What works best to keep teeth clean while wearing braces?

A questions that I am often asked by patients and their parents is, “What works best to keep teeth clean while wearing braces?”  My reply is “whatever works best for you as an individual”.  Many patients do really well with traditional toothbrushes, while others respond really well with to electric brushes. There are also many adjunct devices that help clean between teeth and reach spaces that may be hard for brushes to contact (especially with braces on). With so many choices available when you walk through the dental section of supermarkets and drug stores, here is a guide to help find what will work best for you.

Traditional manual toothbrushes:  As I stated, many orthodontic patients do a fantastic job of keeping healthy teeth and gums using traditional toothbrushes. After braces are placed, our assistants at Meadows Orthodontics review brushing techniques one on one with our patients, as braces add an additional challenge to the brush reaching the surfaces that need plaque removal. I stress to my patients that the most commonly missed areas are where the teeth and gums meet, both below the braces of the lower teeth, and above the braces on the upper teeth. wire. Try to allocate more time to these areas, starting at the back teeth, then working around the mouth one tooth at a time, making sure not to skip any, until you reach the back teeth of the other side. I describe this to kids as “driving around the race track”, as this ensures no areas are missed. Likewise, try to avoid random movements that jump from one part of the mouth to the other- people often get into patterns where some areas are cleaned really well, while other areas are totally skipped over. What about circular motions vs. up and down, vs. side to side? Just like washing a car, as long as all surfaces are cleaned, I tell my patients that they can use whatever motion is the most effective for them! If you want to use trapezoid movements and are good at it… fine!

Use a toothbrush with soft bristles, and avoid stiff  bristles. This will help reduce the chance of brushing causing gingival recession (where the gum recedes to expose the roots of the teeth). As far as all the different bristle shapes, designs, colors, etc…use what is comfortable for you! The one that you use well, consistently and with the correct technique is the best one. At each return visit to have braces or Invisalign checked and adjusted, we will grade your oral hygiene, and give you tips and encouragement if needed.

imagesElectric toothbrushes:  Having said all the above about manual toothbrushes, electric toothbrushes are also a great option. Two of my own kids were not doing well on their own with traditional manual toothbrushes (my third one does amazing with a manual brush), so I got them an electric model. Bingo! they love to use it, and their was a big difference in keeping their teeth clean. A large part of it for them is using something technological and fun, which they responded to immediately.

The biggest difference with a high quality electric brush is that the “scrubbing” movement is taken care of by the brush itself. Children and the elderly especially may lack the coordination for these fine movements, and electric brushes area great option for them. Patients, especially kids, need to be aware that the bristle head still needs to be placed in the correct locations to get the teeth cleaned. Reaching these places is just as described above for the manual brushes. Which brand should you purchase? I recommend both Oral-B and Sonicare brushes. They each claim the superiority of their product, but they are both amazing and your teeth will be happy with either brand. Also, each brand has several levels of brushes. The mechanism and effectiveness is the same for each model, but the more expensive ones have more gadgets built in such as timers, bluetooth tracking for parents, etc… choose the model that has the extras that interest you the most.

Plastic pics, floss, interdental microbrushes, etc.. : The dental aisle usually has many accessories that can be very helpful in cleaning your teeth )I like plastic dental pics, and use them while I am watching TV). Again, choose what you like and what you are comfortable with. They are usually very inexpensive, can be purchased in bulk, and help to clean in areas that brushes cannot reach (in between teeth, under and around braces if food becomes trapped). Flossing will require the use of “floss threaders”. We review how to use these with every patient after braces have been placed.

Waterpiks:  Waterpiks are a great option to use in conjunction with brushes, as the bursts of water are great for flushing out debris and plaque from hard to reach areas, and from around devices such as expanders. You cant go wrong with the Waterpik brand, which is very popular with my patients.

I hope these suggestions help, and if you ever have questions, feel free to ask me, or call Meadows Orthodontics at 303-660-0112.


Dan Rejman, D.D.S., M.S. is the owner of Meadows Orthodontics. There are two locations in Castle Rock, CO for local families: One in the Meadows, and one in the Founders and Terrain area.