Braces create dozens of new places for food and plaque to hide: around every bracket, under the wire and along the gum line. The American Association of Orthodontists (AAO) warns that plaque and trapped food left around braces can cause cavities, swollen gums, bad breath and permanent white marks on teeth. That’s the last thing you want when the braces come off. This guide covers the routine and tools the AAO and the American Dental Association (ADA) recommend.
Why braces need extra effort
The AAO explains that braces take up space in the mouth and create hard-to-reach gaps where food, plaque and bacteria collect. Keeping those spots clean takes more effort, and you may need to brush more often than before. The AAO adds that good hygiene helps minimize time in treatment and supports a healthy result.
Brushing with braces
How often
Your orthodontist will give you specific instructions. In general, the AAO says to brush for two minutes after every meal or snack and before bed.
Which toothpaste and brush
The AAO recommends an ADA-accepted fluoride toothpaste, preferably without whitening. Either a manual or power toothbrush is fine. The AAO says to use the one that works best for you. Change the brush or brush head at the first sign of wear, or at least every three months.
Technique
The ADA’s general advice to hold the brush at a 45-degree angle to the gums and use short, gentle strokes still applies. See how to brush your teeth properly.
Afterward, check your work in a mirror. The AAO suggests carrying a pocket mirror to spot leftover food.
Flossing with braces
The AAO calls flossing crucial during orthodontic treatment and recommends flossing at least once a day. The wire is the obstacle, and there are tools to get past it:
- Floss threader or pre-threaded floss. The AAO recommends these to pull floss under the archwire and clean tight spaces.
- Flossers. For people with aligners, the AAO says flossers may be an easier option.
- Water flossers. The ADA notes that people with braces may find a water flosser helps them reach every nook and cranny.
Once the floss is under the wire, use the ADA method: curve it into a C shape against each tooth and gently slide it up and down, without snapping it into the gums. Our flossing guide walks through it.
Helpful extra tools
- Interproximal brushes. The AAO says these small brushes dislodge plaque and food from between teeth, around brackets and between the wire and teeth.
- Water irrigators flush out food particles.
- Fluoride mouth rinse. The AAO says a daily fluoride rinse, over-the-counter or prescription, can strengthen enamel and help prevent white marks (decalcification). Your orthodontist may suggest dipping an interproximal brush in fluoride rinse. For more on rinses, see our mouthwash guide.
- Orthodontic wax. The AAO suggests carrying it in case braces make your mouth sore, especially after an adjustment.
Cleaning on the go
The AAO recommends a travel kit with a toothbrush, toothpaste, an interproximal brush, floss, a mirror and water. If you truly can’t brush after eating, the AAO says at least rinse with plain water. Rinsing after sugary snacks or drinks clears away lingering sugars that mouth bacteria thrive on.
What you eat matters more now
The ADA warns that too many sugary foods with braces can lead to plaque buildup around brackets that could permanently stain or damage teeth. The ADA suggests avoiding popcorn, corn on the cob, chewing gum, whole apples and other sticky foods. The AAO adds: avoid foods that get stuck in braces. Ask your orthodontist for a full list.
When to call the orthodontist
The AAO says to call as soon as you notice a loose or broken bracket or wire. Keep seeing your regular dentist for checkups and cleanings during treatment.
After braces
The ADA notes that treatment is usually followed by a period of wearing a retainer to hold teeth in their new positions. See retainers after braces.
Frequently asked questions
Do I really need to brush after every meal?
That’s the AAO’s general guidance, along with brushing before bed. Your orthodontist may give you specific instructions.
Can a water flosser replace string floss?
The ADA says a water flosser can help people with braces reach difficult areas. The AAO recommends flossing at least once a day with a threader or pre-threaded floss. Ask your orthodontist which combination suits you.
What are the white marks some people get after braces?
The AAO describes them as decalcification, a result of plaque left on teeth. Careful cleaning and a daily fluoride rinse can help prevent them.
Should I use whitening toothpaste with braces?
The AAO recommends fluoride toothpaste preferably without whitening during treatment.
Sources
- American Association of Orthodontists: Living With Braces
- American Association of Orthodontists: Oral Hygiene Tips During Orthodontic Treatment
- American Association of Orthodontists: The On-the-Go Teeth Cleaning Tool Kit
- ADA MouthHealthy: Braces
- ADA MouthHealthy: Flossing
By the Dentist Review Editorial Team.
This article is for general information only and is not medical advice. Talk to a licensed dentist about your own situation. See our disclaimer.
Featured image: “2015-03-10 teeth wearing dental braces” by Tamaki Sono, via Wikimedia Commons, licensed CC BY 2.0. Resized and compressed for the web.
Our guides are written and reviewed by the Dentist Review editorial team. We research each topic using public, authoritative sources such as the CDC, the National Institutes of Health (NIH/NIDCR), the American Dental Association (ADA) and CMS, and we update guides when guidance changes. Guides are for general information only and are not dental or medical advice; please read our disclaimer and learn more about us.