Braces on teeth make brushing and flossing a little more demanding. Food can collect around the brackets and under the wires, while plaque can build up in areas that were much easier to reach before treatment.
Keeping these areas clean helps protect your teeth and gums throughout orthodontic treatment. It is especially important for preventing tooth decay, swollen gums and the white marks that can sometimes become visible once the braces are removed.
If you have braces, whether you are a few weeks in or mid-treatment, the hygiene habits you form now have a direct bearing on what your teeth look like at the end.
Why Is Oral Hygiene So Important & What Happens if You Do Not Brush Well with Braces?
Tooth damage during orthodontic treatment comes from plaque, not from the braces themselves. This is because the brackets and wires can make certain parts of the teeth harder to reach during brushing, allowing plaque and food debris to collect.
If these areas are repeatedly missed during brushing and flossing, several problems can develop.
1. Higher Risk of Tooth Decay
Plaque contains bacteria that produce acids when they break down sugars from food and drinks. If plaque remains around the brackets or between the teeth, those acids can gradually weaken the enamel and increase the risk of cavities.
Braces can make these areas harder to clean, which is why HealthHub 1 recommends brushing after meals and paying particular attention to the spaces around brackets and hooks.
2. Swollen or Bleeding Gums
Plaque can also build up along the gum line and irritate the gums, leading to gingivitis. This can make your gums look red or swollen and cause them to bleed when you brush or floss. Paying closer attention to the gum line when cleaning can help reduce the inflammation. If the redness, swelling or bleeding continues, have your gums checked by a dentist.
3. Persistent Bad Breath
Food trapped around braces can contribute to bad breath, particularly when plaque is also building up in areas that are difficult to reach.
Regular brushing and cleaning between the teeth helps remove both plaque and the food debris that bacteria feed on. The American Association of Orthodontists 2 lists bad breath among the problems that can occur when plaque and food remain around braces.
4. White Spots Around the Brackets
One of the more noticeable problems associated with poor plaque control during fixed-brace treatment is enamel demineralisation, which can appear as chalky white areas on the teeth.
These marks form when plaque acids repeatedly remove minerals from the enamel around the brackets. A study involving more than 9,000 patients found a pooled white-spot-lesion prevalence of approximately 55% among orthodontic patients 3, although rates varied considerably between studies.
Good brushing, daily cleaning between the teeth and appropriate fluoride use can help reduce the risk.
5. Tartar Build-Up
Plaque that is not removed can harden into tartar, especially around brackets and other areas that are harder to reach with braces. Unlike plaque, tartar cannot be removed with regular brushing and needs to be cleaned away professionally.
A dentist or dental hygienist can also identify areas where plaque is accumulating and show you how to clean around your braces more effectively.
6. Orthodontic Treatment May Need to Be Interrupted
Poor oral hygiene can become serious enough to affect whether orthodontic treatment can safely continue. If plaque is repeatedly left around the braces and the teeth are at increasing risk of decay or permanent damage, an orthodontist may need to remove the appliance before treatment is complete.
This is not a routine outcome, but it shows why brushing, interdental cleaning and regular dental check-ups remain important throughout treatment.
How to Brush Your Teeth With Braces
Photo by Katarzyna Zygnerska on Unsplash
You do not need an elaborate routine. The best way to clean your braces is to spend more time around the brackets, wires and spaces between the teeth.
Step 1: Brush Carefully Around Your Braces
HealthHub recommends brushing after every meal when you have braces because food and plaque can collect around the appliance more easily. If you cannot brush while you are out, rinse your mouth thoroughly with water until you can.
Brush for around two minutes and make sure you clean:
- Above and below each bracket
- Along the gum line
- Behind the teeth
- The chewing surfaces
- Around hooks and other areas where food tends to collect
Use a soft-bristled toothbrush and angle the bristles towards the gum line so they can reach around the brackets. Small, controlled strokes are usually easier than scrubbing quickly across the braces.
Which Toothbrush Should You Use?
You do not necessarily need a special orthodontic toothbrush.
HealthHub recommends a toothbrush with soft, rounded bristles 4. If you prefer an electric toothbrush, a small round oscillating head can also be suitable.
An interdental or single-tuft brush can be useful for areas that your normal toothbrush struggles to reach.
