Food particles and plaque naturally accumulate on the teeth and on braces. This process could lead to tooth decay and/or gum disease. Proper oral hygiene is vital to prevent these problems from occurring during your orthodontic treatment. The extra effort you give to keep your teeth, braces and gums clean and healthy will result in a much better orthodontic outcome.

BRUSHING
Drs. Stone, Hixson and Bumgarner recommend that you use a soft bristled toothbrush with moderate force and a toothpaste that contains fluoride. Place the toothbrush at an angle so that you feel the bristles under your gum line and use small circular motions. Completely clean each surface of every tooth in your mouth, including the areas above, below and between each brace. Each surface of every tooth should be scrubbed with 10 strokes of the toothbrush. This should take 2-3 minutes.

Drs. Stone, Hixson and Bumgarner recommend that you brush at least 4 times per day: after breakfast, after lunch (or as soon as you get home from school), after supper and at bedtime. Your toothbrush will wear out faster because of your appliances, so be sure to replace it whenever the bristles start to fray.

1. Use a soft toothbrush with a small amount of toothpaste. Completely clean each surface of every tooth in your mouth, including the areas above, below and between each brace.	2. Use circular, vibrating motions around the gum line. Scrub each surface of every tooth with 10 strokes of the toothbrush. This should take 2-3 minutes.
3. Brush every tooth slowly. Brush the upper teeth down.	4. Brush the lower teeth up. Also brush your tongue and the roof of your mouth

Remember that a toothbrush might not reach the areas under the archwire properly. Proper oral hygiene also involves flossing and the use of an interdental toothbrush (Proxabrush), an antiseptic mouth rinse (Peroxyl) and a topical fluoride (Phos-Flur).

FLOSSING
For areas between the teeth that a toothbrush can’t reach, dental floss is used to remove food particles and plaque. Dental floss is a thin thread of waxed nylon that is used to reach below the gum line and clean between teeth. It is very important to floss between your teeth every day.
Pull a small length of floss from the dispenser. Wrap the ends of the floss tightly around your middle fingers. Guide the floss between all teeth to the gum line, pulling out any food particles or plaque. Unwrap clean floss from around your fingers as you go, so that you have used the floss from beginning to end when you finish. Floss behind all of your back teeth.
Floss at night to make sure your teeth are squeaky clean before you go to bed. When you first begin flossing, your gums may bleed a little. If the bleeding does not go away after the first few times, let a staff member know at your next appointment.

1. Carefully pull waxed floss between wire and braces.

2. Floss carefully around the gum area.

INTERDENTAL TOOTHBRUSH
An interdental toothbrush (Proxabrush) is another aid you may find useful to keep your teeth, braces and gums clean and healthy. It can be used to clean under orthodontic wires and around braces. Use this device slowly so you do not damage your braces.

ANTISEPTIC MOUTH RINSE (PEROXYL) Peroxyl is an antiseptic dental rinse (active ingredient: hydrogen peroxide 1.5%) used in orthodontics to control minor gum inflammation and irritations from orthodontic appliances. It is also used to cleanse canker sores and minor wounds or other irritations of the mouth and gums such as mouth burns, cheek bites and toothbrush abrasions. Its oxygenating action removes debris allowing natural healing to occur.

Drs. Stone, Hixson and Bumgarner recommend that you rinse with half a capful (two (2) teaspoons) around in the mouth for at least one (1) minute, then spit out. Use up to four (4) times daily after meals and at bedtime while wearing orthodontic appliances.


TOPICAL FLUORIDE (PHOS-FLUR) Phos-Flur is a topical fluoride gel (active ingredient: 1.1% sodium fluoride) used in orthodontics as a dental caries preventive. It is not a substitute for tooth paste. Its action is twofold: to re-mineralize tooth enamel which has been exposed to bacterial acids and to act as an antibacterial agent.



Drs. Stone, Hixson and Bumgarner recommend that you apply a thin ribbon of Phos-Flur Gel to the teeth with a toothbrush for at least one (1) minute at bedtime, then spit out. Drinking and eating are not recommended for thirty (30) minutes after using Phos-Flur, since doing so will dilute or rinse away the active ingredient.


CLEANING A REMOVABLE APPLIANCE
All orthodontic appliances tend to accumulate food particles and plaque just like teeth do. Every time you brush your teeth, brush your removable appliance. Once a day you should soak your appliance in a glass of room temperature tap water with a denture-cleaning tablet, such as Polident or Efferdent. This will help prevent plaque buildup and oral infections and will keep your appliance tasting better.