As you eat, your teeth, braces and appliances collect food.
If food is left on teeth overnight, a thick plaque forms on
the teeth and gums. Plaque causes bad-breath, tooth decay
and gum disease (swollen, puffy, red, overgrown, or bleeding
gums). Drinks and foods containing sugar can damage the tooth
surfaces and gum tissue. Bleeding and swollen gums are a sure
sign that plaque is not being properly removed. If your gums
are swollen and inflamed your teeth will not move as easily,
you will experience more discomfort during your treatment
and white spots or decay will form on the teeth under and
around the braces and appliances. It is discouraging to work
hard to straighten teeth, only to finish and find decay or
white spots on the teeth. The following is essential for the
proper care of your teeth and gums:
Dr. Hsiao recommends that you use a soft-bristled toothbrush
with moderate force and a toothpaste that contains fluoride.
Place the toothbrush at an angle so that you feel the bristles
under your gum line and use small circular motions. Completely
clean each surface of every tooth in your mouth, including
the areas above, below and between each brace. Each surface
of every tooth should be scrubbed with 10-20 strokes of the
toothbrush. This should take 3-4 minutes.
Dr. Hsiao recommends that you brush at least 4 times per day:
after breakfast, after lunch (or as soon as you get home from
school or work), after dinner and at bedtime. Your toothbrush
will wear out faster because of your appliances, so be sure
to replace it whenever the bristles start to fray.
1. Use a soft toothbrush with a small amount of toothpaste.
Completely clean each surface of every tooth in your
mouth, including the areas above, below and between
2. Use circular, vibrating motions around the gum line.
Scrub each surface of every tooth with 10-20 strokes
of the toothbrush. This should take 3-4 minutes.
3. Brush every tooth slowly. Brush the upper teeth
4. Brush the lower teeth up. Also brush your tongue
and the roof of your mouth
Remember that a toothbrush might not reach
the areas under the archwire properly. Proper oral hygiene
also involves flossing and the use of an interdental toothbrush
(Proxabrush), an antiseptic mouth rinse (Peroxyl) and a topical
fluoride (Phos-Flur) or ACT fluoride rinse!
Dental floss is a nylon thread that is used to remove food
particles and plaque from between the teeth. Flossing is more
difficult when you have braces on your teeth. A floss threader
may be needed to get the floss under the archwire (note: floss
threaders are reusable). Use a piece of floss about 12 inches
long. Use the floss threader to get the floss under the wire.
Slide the floss up and down along the tooth surface. When
the tooth is clean, the floss will "squeak" as you
slide it up and down along the tooth surface. Be very careful
to not pull with too much force on your archwire.
Flossing is important and should be done every day. The best
time to floss is before bedtime after brushing to remove the
plaque missed by brushing. This process will take more time
than flossing without braces. If your gums are not healthy,
they may bleed the first few days you floss. Remember that
consistent brushing and flossing will result in a great orthodontic
1. Carefully pull waxed floss between wire and braces.
2. Floss carefully around the gum area.
An interdental toothbrush (Proxabrush) is another aid you
may find useful to keep your teeth, braces and gums clean
and healthy. It can be used to clean under orthodontic wires
and around braces. Use this device slowly so you do not damage
Although it is not absolutely necessary for good hygiene,
an electric toothbrush may make brushing easier.
We highly recommend the use of a Waterpik to loosen food and
plaque before flossing and brushing. The Waterpik should be
used on the lower water pressure settings so the gum tissue
is not excessively irritated. The use of a Waterpik does not
take the place of good toothbrushing.
ANTISEPTIC MOUTH RINSE (PEROXYL)
Peroxyl is an antiseptic dental rinse (active ingredient:
hydrogen peroxide 1.5%) used in orthodontics to control minor
gum inflammation and irritations from orthodontic appliances.
It is also used to cleanse canker sores and minor wounds or
other irritations of the mouth and gums such as mouth burns,
cheek bites and toothbrush abrasions. Its oxygenating action
removes debris allowing natural healing to occur. Dr. Hsiao
recommends that you rinse with half a capful (two (2) teaspoons)
around in the mouth for at least one (1) minute, then spit
TOPICAL FLUORIDE (PHOS-FLUR)
is a topical fluoride gel (active ingredient: 1.1% sodium
fluoride) used in orthodontics as a dental caries preventive.
It is not a substitute for tooth paste. Its action is twofold:
to re-mineralize tooth enamel which has been exposed to bacterial
acids and to act as an antibacterial agent.
Dr. Hsiao recommends that you apply a thin ribbon of Phos-Flur
Gel to the teeth with a toothbrush for at least one (1) minute
at bedtime, then spit out. Drinking and eating are not recommended
for thirty (30) minutes after using Phos-Flur, since doing
so will dilute or rinse away the active ingredient.
A FEW TRICKS
Since most patients watch some TV, we have found it to be
effective to sit down in front of the TV daily with a toothbrush
without toothpaste, and massage the teeth and gums with the
toothbrush bristles for about 30 minutes. Thirty minutes gives
you plenty of time to do a good job, and makes TV time more
productive. Brushing while listening to music or studying
is also acceptable. You may want to use toothpaste to freshen
your breath, but don't use toothpaste during this 30 minutes.
We want you to avoid the "once over lightly" technique.
To concentrate better, you may use your left hand if you are
right handed, and vice versa. The most important time to brush
is just before going to bed. Take your time and do it right.
REGULAR DENTAL CHECK-UPS
Although you are having your braces checked regularly, it
is very important to continue to see your family dentist every
three to six months for a thorough examination and cleaning
of your teeth. If you experience difficulty with good oral
hygiene you my need to see your dentist more frequently.
CLEANING A REMOVABLE APPLIANCE
All orthodontic appliances tend to accumulate food particles
and plaque just like teeth do. Every time you brush your teeth,
brush your removable appliance. Once a day you should soak
your appliance in a glass of room temperature tap water with
a denture-cleaning tablet, such as Efferdent. This will help
prevent plaque buildup and will keep your appliance tasting