Keeping your teeth and gums clean with regular brushing and flossing is a good idea anytime. During orthodontic treatment, though, it becomes absolutely vital, and there are special considerations to keep in mind.

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The importance of hygiene during orthodontic treatment: As you eat, your teeth, brackets and wires collect food. If food is left on teeth overnight, thick plaque (bacterial colonies) forms on the teeth and the space between the teeth and the gums. Plaque causes bad breath, tooth decay and swollen gums (gingivitis).

Bleeding and swollen gums are a sure sign that plaque is not being properly removed. If your gums are swollen and inflamed, your teeth will not move as easily, you will experience more discomfort during your treatment, and white spots or decay will form on the teeth under and around the brackets.

It is discouraging to work hard to straighten teeth, only to finish and find decay or white spots on the teeth. Don't let it happen to you. The following is essential for the proper care of your teeth and gums:

Waterpik- We highly recommend the use of a Waterpik to loosen food and plaque before flossing and brushing. The Waterpik should be used on the lower water pressure settings so the gum tissue is not excessively irritated. But remember, the use of a Waterpik does not take the place of good brushing and flossing.

Soft Bristled Toothbrush - Use your toothbrush after each meal and before bedtime. A travel brush carried in a purse or placed in a locker is great for brushing after lunch. Examine your teeth for food and plaque and thoroughly clean all surfaces of the gums and brackets. Re-examine your teeth to make sure all visible food and plaque have been removed. Repeat this step as often as needed to ensure that no visible plaque or food remains. Extra care must be taken in the area between your gums and the braces. Concentrate on brushing your gums and the space between your gums and your teeth.

Recommendations for Brushing with Braces

•	Use an orthodontic toothbrush that can prevent breakage of orthodontic appliances and is designed to fight tooth decay.
•	If possible, use an electric toothbrush with an orthodontic head. The high speed vibrations created by the electric toothbrush help break down plaque.
•	Use a toothpaste containing aloe vera to help break up the plaque and prevent gingivitis (inflamed and bleeding gums).
•	Force the bristles of a toothbrush at a 45-degree angle to go into the spaces between the teeth and the gums.

Flossing
Some people think flossing is not as important as brushing, but it is just as important. Flossing removes plaque and food particles from between teeth and in the spaces between the teeth and gums - cavity-prone areas your brush can't reach. If plaque (bacterial colonies) are not disorganized daily by the brush and floss, your gums will become inflamed and bleed (gingivitis).

Failing to floss leaves 35 percent of your tooth surface uncleaned!

Recommendations for Flossing with Braces

•	Even though it is more difficult than without braces, it is important to floss daily.
•	Use a floss threader to help guide floss between braces or under the archwire.
•	Rinse your teeth to wash away food or other particles that you have removed.

A Few Tricks - Since you probably watch some TV, try sitting down in front of the TV every day with a toothbrush (without toothpaste), and massage the teeth and gums for about 30 minutes. That will give you plenty of time to do a good job, and makes TV time more productive.

Or try brushing while listening to music or studying. You may want to use toothpaste to freshen your breath, but don't use toothpaste during this 30 minutes. Avoid the "once over lightly" technique. To concentrate better, you may use your left hand if you are right handed, and vice versa.

The most important time to brush is just before going to bed. Take your time and do it right.

Regular Dental Checkups - Although you are having your braces checked regularly, it is very important to continue to see your family dentist at least every six months for a thorough examination and cleaning of your teeth. If you experience difficulty with good oral hygiene, you might need to see your dentist more frequently.

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