Why Flossing Is Harder with Braces
Braces create dozens of small spaces where food particles and plaque can collect. The archwire that runs across your teeth blocks you from sliding floss straight down between teeth the way you normally would. Brackets bonded to each tooth create additional surfaces that trap debris.
Without proper cleaning, plaque builds up around the brackets and along the gum line. Over time, this leads to decalcification, which shows up as permanent white spots on the tooth surface when the braces come off. These white spot lesions are one of the most common cosmetic problems after orthodontic treatment, and they are preventable with consistent flossing and brushing.
How to Floss with a Floss Threader
A floss threader is a flexible plastic loop that works like a sewing needle for your teeth. It allows you to thread regular dental floss under the archwire so you can floss normally between each pair of teeth. Floss threaders are inexpensive and available at any pharmacy.
Step-by-Step Instructions
- Cut about 18 inches of waxed dental floss. Waxed floss is less likely to shred on brackets.
- Thread one end of the floss through the loop of the floss threader.
- Slide the pointed end of the threader under the archwire, between two teeth.
- Pull the floss through so you have enough length on both sides to grip.
- Wrap the floss around each tooth in a C-shape and slide it gently up and down along the side of each tooth, going just below the gum line.
- Remove the floss and re-thread for the next pair of teeth.
- Repeat for every space between teeth. This process takes 10 to 15 minutes with braces.
Tips for Better Results
Use waxed floss to reduce the chance of snagging on brackets. If regular floss shreds frequently, try orthodontic floss, which has a stiff end built in so you do not need a separate threader. Work in front of a mirror with good lighting until you get comfortable with the technique.
How to Use a Water Flosser with Braces
A water flosser (such as Waterpik) uses a pressurized stream of water to flush food particles and bacteria from between teeth and around brackets. It is the fastest flossing method for braces patients and is especially useful for younger patients who find floss threaders frustrating.
Research published in the Journal of Clinical Dentistry found that a water flosser removed significantly more plaque around orthodontic brackets than manual flossing with a floss threader.
Step-by-Step Instructions
- Fill the reservoir with lukewarm water. You can add a small amount of antimicrobial mouthwash if your orthodontist recommends it.
- Use the orthodontic tip (a tapered, brush-like attachment) if your water flosser includes one. A standard tip also works.
- Start on the lowest pressure setting and increase as you get comfortable.
- Lean over the sink and close your lips enough to prevent splashing, but let water flow out of your mouth.
- Aim the tip at the gum line and move slowly along each tooth, pausing briefly between teeth and around each bracket.
- Work from the back teeth to the front on both the outer and inner surfaces.
How to Use Interdental Brushes with Braces
Interdental brushes are small, cone-shaped or cylinder-shaped brushes on a thin wire handle. They slide easily under the archwire and around brackets to clean areas that both regular floss and water flossers can miss. They are especially effective at removing plaque from the base of each bracket.
Choose a brush size that fits snugly between your teeth without forcing it. Most orthodontic patients use a size 0 or size 1 (the smallest sizes). Push the brush gently under the archwire and use a back-and-forth motion along the side of each tooth and around the bracket. Replace the brush when the bristles become bent or worn, typically every 3 to 7 days.
How Often Should You Floss with Braces?
Floss at least once per day. Most orthodontists recommend flossing before bed so that food particles and plaque do not sit against your teeth overnight. If you can floss after meals, even better.
Many patients find that combining methods works best. For example, using a water flosser after meals for quick cleaning and using a floss threader or interdental brush once a day for a more thorough clean. Your orthodontist can recommend the combination that works best for your specific bracket type and tooth alignment.
What Happens If You Do Not Floss with Braces
Skipping floss during orthodontic treatment puts your teeth at real risk. The brackets and wires make it harder for saliva to wash away food debris naturally, and plaque accumulates faster than it does on bare teeth.
White Spot Lesions (Decalcification)
White spot lesions are areas of enamel demineralization that appear as chalky white patches on the tooth surface. They form when plaque acids dissolve minerals from the enamel around the brackets. These spots are often permanent and become visible once the braces are removed. Studies show that 50% or more of orthodontic patients develop at least one white spot lesion during treatment.
Cavities and Gum Disease
Plaque that is not removed hardens into tartar within 24 to 48 hours. Tartar irritates the gums and leads to gingivitis (red, swollen, bleeding gums). Left untreated, gingivitis can progress to periodontitis, a more serious form of gum disease that damages the bone supporting your teeth. Cavities are also more common during orthodontic treatment when oral hygiene is poor.
In some cases, severe gum disease or decay may require your orthodontist to remove the braces early to allow for dental treatment, delaying the completion of your orthodontic care.
Flossing with Clear Aligners vs. Traditional Braces
Patients who use clear aligners, such as Invisalign, have a significant advantage when it comes to oral hygiene. Because the trays are removable, you can take them out before brushing and flossing. This means you can floss normally, with no threaders, special tools, or extra time needed.
If maintaining oral hygiene is a major concern for you or your child, ask your orthodontist whether clear aligners are an option for your case. Not every bite problem can be treated with aligners, but for cases where both braces and aligners are viable, easier hygiene is a meaningful benefit to consider.
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