How to maintain oral hygiene with braces and aligners?
You finally get your braces on. Or maybe you’ve just opened your first set of clear aligners. You look in the mirror, imagine how your smile is going to look a year or two from now, and feel like the treatment has officially begun. But there’s another part of orthodontic treatment that doesn’t get quite as much attention: what happens between the appointments.
While your braces or aligners are working on moving your teeth, you still have to keep those teeth clean and healthy every single day. And that can be a little different from what you’re used to. If your teeth are crowded, overlapping, or not positioned correctly, brushing can already take some extra effort. Once braces, wires and brackets are added, there are even more areas where food debris can get stuck. With aligners, cleaning becomes easier because you can remove them, but now the aligners themselves need to be cleaned and cared for too.
So, orthodontic treatment isn't just about moving your teeth from one position to another. It is also about taking care of them while they move. With the right routine, oral hygiene can become a simple part of your everyday orthodontic care rather than something you have to constantly worry about.
Why oral hygiene matters during orthodontic treatment
When teeth are crowded or not positioned in a straight line, cleaning them can already require additional effort. Once braces are placed, there are even more surfaces and spaces that need to be cleaned. Brackets and wires can hold food debris around the teeth. If this debris is not removed properly, it can remain between the teeth, around the brackets, and along other areas of the appliance. Over time, this soft debris can harden into tartar. Tartar can interfere with tooth movement and potentially delay orthodontic treatment. Think of it like moving a brick that’s fixed in place with cement. If the cement is holding it tightly, moving that brick becomes much harder.
In a similar way, when plaque and bacteria build up around the teeth, they can create an unhealthy environment for the teeth and gums while the teeth are being moved. That’s why oral hygiene during orthodontic treatment is so important. It’s not just about keeping your mouth clean or fresh, it’s about keeping the teeth and gums healthy while we gradually move the teeth into their new positions.
Maintaining hygiene with braces
Braces require particular attention because the brackets and wires remain fixed to the teeth throughout treatment. Food particles can become trapped around these components, making regular brushing alone more challenging.
Patients should consciously brush around the brackets, wires and attachments rather than focusing only on the visible tooth surfaces.
A regular toothbrush can be used along with a small interdental brush that can reach between the braces and help remove food debris.
Interdental brushes are particularly useful for cleaning around the orthodontic appliance. However, they naturally wear out with use. This can happen even more quickly when the teeth are crowded. In some cases, an interdental brush may wear out within a week.
A common mistake is noticing that the brush is wearing out and then becoming overly careful with it because of the concern that it may break. This can result in inadequate cleaning. When an interdental brush has worn out, it should simply be replaced so that proper cleaning can continue. Another common concern among patients is that brushing normally might cause the braces to break. This can make patients excessively gentle while brushing. However, normal brushing pressure is necessary to properly remove food debris and plaque. Braces are designed to remain on the teeth throughout treatment, and regular brushing is not expected to cause them to break. The aim is to maintain proper brushing without being excessively forceful, while also avoiding the mistake of being so gentle that the teeth and braces are not cleaned properly.
Maintaining hygiene with clear aligners
Clear aligners provide a different approach to oral hygiene because they can be removed. Patients can take their aligners out while eating, brushing and cleaning their teeth, allowing them to maintain their usual brushing routine more easily. However, the aligners themselves also need to be cleaned. An additional toothbrush can be kept specifically for cleaning the aligners. The aligner can be brushed on both the inside and outside using the same toothpaste used for regular brushing. Ideally, this should be done two to three times a day, with three times being recommended.
There will also be situations where it is not practical to brush the aligners properly, particularly when a patient is at work, school or elsewhere outside the home. In such situations, the aligner can be rinsed and, if it is going to remain outside the mouth for some time, wiped with gauze or a soft muslin cloth. This helps remove remaining debris and reduces the chances of bacterial growth while the aligner is stored. Once the patient returns home, the aligner can be brushed properly. Aligner cleaning solutions are also available and can be used when additional cleaning is required.
One important point to remember is that aligners should never be cleaned with hot or warm water.
Aligners are made from thermoplastic material, which can deform when exposed to heat. Patients may sometimes use hot water with the intention of sterilising the appliance, but this can affect its shape and fit. Cold water and proper brushing are therefore the preferred approach for routine cleaning.
The importance of cleaning around attachments
Both braces and aligners can involve components that are attached to the tooth surface. With braces, brackets need to remain securely attached to the teeth. With aligners, small attachments may be placed on the teeth to help hold the aligner and assist with particular tooth movements. Because these components are attached to the tooth surface, proper cleaning around them becomes important. During orthodontic treatment, the tooth surface is treated so that the bracket or attachment can stay in place. The surrounding area therefore needs to be maintained carefully with brushing and cleaning. If oral hygiene is neglected, patients may develop cavities or white spots around the braces or attachments. This is one of the reasons patients are educated about brushing properly over and around these areas and may be advised to use additional hygiene aids. The priority throughout treatment should always be maintaining the health of the teeth.
What happens when oral hygiene is neglected?
Poor oral hygiene can affect orthodontic treatment in several ways. When food debris and plaque remain around the teeth, they can eventually harden into tartar. This can make tooth movement more difficult and may delay treatment. There is also the risk of developing cavities or white spots around areas where brackets or attachments are present. For this reason, if a patient undergoing braces treatment develops a cavity or significant problems with oral hygiene, the orthodontic treatment may need to be stopped temporarily. The focus then shifts to restoring the health of the teeth and improving hygiene before orthodontic treatment continues. This highlights an important principle of orthodontic treatment: moving the teeth is only one part of the process. Maintaining their health while they are being moved is equally important.
Making oral hygiene part of your routine
Maintaining good hygiene during orthodontic treatment does not have to mean completely changing your lifestyle. It means becoming more conscious of the areas that require additional attention. For patients with braces, this means taking the time to clean around brackets and wires, using an interdental brush, and replacing the brush when it wears out. For patients with aligners, it means taking advantage of their removable nature to brush the teeth normally while also cleaning the aligners regularly. It also means avoiding habits such as placing the aligners in hot water.
The key is consistency. Orthodontic treatment can take time, and maintaining hygiene needs to continue throughout that entire period. Small lapses can eventually become larger problems if food debris and plaque are repeatedly allowed to accumulate.
Healthy teeth are the foundation of a good orthodontic result
Braces, aligners, expanders and other orthodontic appliances are all tools used to move teeth. The choice of appliance may differ from patient to patient, but the health of the teeth remains a priority regardless of the treatment method. Good oral hygiene allows orthodontic treatment to progress while keeping the teeth healthy. It also helps prevent problems that could require treatment to be paused. Ultimately, orthodontic treatment is not simply about achieving straighter teeth. It is about moving the teeth while maintaining their health throughout the process. Whether you choose braces or clear aligners, the principle remains the same: take care of your teeth while they are being transformed. A consistent hygiene routine, the right cleaning techniques and regular attention to your orthodontic appliance can help keep the treatment process healthy from beginning to end.
