Protecting your teeth from the high Cavity Risk of Braces

First I want to be clear that braces do not cause cavities. However, they do gather a lot of food debris which dramatically increases the risk of getting cavities. Actually, poor care of braces can lead to cavities, root canals, gum disease, gum surgery, and loss of teeth! Taking good care of the braces will completely eliminate this higher risk situation.

First, obviously, is just plain good tooth brushing. It is going to take more time. There are lots of nooks and crannies that will take some diligence to get clean. You are going to use up a lot of toothbrushes so feel comfortable asking for more. We have a few ideas and tools that can help this immensely. It just takes diligence.

Second you will hear about flossing, again, as if we don't talk about that enough already! Flossing is a time consuming challenge with braces. Obviously I would love to see the teeth flossed completely every day. A more realistic thought is to floss 1/4 of the teeth each day. Do it properly and the teeth end up being well flossed every 4 days. A short routine every day will get better results that a long routine occasionally.

Third, and I think critically important, is using a fluoride mouth rinse daily or a high potency fluoride toothpaste available by prescription from your orthodontist. This is something I prescribe for all my "high risk for cavities" patients. Research the last 20 years has shown the topical exposure of fluoride to the teeth is what is important. We don't have to swallow it to get the benefit. We just need to expose the saliva to fluoride a few times a day to gain adequate protection. The best regimen I can prescribe to accomplish this is:

1. Brush your teeth immediately after breakfast and dinner with a fluoride toothpaste. Spit it all out and do not rinse your teeth after. The small residue of fluoride that clings to your teeth will remain nearly 6 hours, depending on your eating habits after.
2. Use a fluoride mouth rinse just before going to bed. Please no snack, drink or rinse after the fluoride. Saliva flow slows down during sleep and we can get an 8-hour benefit from this simple rinse.
3. The fluoride rinses available in the stores are:

Fluorigard
ACT
Oral B with Fluoride

Our objective here is multiple. We want to prevent cavities for sure. We also want to avoid the unsightly white and brown scars that can blemish the front teeth if they are not well cared for during braces. We also want the gums healthy so they don't overgrow the braces.