Cleaning the mouth properly when undergoing orthodontic treatment is a little more complicated. To help make it easier, our oral hygiene advisor, Dirna Grobbelaar, has put together expert advice so you can ace your ‘brace face’, plus product recommendations to make your orthodontic journey more comfortable.

EXPERT TIPS

• Take a travel toothbrush and GUM Soft-Picks when you’re eating out.
• Use an interdental or end-tuft brush to clean around brackets and wire.
• Have a professional clean every 3 to 4 months

GLOSSARY

• Braces are fixed orthodontic appliances designed to align teeth and correct the bite
• An orthodontist is a dentist who has specialised in orthodontics
• Brackets are tiny metal or clear ceramic brackets fixed to each tooth
• A U-shaped wire is attached to the brackets
• A retainer is used once the braces have been removed to keep the teeth in place.

Orthodontic treatment can make a life-changing difference to how you look and feel. Straightening misaligned teeth can magically transform your smile AND have long-term health benefits. Your orthodontic treatment will be more successful and may take less time if you have a healthy mouth at the outset. During treatment, good oral care is essential to keep your appliance clean, prevent white marks, maintain fresh breath and healthy teeth and gums

HOW TO ACE YOUR ORAL CARE ROUTINE WHEN YOU WEAR BRACES

Accept that it will be more time consuming to clean your mouth properly when you wear orthodontic braces. The brackets and wire create more surfaces; food debris and plaque are easily trapped.

Here’s a tailored 1-2-3-4 step oral care routine to ace your ‘brace face’:

1) Brush

• Use a soft-bristled electric brush or a specially adapted orthodontic toothbrush.
• Brush gently for at least two to three minutes each time. Focus on the area between the brackets and gums, first angling the brush away from the gums to clean under and below the wire. Then turn the bristles to clean up to the gums. Use small movements, not long strokes, to clean the whole surface of the front teeth and the wire and brackets. You can brush the back of your teeth as normal unless you are wearing lingual braces.

2) Clean in-between

• Cleaning in-between the teeth every day is essential for good oral health. When you wear braces, the wire prevents flossing in the traditional way. To see how to floss when you have braces, watch Dirna demonstrate in this short video.
• Using a specialised floss with a built-in threader, like GUM Ortho Floss, makes it a lot easier to insert.
• If the space between your teeth allows, a small interdental brush or GUM Soft-Pick is an easy tool for cleaning in-between.
• An oral irrigator or AirFloss are effective at removing food debris from in-between teeth and around braces.

3) Rinse

Rinse with a salt or an alcohol-free mouth rinse after eating. An antibacterial mouthwash will help prevent plaque build-up and fluoride helps prevent cavities.

4) Bring in the professionals

Have your teeth professionally cleaned by the oral hygienist, ideally three or four times a year. The hygienist can safely remove hardened plaque (tartar) which is impossible to remove with brushing and flossing and can clean any hard-to-reach areas you might be struggling with at home.  The hygienist can advise you on how to adapt your homecare routine for optimum results, using the most suitable tools. For a superior professional clean, ask for EMS Guided Biofilm Therapy.

WHY IS YOUR ORAL CARE SO IMPORTANT WHEN YOU WEAR BRACES

Your oral care routine is even more important when undergoing orthodontic treatment. Brackets, wires and retainers create more surfaces to be cleaned. They are ‘plaque traps’ that easily lodge food particles and bacteria.

Here are some of the potential consequences if you don’t look after your oral hygiene. If you notice any of these symptoms, chat to your dentist or orthodontist:

Yellow stains and/or white spots: braces create more places for plaque to hide. If not manually removed by meticulous brushing and cleaning in-between, plaque can build up, making the teeth look yellow and dull.  Older plaque can start to demineralise the teeth enamel, causing white spots on the surface and eventually leading to tooth decay.

What are white spots? When plaque is not removed it starts to demineralise the teeth enamel and white spots appear where the enamel has become demineralised. These spots may be more visible when the braces are removed. White spots can be permanent so it is best to prevent them from forming by making every effort to remove plaque effectively. If you have white spots, professional fluoride treatments might help to reduce them.

Bleeding gums: bleeding gums are usually a sign of gum disease. Because it’s harder to clean the mouth when wearing braces, orthodontic patients with inadequate home oral care are at higher risk of gum disease. It is preventable with good oral care.

