Orthodontics (Braces)
The benefits that braces produce, such as restoring proper function of the teeth and a winning smile, come with some risk. These potential problems include gum disease and white spots of the teeth. 1 - 6 These negative results can be due to the challenges of cleaning around the brackets. While they are common problems, they can be prevented with good oral hygiene.
There are a number of steps involved in caring for teeth with braces. The first is removing plaque and is primarily done with a toothbrush. A manual toothbrush works well if it is properly used, but individuals with brackets and other fixed orthodontic devices may find it easier to use a power or sonic toothbrush. But even a sonic toothbrush can't remove all the plaque because there remain some areas that can't be reached, so other tools may be needed. Flossing is difficult without braces and increases in difficulty when working around the brackets and wires. Although, with practice, it can be done, an easier and more effective way to clean between the teeth and under the gums is a Waterpik® dental water jet oral irrigator with the new orthodontic tip. The tip is designed with a tapered brush on the end that helps remove the plaque that sticks to the brackets and between the teeth while also flushing the bacteria and food debris from around teeth and under the gums. In a recent study the Waterpik® dental water jet oral irrigator removed three times more plaque and reduced bleeding better than brushing and flossing in 11 - 17 year olds with fixed orthodontic appliances. And they liked it so much that 92% said they would continue to use the Waterpik dental water jet "every day" or "frequently" when the study was completed. 7
It's so important to have regular dental check ups during orthodontic treatment. Using fluoridated toothpaste or adding a fluoride rinse to your routine can also help prevent white spots (decalcification) and decay.
1 - Chang HS, Walsh LJ, Freer TJ. Enamel demineralisation during orthodontic treatment. Aetiology and prevention. Aus Dent J 1997;42:322-327.
2 - Gorelick L, Geiger AM, Gwinnett AJ. Incidence of white spot formation after bonding and banding. Am J Orthod 1982;81:93-98.
3 - O'Reilly M, Featherstone J. Demineralisation and remineralisation around orthodontic appliances – an invivo study. Am J Orhod Dento Orhop 1987;92:33-40.
4 - Oggard B, Rolla G, Arends J. Orthodontic appliances and enamel demineralisation. Part 1. Lesion development. Am J Orthod Dento Orthop 1988;93:29-37.
5 - Naranjo AA et al. Changes in the subgingival microbiota and periodontal parameters before and 3 months after bracket placement. Am J Orthod Dentofacial Orthop 2006;130:e17-e22.
6 - Atack NE, Sandy JR and Addy M. Periodontal and microbiological changes associated with placement of orthodontic appliances. A review. J Periodontol 1996;67:78-85.
7 - Sharma N et al. Effect of a dental water jet with orthodontic tip on plaque and bleeding in adolescent patients with fixed orthodontic appliances. Am J Ortho Dentofacial Orthop 2008;133(4):565-571.
