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VERIFIED CONTENTAuthor: Dominika Wilk

An orthodontic appliance is the best invention for correcting a malocclusion or crooked dentition, but it has one serious disadvantage - it promotes faster plaque deposition, and thus increases the risk of caries. If you wear such braces and you do not want to have cavities, check how to properly clean your teeth and what accessories you should use to fully take care of oral hygiene.

Why does wearing braces increase my risk of tooth decay?

A greater risk of caries development when wearing a fixed orthodontic appliance is associated with the presence in the oral cavity of additional braces, such as brackets, springs, as well as materials necessary for their attachment, which make it difficult to clean the tooth surface.

This is both about the problem of self-cleaning of the teeth with the help of saliva, which in the oral cavity washes the teeth without braces and thus washes away food residues, as well as difficulties with mechanical cleaning with a toothbrush or additional accessories cleaning agents such as: dental floss, cleaners.

Braces and increased bacterial biofilm

Bacteria in the mouth may appear as diffuse microorganisms or clump together to form a biofilm. In the latter case, they are surrounded by polymers of sugars and proteins, which additionally protect them against removal from the surface of the teeth.

In an orthodontic mouth, bacteria are continually flushed away with saliva, reducing the risk of plaque build-up. Additionally, saliva maintains the pH between 6.75 and 7.25, making the environment unfavorable for microorganisms.

Bacterial biofilm, under favorable conditions for the microorganism (e.g. when wearing an orthodontic appliance), can be formed in a few hours. First, a skin appears on the teeth (it can be formed even a few minutes after brushing the teeth), to which planktonic bacteria attach. Their attachment to the tooth is not yet stable.

For this to happen, bacteria start to produce a special, slippery substance that allows them to stick better to the surface of the teeth. Then, thanks to the splitcells, the microbial colony begins to grow to form a biofilm.

After creating the appropriate thickness of the colony, some of the clustered bacterial cells may detach and attach to the next surfaces of the teeth. This way it takes up new areas.

The orthodontic appliance creates conditions conducive to the formation of biofilm. It is easier for bacteria to surround the surface of the teeth under the individual parts of the appliance, and saliva has more difficult access to the enamel and cannot wash it thoroughly.

According to scientific reports, long-term orthodontic treatment promotes the growth of bacteria responsible for the development of caries and increases the risk of periodontitis. Therefore, people wearing orthodontic appliances must expect an increased number of cavities, enamel demineralization or gingivitis.

How to clean your teeth with an orthodontic appliance on?

Although many people are used to brushing their teeth with an ordinary manual brush with flat bristles, after putting on the orthodontic appliance, they must change it to an orthodontic brush with different bristles and a special groove in the middle. There is one reason: this type of brush can reach all layers of the tooth and the braces.

An ordinary toothbrush only slides over the surface of the appliance and it will not be possible to thoroughly clean the teeth. When the longer bristles of an orthodontic brush reach the teeth and clean them thoroughly, the shorter bristles clean the parts of the appliance at the same time. If someone is unable to brush their teeth manually, they can reach for an electric toothbrush.

It is important, however, that he use a special tip designed for cleaning the orthodontic appliance. This type of toothbrush will make brushing your teeth easier, although you should also pay close attention to whether all the nooks and crannies between the teeth and the appliance have been cleaned.

In addition to the dedicated brush, a special orthodontic thread is required, as well as an irrigator and mouthwash to maintain complete oral hygiene.

How to properly clean teeth with braces?

In oral hygiene, the frequency of brushing your teeth and orthodontic appliances is important. While for teeth without braces it is enough to wash them twice a day, in orthodontic patients it must be multiplied.

Sometimes the situation calls for brushing your teeth after each meal, especially where food gets stuck between the braces and teeth. Research shows that the frequency of washing is related to the formation of lesions in the oral cavity.

One of the statistical analyzes conducted among children wearing orthodontic appliancesshowed that children who brushed their teeth more often, at least 3 times a day, and who thoroughly cleaned the braces with a toothbrush, had no changes in their teeth or mucosa.

On the other hand, those children who limited themselves to oral hygiene only 2 times a day, and who did not wash the apparatus but rinsed it, had lesions (up to 64% of respondents).

Both children wearing fixed and removable braces participated in the study. However, this does not change the fact that more frequent hygienic procedures and thorough washing of the appliance that covers the teeth determine the frequency of carious and gingival changes.

As recommended by orthodontists, people wearing fixed braces should brush their teeth after each meal.

Stages of brushing teeth with an orthodontic appliance in place

The first step in cleaning your mouth with an orthodontic appliance should be to thoroughly clean the braces on the front. This can be done, for example, with a manual orthodontic brush, which we place horizontally and then we clean the surface of the braces.

The next step is to use a brush to sweep your teeth, similar to the one we use to clean our teeth without braces. Then we place the brush at an angle of 45 degrees and, starting from the gum line, make a sweeping motion towards the braces and the bottom of the teeth. We do this with each tooth in turn.

The second step is cleaning the interdental surfaces. A special interdental brush, the so-called swab, helps to keep them clean, which we put under the wires of the braces and there we use it to clean both the braces and the interdental spaces. This stage is complemented by the use of a small brush-shaped brush, which will clean the space that we have not been able to clean with a swab.

The third stage is the thorough removal of all food particles with a special orthodontic thread. It differs from a regular thread in that it has three layers. The first one is stiff, the second is soft and is used to clean braces and interdental spaces, and the third one resembles a regular dental floss.

We thread this thread under the wire of the braces, insert it into the interdental space and remove the remains of food that we were unable to clean with the brush.

The last step is rinsing the mouth with a special disinfectant liquid. It allows us to maintain full oral hygiene and has a bactericidal effect. When wearing a brace, however, it is important to use a colorless liquid, as colored fluid can discolor the elastics and cause a brown formation around the teeth.discoloration.

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