How to take care of braces

Brushing with braces

Braces trap plaque and food, so brushing matters more than usual. The American Association of Orthodontists advises brushing for about two minutes after meals and snacks and again before bed, carrying a travel toothbrush and toothpaste, and rinsing with plain water if you cannot brush after eating. It suggests ADA-approved fluoride toothpaste, ideally without whitening, and replacing the brush head at the first sign of wear or at least every three months.

Cleveland Clinic adds a soft-bristled brush used at least twice a day, and rinsing twice daily with an alcohol-free, antibacterial mouthwash.

Flossing and cleaning tools

The AAO says to floss at least once a day because flossing removes plaque from areas brushing misses. Cleveland Clinic suggests floss designed for braces. The AAO also lists interproximal brushes for cleaning between teeth and around wires, water irrigators for flushing out food, and a daily fluoride rinse to strengthen enamel and help prevent white marks.

The NHS recommends an interdental brush every day, between the teeth and under the braces, plus fluoride toothpaste in the morning, at night and after meals.

Food and drink rules

The AAO's list is consistent with the other sources: avoid hard, sticky, crunchy or chewy foods such as popcorn, nuts, taffy, caramels, hard candy and hard pretzels. Cut fruit and vegetables into smaller pieces, slice apples and pears, cut sandwiches and pizza into bite-sized pieces, and cut corn off the cob.

For drinks, the AAO says tap water and milk are best, coffee, tea and red wine can stain teeth, and soda, sports and energy drinks, flavored sparkling waters and fruit drinks should be avoided because their acids and sugars can cause cavities. Brush soon after them, or rinse with water if brushing is not possible. The NHS also says not to chew gum, which can get stuck in braces.

A braces kit for problems

The AAO suggests keeping a small kit at home or in your bag. It also says some soreness after placement or an adjustment is normal and short-lived, and that unusual discomfort or a shifted bracket or wire should be reported.

• Orthodontic wax to cover sharp or rubbing spots.
• Floss, tweezers and interproximal brushes.
• A topical oral numbing gel and an over-the-counter pain reliever, used as directed.
• A warm salt water rinse (about one teaspoon of salt in 8 ounces of warm water) to soothe discomfort.

Pain relief: a point where sources differ

Cleveland Clinic advises against ibuprofen and other NSAIDs for braces discomfort, saying they can interfere with tooth movement, and suggests acetaminophen instead. The AAO kit lists an over-the-counter pain reliever without naming a type. Because the advice varies, ask your orthodontist which one they prefer, and follow the label or pharmacist's advice.

What to do about a poking wire or loose bracket

The AAO says most orthodontic problems are uncomfortable but not dangerous, and to call your orthodontist as soon as possible for any loose or broken bracket, poking or loose wire, or loose band, because the office may want to see you right away to keep treatment on schedule.

While you wait, the AAO suggests gently pushing a poking wire toward the tooth with a clean pencil eraser or cotton swab, and if that does not work covering the end with orthodontic wax. If a bracket is still attached to the wire, slide it back toward the center of the tooth, hold it in a comfortable position with wax, and avoid hard, chewy or sticky foods until it is repaired. If the office is closed, follow the after-hours instructions on its voicemail.

Sports, checkups and staying on schedule

The AAO says you can play sports during treatment and to ask your orthodontist which mouthguard to use. See your family dentist at least every six months, or more often if recommended, and keep all orthodontic appointments, which the AAO says are typically every 6 to 10 weeks. Removing braces early for an event is not usually in your best interest, so discuss it with your orthodontist first.

Frequently asked questions