Braces do their job of straightening teeth regardless of how well you clean around them, but the surrounding gums and enamel will only stay healthy if you adapt your oral hygiene routine to the extra hardware in your mouth. Brackets and wires create dozens of new nooks where food and plaque can hide, which is why cavities and gum inflammation are the most common complications during orthodontic treatment. This guide walks through exactly how to brush, floss, and maintain a healthy mouth from the day braces go on to the day they come off.
Standard brushing motions miss the small ledges above and below each bracket where plaque collects, so a modified technique is needed. Angle the bristles of a soft-bristled toothbrush toward the gumline and brush in small circular motions along the top of each bracket, then repeat along the bottom edge, effectively brushing each tooth in three sections rather than one broad sweep. An electric toothbrush with a small, rounded head can make this easier and more consistent, especially for children still building the manual dexterity for careful brushing. A full brushing session with braces typically takes longer than without, often close to three minutes, precisely because of this extra care needed around each bracket.
Flossing is more time-consuming with braces because the archwire blocks the floss from being threaded normally between teeth, but skipping it lets plaque build up between teeth where a brush cannot reach. An orthodontic floss threader, which looks like a small plastic needle, lets you guide floss under the archwire and between each pair of teeth. Pre-threaded orthodontic flossers, sold specifically for braces wearers, speed this process up considerably and are worth keeping at home, in a school bag, or at the office for a midday clean. Water flossers are a helpful supplementary tool that can dislodge trapped food quickly, though they work best in combination with, rather than as a full replacement for, threaded floss.
Beyond a soft-bristled or electric toothbrush and floss threaders, an interdental brush (a tiny bottle-brush-shaped tool) is excellent for cleaning directly around and underneath the archwire and between brackets. A fluoride mouthwash used once daily adds an extra layer of protection against decay in hard-to-reach spots, and disclosing tablets, which temporarily stain leftover plaque a visible color, can be a useful teaching tool for children to see exactly where they are missing spots during brushing.
Inconsistent cleaning during orthodontic treatment can lead to two common problems: gingivitis, where gums become red, swollen, and prone to bleeding due to plaque buildup along the gumline, and decalcification, permanent white or discolored spots on the enamel around where brackets sat, visible once braces are removed. Both are largely preventable with a consistent routine but can be difficult to reverse once they occur, which is why orthodontists check gum health and enamel condition at every adjustment visit and will flag early warning signs before they become permanent problems.
The most successful braces patients treat oral hygiene as a short daily ritual rather than an afterthought: brush after breakfast and dinner at minimum, floss with a threader at least once daily, ideally before bed, and keep a travel kit with a toothbrush, floss threaders, and wax handy for school or work. For younger children, parents may need to check or assist with brushing technique periodically throughout treatment, since thorough technique around brackets takes practice to master.
Brush after every meal or snack if possible, or at minimum in the morning, at night, and once during the day. Braces trap food more easily than smooth teeth, so more frequent brushing helps prevent plaque buildup around the brackets.
A water flosser is an excellent addition for braces wearers because it can flush out debris that string floss struggles to reach around wires, but it works best alongside, not instead of, a floss threader or orthodontic floss for a truly thorough clean between teeth.
These are decalcification marks caused by plaque sitting against the enamel around brackets for extended periods, often from inconsistent brushing. They can sometimes be improved with fluoride treatments or cosmetic procedures, but they are best avoided through diligent daily cleaning during treatment.
Speak to our team about the right cleaning routine for your braces today.
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