In our last blog we talked about how brushing and flossing relate to orthodontic treatment with either braces or clear aligners. We also talked about why it is extremely important to have a good diet, brush and floss daily, and maintain consistent dental care and hygiene visits to maximize oral and dental health as well as aesthetics. We want to follow this up with some specific instructions on how to do a great job of brushing and flossing with braces and encourage readers to develop great oral hygiene habits as they go through treatment with clear aligners.
Let’s do brushing and flossing with clear aligners first. This is easy…it’s the same as if you were not doing any treatment. Since the aligners are removable, you can just take them out and brush and floss normally. The recommended routine can be followed, but you are well advised to brush, floss, and rinse your mouth more frequently because the aligners can trap food debris, liquids, and other sugars that can be detrimental to the health of the teeth.
A normal home care cleaning routine as recommended by the ADA (American Dental Association) is to brush twice a day for 2 minutes with a fluoride toothpaste and floss once a day. The ADA recommended brushing technique is to hold the brush with the bristles at a 45-degree angle facing towards the gums and brush using short back-and-forth motions using light pressure against the teeth and gums to clean the whole surface of each tooth using a soft bristled toothbrush. This technique should be used to clean every exposed surface of each tooth, the outside, the inside, and the chewing surfaces.
Unfortunately brushing does not clean the surfaces between the teeth. This is where flossing comes into play and why it is so important. The proper flossing technique is to gently slide the floss between the teeth then once it is below the contact, pull the floss into a C-shaped curve around the side of the tooth and slide it up and down along the side of the tooth to clean that area. Then do the same for the adjacent tooth and pop the floss out of the contact and move into the next area between the teeth. This is to be done between every tooth and for the back of each of the terminal tooth surfaces at the back of the mouth.
Although very similar, the AAO (American Association of Orthodontists) has a little different recommendation for brushing and flossing with traditional braces. They recommend using a soft bristled toothbrush specifically designed for use with braces brushing at least twice a day; after meals, and before going to bed. The recommended brushing technique is to hold the brush with the bristles at a 45- degree angle facing away from the gums and brush and using small circular motions to brush around the braces, under the wires, and massaging the gums, paying particular attention to the tooth area between the gums and the braces. If this does not clean the tooth between the chewing surface and the braces, hold the toothbrush so the bristles point straight at the tooth and brush that area making sure the tooth is being cleaned as well as the area under the wire and between the braces. Focus on tight spaces where plaque can build up and infect the gums or damage and discolor the teeth.
The flossing technique is the same, except it is impossible to get the floss to go between the teeth and under the gums with the orthodontic wires in place. Use a floss threader to feed the floss underneath the wire, then follow the flossing technique detailed above. You will need to thread the floss underneath the wire between every set of teeth to be flossed, so it is more time consuming, but is worth the extra effort!
There are some new brace treatment techniques that place the braces on the inside instead of the outside, making treatment virtually invisible. The recommended brushing technique is the same for braces on the inside as well as the outside of the teeth. The flossing technique is the same for braces on the inside if the technique is older and uses a flat continuous wire running from brace to brace. If it is a newer modern technique, the wires do not interfere with the ability to floss, and the technique is the same with or without the braces.
Good oral hygiene and proper brushing and flossing techniques pay big dividends in the long run.