to limit brushing to a couple of teeth at a time. Do not rush. I usually recommend to spend at least 2 minutes each time. For teenage patients a good indication of time is a song (as most teenagers are obsessed with music). This way, areas on certain teeth will not be missed.
In addition to this, effective brushing requires time. Avoid rushing and make sure any areas that may have been missed are checked and re-brushed. A good technique would be to use a timer (some electric toothbrushes have timers built in).
Lastly, brush from the top, bottom, and middle towards and between the braces and wire. Also remember to brush gently towards the gums , since aggressive brushing can cause recession of the gums.
Disclosing tablets
At the start of your Orthodontic treatment, a good idea is to self-check your brushing. For this purpose, a specially designed plaque disclosing tablets or liquid is used to indicate if all areas are plaque free. If not, the areas where plaque was not fully removed, will pick up the colour of disclosing tablet or liquid (pink/purple). If this is the case, those areas need to be re-brushed and disclosing tablets used again.
