Proper Braces Care

How to Brush & Floss with Braces

Did you know that how well you keep your braces clean has a huge effect on the results of your orthodontic treatment? In this blog post, we will cover why it’s important to keep your braces clean as well as go over steps on how to brush and floss properly so you can have the best treatment results possible.

Why Is It Important To Keep Your Braces & Teeth Clean?

Cavities/Tooth Decay

Have you ever looked at an orthodontic bracket up close? There are a lot of places where food and plaque can stick to as opposed to the smooth surface of your tooth. Plaque is a sticky film that contains bacteria, saliva, and food particles. Some bacteria are good! But if you don’t clean your teeth, more and more bad and harmful bacteria will get trapped. This bad bacteria makes acid from the sugars and starches in your food.

Your enamel is the outer protective layer of your tooth and it is the hardest substance in your body – even harder than bone. But, if your enamel is continuously attacked by acid, it can break down through a process called demineralization. A white spot can appear where the minerals have been lost and this is one of the early signs of tooth decay. If severe enough, these white spots can remain forever even after your braces have been removed, leaving ugly white boxes on your teeth that are extremely noticeable and are permanent.

Eventually, enamel will break down from the acid, forming a hole also known as a cavity. It’s important to remember that just because you don’t feel any pain, that does not mean you don’t have a cavity. Some cavities won’t cause you any discomfort until it’s too late!

Unfortunately, because your tooth can’t regenerate or grow back, a dentist will need to drill out and remove the dead tissue and restore it to its original shape with an artificial filling material, which is NOT as strong as your natural tooth structure.

Imagine if you lost your hand or your foot – obviously you would be devastated because you can’t grow them back and it’s the same with your tooth! If this hole or cavity grows large enough, it can enter the middle of the tooth, the pulp, which is where the nerves and blood vessels are, and the tooth will die. When the pulp is attacked by bacteria, you may experience severe pain and discomfort. At this point your tooth may need a root canal, a crown, or even worse, be extracted.

One of the most common regrets I hear from older patients is that they wish they took care of their teeth better when they were younger. Imagine losing the majority or all of your teeth? It will be impossible for you to eat the things you love to eat, not to mention that dental work can be expensive. A single root canal and a crown can cost several thousand dollars from a good dentist. So if you want to save yourself some heart-ache, pain, and money, all it takes is less than 10 minutes a day.


If plaque is left for too long on your tooth, it can harden as it combines with the minerals in your saliva and become calculus. This calculus is impossible for you to remove at home with just a toothbrush or floss and you will need to see your dentist or hygienist for a deep cleaning. This calculus is full of bacteria and can smell bad and destroy your gums and bone around your teeth.

Swollen Gums & Periodontitis

This leads to the next consequence of not brushing properly – swollen gums or what is known as gingivitis. Because your body wants to fight the infection and build-up of bacteria on your tooth and gum line, it will bring in more blood flow to the area which brings bacteria-fighting cells to fight the infection in a process known as inflammation. This is when your gums get swollen, painful, and dark red. Gums with severe gingivitis will bleed very easily because of the increased amount of blood in the gums. So if you have ever noticed that when you brush or floss, you bleed and it is painful, that does not mean you should stop cleaning them. That means you are not cleaning them enough or properly

Teeth are held in your mouth by bone and if gingivitis becomes severe enough, it will actually start to destroy the bone that holds your teeth in place. This condition is called periodontitis. Eventually your teeth will get loose and have to be taken out or extracted. It can also hurt to chew, you may experience bad breath or halitosis, you will see receding gums, and black triangles or spaces between your teeth. 

Why Does It Matter?

So why does this all matter besides the fact that you can lose your teeth? In terms of your orthodontic treatment, if you don’t keep your braces, gums, and teeth clean, it makes it difficult for your orthodontist to finish your case properly.

I do absolutely everything in my power to give my patients the best results possible, but when I have a patient that doesn’t do their part to keep their teeth clean, it puts a lot of pressure on me to remove the braces quickly because I can see the teeth and gums getting damaged. Sometimes we will leave the wires out for a month or two to give our patients an opportunity to build better hygiene habits, but this sets them back in treatment time. In extreme situations, I am forced to remove braces early because poor oral hygiene is severely damaging the teeth and we unfortunately have to accept a less than ideal result. Put simply, if you want the best bite and esthetics from your orthodontic treatment, please keep your teeth clean.

How to Brush & Floss Your Braces

Watch our YouTube video on proper brushing and flossing techniques!

Final Tips

Remember to be gentle to avoid damaging your braces or hurting your gums. It is a very common misconception that you must brush HARD to brush effectively. If you brush too hard, you can cause gum recession or break a bracket.

You must still see your general dentist for dental check-ups and cleanings at LEAST every 6 months. It is much easier for your general dentist or hygienist to clean your teeth if your wires are out. You can call your orthodontist’s office to schedule an appointment right before your cleaning and right after so that they can remove your wires before your cleaning and replace them afterwards.


Brushing and flossing with braces is a bit more time-consuming, but trust me, it is totally worth it to keep your gums and teeth nice and healthy throughout your orthodontic journey. It will be extremely disappointing if you have to get your braces off early with a less than ideal result, or if you have a bunch of holes or permanent stains on your teeth when you’re finished. I tell all my patients to be patient, especially in the beginning. It will take time to build up this habit, but just take it one day at a time and eventually this will be a breeze and you’ll be able to clean your braces in under 10 minutes a day.

NOTE: The author, Dr. Phillip Ha, is a board-certified orthodontist who serves patients at his private practice, Rise Orthodontics, in Modesto, California. He was trained at Loma Linda University in Loma Linda for both his dental and orthodontic specialty training. Dr. Ha is an expert in two-phase treatment, extraction, non-extraction, clear aligners (Invisalign, Spark, uLab), and multiple brackets such as Stride Custom Braces and Traditional Metal Twin braces. This blog is for informational purposes only and was written to help consumers understand important orthodontic topics