Oral hygiene is the practice of keeping the mouth clean in order to prevent cavities, gingivitis, periodontitis, bad breath, and other dental disorders. Oral hygiene consists of both personal and professional care.
Careful and frequent brushing with a toothbrush and the use of dental floss help to prevent build-up of plaque bacteria on the teeth. These bacteria metabolise carbohydrates in our meals and snacks and excrete acid which demineralizes tooth enamel, eventually leading to tooth decay and toothache if acid episodes are frequent or are not prevented. Frequent brushing and swishing saliva around helps prevent tartar deposits. Almost all cavities occur where food is trapped between teeth and inside deep pits and fissures in grooves on chewing surfaces where the brush, toothpaste, mouthwash, saliva and chewing gum, cannot reach.
When you have an orthodontic appliance, there are many more places that food can get caught. You will need to clean more often to keep your teeth and orthodontic equipment in good shape.
Brushing Orthodontic Appliances
Aims and Goals
Our aim is to get your teeth straight as soon as we can so that your braces or appliances will not be on for longer than they need to, and have your teeth and gums in a healthy condition at the end of your treatment.
If this is your aim too, we will all need to work together, to make it happen. We will make sure we keep your teeth moving, by changing the modules and activating or changing the wires as required. You will need to help us by avoiding breakages, and by keeping your teeth and gums healthy.
How to brush effectively while you have braces
Brushing your teeth will take a lot longer now that you have braces on. Any brush with soft bristles and a small head that is comfortable to hold is fine. In the morning we understand that your time is limited, so just a quick but thorough brush with your regular toothbrush. Start at the back and work your way around your mouth, from one side to the other. That way no teeth will be missed.
Hold the toothbrush not on top of the braces, but on the gums, wriggling in small circles. You can then push the bristles of the brush under the wires from above and below the braces to remove food and more importantly, plaque from under the wires.
This will require placing the brush in one spot, then pushing the bristles. It won’t work if you are just scrubbing the under and top sides of the braces.
At lunchtime (at school), you don’t have to brush unless you want to. You will find though, that lots of food will get caught in your braces, so you’ll need to rinse thoroughly with water to get rid of it. At night, or whenever you have more time, you should spend at least 5 minutes having a really good thorough brush.
Start with the spiral brush. This is great for getting huge chunks of food out, but it is also essential for daily use to remove all the plaque from your teeth and gums. Bend the wire part of the brush so that it is at right angles to the handle. Direct the brush under the arch wire of your braces, going from the gums towards the biting edge of your teeth, then using long strokes, brush 15 strokes, from above one bracket, to above the other bracket.
Make sure the bristles of the brush are held firmly against your gum and the tooth above/below each bracket. If you pull against the arch wire with the brush, you will be holding the brush away from your gums, and this will be ineffective. Once you have used the spiral between each of the brackets, then use your regular toothbrush in the same way discussed above. After brushing, have a good look and make sure everything looks clean and shiny. If anything looks dull or cloudy, there is still plaque there, and you need to brush again.
For the first month, you should be testing your brushing once a week, by using a plaque-disclosing tablet. These will cause any plaque in your mouth to go bright pink.
- Brush your teeth as normal
- Rinse out all the toothpaste, and then chew one of the tablets. It will taste awful, but swish around everywhere so that the dye touches all of your teeth.
- Spit it out and then rinse with plain water a couple of times.
- Have a really good look at where the pink bits are – these are the areas that you have missed with your toothbrush.
- Concentrate on these areas in the future, and check your brushing again the next week.
Extra protection for your teeth
While your braces are on, we recommend that you use a fluoride mouth rinse weekly. Fluoride is a mineral that can strengthen your teeth and make them more resistant to decay. Brush your teeth as normal, then after rinsing out all the toothpaste, take 5-10ml of Fluorocare in your mouth and swish vigorously for 30 seconds. Spit this out and then leave the residue sitting on your teeth for at least 30 minutes. It is best if this is done just before going to bed, then the fluoride will be working to strengthen your teeth all night. A helpful hint is to do this on the same night each week. Sunday nights can be your fluoride night!
If you play contact sports we can give you a non-fitted mouthguard. These help to protect your cheeks and lips from the braces if you get a hit to the face. Your braces will hold your teeth in position, but as you can imagine, all that metal being embedded into your cheeks would not be fun.
Caring for Orthodontic Appliances
We use a number of different types of appliances other than the traditional fixed appliance most people refer to as “Braces”. The types of appliances we use can be categorised as either fixed or removable:
Fixed appliances are cemented into position in your mouth. They are usually made up of metal bands around at least two teeth, and a wire joining these bands.
Care of Fixed Appliances
Avoid eating all sticky foods, as they can cause the appliance to become loose. Eating sweets between meals should also be avoided, as there is a greater chance of decay while the appliance is in your mouth.
Brush carefully around all of the wires and where the band meets your gum. If you are having difficulties getting into the small areas, please speak to our hygienist, who will be able to advise you on brushing those hard to reach areas. Floss can be used under the wire. It needs to the threaded through under the wire and then used as normal.
We use removable appliances to either hold the teeth in their new positions, or to make minor adjustments to form minor tooth movement. Clear aligners such as Invisalign are also a removable appliance. It is important that they are worn as instructed by your Orthodontist, and that you contact us if at any stage you are having problems with them.
Care of Removable Appliances
Each time the appliance/ aligner is taken out of the mouth, it should be rinsed with water to remove the saliva. This will keep the appliance from becoming slimy and hard to clean. Twice a day the appliance must be taken out of the mouth and scrubbed with toothpaste and a toothbrush. A hard toothbrush can be used on the appliance, but always use a soft one in the mouth. Do not use hot water as it can distort the appliance. Don’t forget to take your appliance out of your mouth to give your teeth and gums a thorough brush.
Your appliance should be in its box at all times when it is not in your mouth. It should never be in a pocket or bag as it can be easily lost or broken. Wrapping a retainer or aligner up in a tissue will usually result in the whole thing being thrown out, so leave it in the mouth to eat if the box is not available. If a retainer or aligner is lost or broken, a new appointment will be needed to repair or replace it.
Replacing retainers are costly mistakes, as a lab fee will need to be charged to your account.
Your speech may be affected for the first few days. Don’t remove it though, if you need to speak clearly at first, or it will take longer to get used to. The only exception to this is for singing or playing a wind instrument.