Oral Hygiene

Linda J. Krebs, DDS, PhD

19 Fletcher Street
Chelmsford, MA 01824

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Orthodontic treatment is an important investment for your future. Everyone helping with your orthodontic care wants you to have the best results possible. While you are wearing braces, it is essential that you take care of your teeth and gums. Click on the tabs below to learn more about the importance of good oral hygiene.
Have a look in the mirror at your new braces. As you see, the brackets and wires have many nooks and crannies that can trap food and plaque. This means your risk of tooth decay and gum problems may be higher while you are wearing braces. You need to pay special attention to cleaning your teeth everyday and to your diet.

Permanent damage to tooth enamel can occur if the teeth and brackets are not kept clean. Areas on the enamel surface may begin to lose minerals (the early stage of tooth decay) leaving unsightly white spots. You may also develop inflamed, bleeding gums (gingivitis).

Gingivitis and the early stages of tooth decay can be reversed by taking extra care with your cleaning and diet. If left untreated, they can lead to bigger problems that will require treatment and have life long effects. While you are having orthodontic treatment, you need to continue to have regular check-ups with your family dental professional to ensure little problems don´t become big ones.


Here are ten simple steps for keeping your teeth, gums and braces in great shape:

1 – If your orthodontist has fitted you with elastics, remove them before brushing.

2 – Floss! You can use the floss threaders, superfloss, or even a water pick.

3 – Using a fluoride toothpaste and a small soft toothbrush, place your brush at an angle of 45 degrees against the gums. Gently brush along the gumline where the gums and teeth meet, using a small circular motion on each tooth.

4 – Spend about 10 seconds on each tooth before moving onto the next tooth, brushing in a set pattern so that you don’t miss any teeth.

5 – Gently brush the braces. Press your toothbrush firmly enough so that the bristles spread into the gaps between the wire and the tooth. Brush in and around all of the brackets and wires. Ensure that you brush under the wires, sometimes using an interproximal / “Christmas tree” brush can help. A battery powered brush may also be helpful.

6 – Brush both the inside and the outside surfaces of your teeth using a gentle circular motion on each tooth.

7 – For the chewing surfaces, use a firm back and forth motion.

8 – Don´t forget to replace your elastics.

9 – Occasionally use plaque disclosing tablets to help you see if you are leaving plaque in any areas. Feel free to ask someone from our office about these.

10 – Use other oral care products as instructed by your orthodontist.

The white spots on teeth while in or after braces are normally caused by the buildup of plaque. You develop plaque when bacteria are able to accumulate on the surface of your teeth. Your braces sometimes help this by providing new areas where the bacteria can hide and grow. The bacteria cause a layer of plaque to form. This layer eventually starts to break down and remove the essential minerals your teeth need to stay healthy. If left untreated, the white spots can actually turn into cavities. Something that can contribute to these spots is poor oral hygiene that allows the bacteria to prosper on your teeth around the braces.

A simple way to help prevent the problem is by practicing good oral hygiene. This means brushing at least three times a day and flossing daily. This benefits your teeth in two ways. The first is that the action of brushing is going to help fight plaque and prevent the spots all together. The second way is by removing any bacteria that could easily get into the demineralized areas and cause more damage or staining.

One of the most common ways to treat white spots on teeth after braces is through a process known as re-mineralization. This technique is effective because it directly addresses the problem causing the spots in the first place. Re-mineralization involves applying some type of cream or other substance to your teeth for a set period of time. The cream contains the minerals that the bacteria have removed from your teeth. Your teeth will reabsorb those minerals rebuilding the area. Re-mineralization can cause the spots to fade or could remove them completely depending on your individual situation.

Taking care of Invisalign and clear aligners is very simple. Every time you brush your teeth you can brush your aligners as well using cold or room temperature water, a soft bristled tooth brush, and soap.  They can also be soaked and cleaned in a denture cleaner or retainer cleaner while you are busy eating. Just make sure not to use hot water on the Invisalign trays as it can distort the material. While wearing the trays, it is safe to drink cold/room temperature water but it is advised to not drink sugary drinks as the sugar can seep under the trays and sit on your teeth. Also, always make sure to place trays on clean teeth only to prevent cavities.
Tel: 978-256-8531

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