Which Toothpaste Should You Use?
Choose a fluoride toothpaste.
HealthHub recommends toothpaste containing more than 1,000 ppm fluoride 5 for people wearing braces. Fluoride helps strengthen enamel and protect against tooth decay.
You may also want to avoid whitening toothpaste while wearing fixed braces. The brackets cover part of each tooth, so whitening products cannot act evenly across the entire enamel surface.
Step 2: Clean Between Your Teeth Every Day
Brushing cannot reach all the plaque between neighbouring teeth.
Floss once a day using a method that works around your braces. Options include:
- Waxed dental floss with a floss threader
- Super floss designed for braces
- Interdental brushes
- A water flosser
A floss threader helps guide floss underneath the archwire so you can clean between the teeth normally. Interdental brushes are also useful for reaching underneath wires and around bracket edges. HealthHub recommends daily interdental cleaning for people wearing braces.
Whichever method you use, be gentle around the wires and gums.
Step 3: Use an Interdental Brush for Tight Areas
An interdental brush has a small head that can fit underneath the archwire and between brackets. It is particularly useful after meals when you can see food caught around the appliance but cannot reach it easily with your toothbrush.
Move the brush gently through the space instead of forcing it between the teeth or against the wire.
Step 4: Use Fluoride Mouthwash if Recommended
A fluoride mouthwash can provide additional fluoride protection during orthodontic treatment.
HealthHub recommends using a fluoride mouth rinse for around one minute at least once a day, particularly at night 6. There is no need to use it after every meal.
Follow the product instructions and any advice given by your dentist or orthodontist.
What Should You Avoid Eating With Braces?
Braces do not mean giving up every crunchy food, but you do need to be more careful about anything that can stick to the appliance or damage the brackets and wires.
Try to avoid these foods when you have braces:
- Caramel and toffee
- Chewing gum
- Popcorn
- Hard nuts
- Hard sweets
- Very sticky or chewy foods
These foods can become trapped around the appliance or place enough force on the braces to loosen or damage a component.
You can still eat firmer fruits and vegetables such as apples and carrots. Cut them into small pieces instead of biting directly into them with your front teeth. HealthHub specifically recommends this to reduce the risk of damaging the wires.
How Do You Know if Your Braces Are Properly Cleaned?
After brushing, take a quick look in the mirror.
There should not be visible food around the brackets, and your teeth should feel clean rather than coated. Pay particular attention to the gum line and the areas directly above and below each bracket, as these are easy to miss.
Other signs that your routine may need some attention include:
- Gums that regularly bleed when brushing
- Persistent redness or swelling
- Bad breath that does not improve after cleaning
- Visible plaque around the brackets
- New chalky white areas on the enamel
If you are unsure whether you are reaching every area properly, ask your dentist to show you where plaque is collecting and how to clean those spots more effectively.
Keep Your Teeth Healthy Throughout Braces Treatment
Good oral hygiene with braces is mostly about being consistent. Brush carefully around the brackets, clean between your teeth every day and pay attention to areas where food repeatedly gets trapped.
Regular dental reviews are also important because early signs of decay, gum inflammation or enamel demineralisation may be easier to manage when they are identified sooner.
TWC Dental provides dental and orthodontic care at our Yishun and Jurong dental clinics. If you are unsure about cleaning your braces or have noticed changes in your teeth or gums during treatment, contact TWC Dental to arrange a dental review.
1. https://www.healthhub.sg/well-being-and-lifestyle/personal-care/how-to-care-for-your-teeth-when-you-have-braces
2. https://aaoinfo.org/whats-trending/life-during-treatment/
3.. Prevalence, Incidence and Risk Factors of White Spot Lesions Associated With Orthodontic Treatment – A Systematic Review and Meta-Analysis – PubMed
4. https://www.healthhub.sg/well-being-and-lifestyle/personal-care/how-to-care-for-your-teeth-when-you-have-braces
5. https://www.healthhub.sg/well-being-and-lifestyle/personal-care/how-to-care-for-your-teeth-when-you-have-braces
6. https://www.healthhub.sg/well-being-and-lifestyle/personal-care/how-to-care-for-your-teeth-when-you-have-braces