Oral Hygiene

Teeth move more quickly in a healthy gums environment!

When orthodontic appliances are placed, we provide detailed instructions regarding the care of your appliances. In addition, we apply fluoride to your teeth and give you a Sonicare rechargeable electric toothbrush.

We also instruct our patients on the best way to ensure a clean and healthy smile – brushing and flossing. Braces themselves do not cause decay, but they act as a shelf and hold food and debris on the teeth until it is removed by brushing and flossing. Food particles that are allowed to accumulate on the teeth and braces will turn into plaque. Plaque that is left on the teeth will calcify and harden into calculus (tartar.) The bacteria that results from this accumulation of plaque/tartar can lead to gum disease, tooth decay, and even loss of teeth. It is also prudent to minimize the amount of sugar in the diet, especially during orthodontic treatment. When sugar mixes with the bacteria in plaque, it forms an organic acid that demineralizes or breaks down the enamel on the teeth. The result of the demineralization is a permanent white scar on the surface of the tooth known as decalcification. Allowed to continue, the enamel breakdown will eventually result in a cavity, potentially even on the visible surfaces of the front teeth. To avoid these problems while you are in orthodontic treatment, take special care of your braces, teeth, and gums EVERY DAY to ensure you will have the best possible result.

We give each of our braces patients a Sonicare toothbrush and a home care starter kit at the start of treatment. As well, you will be given detailed oral hygiene instructions involving the use of the items in the orthodontic oral home care kit. It is of utmost importance that the dental cleanings and check-ups are continued with your general dentist at least every 6 months during orthodontic treatment. In some cases, more frequent dental cleaning may be necessary.

If you notice areas where the gum tissue appears larger or swollen or if it bleeds when you brush, this almost always means that you need to brush and floss better in that area.


Most people do a better job in cleaning their teeth with a Sonicare brush than with a manual toothbrush, so our doctors recommend that you use the Sonicare brush that we give to you with a small strip of fluoride toothpaste. When you brush your teeth, move the brush in small, circular motions to reach food particles that may be under your gum line. Hold the toothbrush at an angle toward the gums and brush slowly and carefully, covering all areas between teeth, between braces, and the surface of each tooth. It will take you a minimum of 2 ½ to 3 minutes to thoroughly brush your teeth, braces, tongue and roof of your mouth. This means at least 5 to 6 “beeps” of the Sonicare toothbrush. Be sure to brush the outside, inside and chewing surfaces of all top and bottom teeth. Also, brush your tongue and the roof of your mouth before you rinse.

While we recommend brushing three times per day, it is critical that you do a very thorough job of cleaning the teeth at least one time each day.  So, for instance, the lunch time brushing could be a quick one to just get the food out of your teeth as long as you brush well at other times. If you brush three times per day but miss cleaning some teeth each time, those teeth will accumulate plaque and likely develop problems over time.

While wearing orthodontic appliances, you will need to replace your toothbrush head approximately every 8 weeks or when the bristles begin to fray. The Sonicare brushheads are available for purchase at retailers such as Kohl’s, Target, Sam’s Club or Costco. They may also be purchased online. It will be difficult for your toothbrush to reach some areas under your archwire which makes it especially important that you take your time and brush thoroughly. After brushing, it is important to floss and use an antibacterial mouthwash such as  Listerine Zero or Crest Pro-Health as well as a fluoride rinse such as ACT throughout your orthodontic treatment for optimal oral hygiene.


For areas between the teeth that a toothbrush can’t reach, use dental floss to remove food particles and plaque. Flossing takes more time and patience when you are wearing braces, but it is important to floss your teeth every day.

Use either regular floss with a floss threader or Superfloss (floss with a built-in threader) to floss under your archwire daily. Guide the floss up and down along the side of each tooth to the gum line, pulling out food particles or plaque. Be sure to use a clean area of the floss for each tooth so as not to put bacteria and debris from the previous tooth back into your mouth. Use care around your archwire and do not floss too forcefully around it or put too much pressure on it. Floss behind all of your back teeth.

Flosspicks can be helpful to do a reasonable job cleaning between the teeth when you are in a hurry, but flossing regularly is best.

Floss at night to make sure your teeth are clean before you go to bed. When you first begin flossing around your braces, your gums may bleed a little. Although the bleeding is not uncommon, it is indicative of a bacterial infection below the gum line. Even the mildest infection can cause the gum tissue to swell and bleed during brushing and flossing. Although the natural response to the bleeding gum tissue may be to shy away from brushing and flossing, that is exactly the opposite of what is needed. Bleeding gums is a sure sign that more frequent and more effective brushing and flossing is necessary to maintain a healthy mouth. If the bleeding does not improve after several days of excellent brushing and flossing, inform a member of our office team at your next appointment.