Bad breath: food can easily become trapped in your orthodontic appliance and if not removed, will cause bad breath.

Mouth ulcers: it’s quite common to get sores or mouth ulcers initially, as the soft tissues inside your mouth rub against the brackets or wire. These usually ease in a short time and can be prevented by using orthodontic wax. If you develop sores or ulcers, use Aloclair for immediate relief and to help speed up healing. For expert advice on managing mouth ulcers read this.

7 REASONS TO GET BRACES

There are health and cosmetic reasons to have orthodontic treatment:

1. To correct crooked, crowded or overlapping teeth
2. For better oral health – misaligned teeth are harder to clean which puts you at higher risk of gum disease and cavities
3. Crooked teeth can be more likely to break or wear down the wrong way
4. To fix a malocclusion, which is when there is a difference in the size of the top and bottom jaws – causing an underbite or overbite
5. Problems with eating and digestion, particularly if you have an overbite or underbite
6. Confidence and self-esteem – some people feel uncomfortable about how their teeth look
7. A more beautiful smile

4 TYPES OF ORTHODONTIC BRACES

There are several types of orthodontic braces. To decide upon the most suitable option, chat to your dentist or orthodontist who will make an assessment based on your mouth and budget, then guide you safely through the process.

1) Traditional metal braces

Metal braces are still the most common type, especially for children and teenagers. They are usually cheaper than some of the newer, less visible varieties. Small, metal ‘brackets’ are glued to each tooth and connected with a thin wire which is regularly changed to gradually align the teeth.

2) Ceramic braces

Ceramic braces are less noticeable than metal braces because the brackets are clear or tooth-coloured. They work in the same way as metal but are more expensive.

3) Lingual braces

If you don’t want your braces to be visible, lingual braces are an excellent option. They are attached to the inside surfaces at the back of your teeth. Because they are in closer contact with the tongue it can affect speech and eating more than metal or ceramic braces.

4) Clear aligners

Clear plastic aligners are removable and almost invisible, like a thin clear plastic gum guard or whitening tray. They are helpful for less serious orthodontic problems. It’s important to wear the aligner for at least 22 hours a day. Only remove it to eat, drink or brush the teeth.

HOW DO BRACES WORK?

Braces work by putting gentle pressure on the teeth over time, to slowly move them to a better position.  The bone under the teeth also moves. It usually takes around 2 to 3 weeks before seeing a difference. Treatment usually lasts 12 to 18 months.

The duration of orthodontic treatment depends on a few factors:

• How well you follow instructions – listen to your dental professional
• The health of your gums, teeth and supporting bone – good oral care is essential 😊
• How far the teeth must move i.e. how significant is the malocclusion
• The amount of space inside the mouth – sometimes the dentist will remove teeth to allow more room.

Once your braces are removed, you may need to wear a retainer that holds the teeth in place.

WHAT’S A RETAINER?

There are two types of retainers, worn to maintain the new position of the teeth:

• A thin wire bonded to the front upper and lower teeth which remains on the teeth for a long period.
• Clear removable plates which are worn most of the time initially and when sleeping later on.

WHEN SHOULD YOU START WEARING BRACES?

If needed, orthodontic treatment usually starts after the permanent teeth have erupted, around 12 years of age. Before that, removable orthodontic plates may be used to encourage jaw alignment.

There is no age limit. According, to the South African Society of Orthodontists (SASO) you are never too old for braces if your gums and bones around the teeth are healthy. About 20% of orthodontic patients in SA are adults.

The Orthodontic Society of Australia has put together some excellent information on things to do before you have your braces fitted, including foods that are best avoided during treatment.

HOW MUCH DO BRACES COST?

Orthodontics is an investment in a more beautiful smile. The cost will depend on the type of braces required and the duration of treatment. The South African Society of Orthodontists (SASO) is clear that orthodontic treatment at the right time can prevent more costly procedures when older. Many medical aids now include the cost of orthodontics.

DO YOU NEED TO SEE A SPECIALIST ORTHODONTIST?

General dentists can fit orthodontic braces and are qualified to do so. Some will refer to an orthodontist, particularly if the case is complicated. Orthodontists have chosen to specialise and have an additional 3 to 4 years of study.

To shed light on misunderstandings about orthodontics, Sunstar GUM global has put together a handy guide to myths and truths about orthodontics.