Oral hygiene and orthodontics

By Sarah Macdonald DipOrthTher RCSEd

Whether you’ve decided on fixed or removable braces, it’s important that you keep them, and your mouth clean. This short article should emphasise why a high standard of oral hygiene is crucial during orthodontics, and how you can look after your teeth and gums while achieving a beautiful smile.

The last thing you want after all the time and effort involved in getting straight teeth is to cause damage (sometimes irreversible). We’ve all heard the horror stories, granted most are exaggerated, but there is truth behind some of them.

I wouldn’t normally recommend brushing straight after meals due to the abrasive nature of the action, it can be harsh on the already compromised tooth structure due to the acids and sugars in our foods. However, when it comes to braces, you’re going to want to brush immediately as there are so many additional areas for food and plaque to get trapped. I appreciate this isn’t always going to be possible, but the general advice is to brush three times daily and to use a fluoride mouthwash in between times. Floss, or use interdental brushes once a day every night before brushing, using the technique shown to you and sizing recommended by your hygienist. Also be sure not to rinse away toothpaste with mouthwash or water before you go to sleep, just leave a coating over the teeth to soak in over night to make your teeth stronger and restrengthen any weakened areas.

You’ll also soon learn to leave the house armed with pocket sized cleaning aids if you find yourself in a situation where brushing may not be accessible. Electric or manual tooth brush? It doesn’t matter, its how you use it that’s important. The temptation is to scrub, don’t, small circular motions are more effective in the removal of plaque. Your gums and tongue are just as important as teeth, and require as much care and attention in your routine, this extra attention can reduce the risk of bad breath during your treatment.

An increase in sensitivity is normal whilst teeth are moving, it may be worth investing in a specific toothpaste to target this. Try to avoid whitening toothpastes as the micro particles can chip white-coated wires and roughen aligners. This can cause aligners to be more porous resulting in a cloudy appearance and increase risk of potential staining. This extends to retainer care as well, clean removable retainers with a separate brush, soap and lukewarm water. Pay extra attention to fixed retainers in your daily routine. Proper care will save you money in future!

Excellent oral hygiene will significantly aid treatment goals, whereas poor oral hygiene can impede the process and can ultimately lead to delays and possibly damage. Please ask if you are unsure and inform your clinician if you experience or notice anything out of the ordinary for you, as oral care requirements vary from person to person, and although most of the time you will be reassured, any changes should be monitored.


I’m very grateful to Sarah for writing another great post for my blog. You can read her first post on orthodontic therapy here.