Cleaning Instructions, 410-696-4624, Dr. Trepp, Orthodontist

BRUSHING

Brushing 2 minutes two times a day with a fluoride toothpaste is one of the most important things that you can do to keep your breath fresh, your smile shining bright and gum inflammation at bay. The most important time to brush is just before you go to bed because the protective cleansing action of saliva decreases during sleeping. When children less than 8 years old are using a fluoride toothpaste, they should be supervised to make sure that they only use a pea sized amount of toothpaste and that they spit the toothpaste out when done brushing. Permanent stains, cavities and gum disease are all caused by bacteria (germs) that live on teeth in a white sticky coating called plaque. PLAQUE MUST BE REMOVED EVERY DAY. Braces make it harder to remove plaque and place you at higher risk for cavities and gum disease. Brackets, bands and archwires create nooks and crannies that are hard to reach, therefore cleaning is different and can take up to three times longer. Poor oral hygiene (cleaning) during orthodontic tooth movement can accelerate deterioration of your gums and the bone around your teeth leading to tooth loss.

Harsh brushing can damage or abrade your teeth and cause gum recession. Use a gentle touch and a soft bristle toothbrush when cleaning your teeth. Rinse your toothbrush under hot water to soften its bristles even more. The brush should be placed against the teeth at an angle. The bristles should be gently pushed UNDER the wire and between the teeth.

tooth brushing sketch

The brush should then be wiggled and moved in small circles, a few teeth at a time. This should be done from above and below the main wire. Pay particular attention to the area between the braces and gums which are so prone to holding plaque that we call it the "danger zone". Spend about 10 seconds brushing each tooth. When the brushing is finished, the braces should be shiny, the gum margin should be distinct and the gum tissue should be firm and a light pink color. Don't forget to gently brush your tongue, cheeks and roof of your mouth to reduce the germ level and improve breath freshness. A careful brushing should take 2 minutes and should be done within 10 minutes after eating.

The latest 2010 studies recommend the following brushing technique and frequency to maximize the benefits of fluoride in your toothpaste:

1 Use 3/4 inch of toothpaste on a wet toothbrush
2 Spread the toothpaste evenly on the upper and lower teeth
3 Brush all surfaces for 2 minutes (figure A)
4 Then Sip a little water with the toothpaste still in your mouth and swish the toothpaste all around your teeth by active cheek movement for 30 seconds (figure B)
5 Spit out the toothpaste and avoid further rinsing with water
6 Rinse your brush with water to thoroughly clean it
6 Avoid drinking or eating for 2 hours (figure C)
7 Brush twice a day, after breakfast and at night before going to bed (figure D)

Some people will supplement their toothbrush with a interproximal brush which can clean spaces between too small for a regular tooth brush and too large for floss.

Interproximal Brush

FLOSSING

Flossing during orthodontic treatment is tricky and time consuming, but with practice it can become an easy daily routine. Flossing WITH braces is more important than flossing without them, because plaque collects around the appliance. Plaque is the major cause of gum disease and must be removed daily. Only floss can reach BETWEEN the teeth to remove plaque.

WAXED floss or tape should be used; unwaxed floss will shred on the metal edges of the bands and brackets. Use a piece of floss about 18" long. Your orthodontic assistants can show you how it is held. The floss must be threaded under the main wire before it is passed between the teeth. A plastic "floss threader" or "bridge aid" can be used to help thread the floss under the main wire.

Be careful not to snap the floss as it is moved between the teeth. Steady pressure works best. Rub the floss up and down against the sides of each tooth; avoid using a shoeshine motion. Do not force the floss hard into the gums, but be sure to clean the tooth surface under the loose collar of the gum tissue. Repeat this procedure for each tooth. Do not forget the back side of the last tooth. Parents should floss younger children who may not have the fine motor skills to floss properly.

A newer hand flossing alternative is the DenTek Braces Clean Angled Floss Picks. This specially shaped plastic fork with floss pre-attached is slid up behind the archwire to floss in between the teeth.

Another hand flossing alternative is Oral B Superfloss. Slide the stiffened end of the Superfloss behind the main wire and either use the spongy section of the Superfloss for wide spaces and the regular floss section for between the teeth.

An alternative to hand flossing is the Waterpik Power Flosser. It is a battery operated device that has a replaceable rubber tip which vibrates. The rubber tip is placed between adjacent teeth and is moved up and down the sides of the teeth to rub off food and germs clinging to the sides of the tooth. Wipe off the tip if it becomes covered with debris before placing it against the side of the next tooth. This cleaning device is available at major retailers for less than $30.

Teledyne Flosser Image

RINSING

Rinsing your mouth with Crest ProHealth Rinse for 30 seconds twice a day has been shown to reduce bacterial plaque and gingivitis.

Listerine Image

When done brushing, flossing, and rinsing, pull your lips and cheeks away from your teeth and inspect your work in a mirror. Metal braces should shine, your teeth should be free of the cream colored filmy plaque, your gums should not bleed or be inflamed. Inflamed gums can cause complications.

Remember that you may be a role model for younger family members watching you, so set a good example.

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You may schedule an orthodontic appointment with Dr. William Trepp in his Severna Park, MD office by calling 410.696.4624 or in his Clinton, MD office by calling 301.868.6200. Written inquiries should be mailed to: 69 Robinson RD, Severna Park, MD 21146, USA or 8918 Woodyard RD, Clinton, MD 20735, USA