Brushing and Flossing Best Practices

The best way to ensure a clean and healthy smile is through proper oral hygiene, including brushing, flossing, and using a fluoride mouthwash. Food particles can accumulate on teeth and in braces, and, over time, turn into plaque. The bacteria that results from this accumulation can lead to gum disease, tooth decay, and even loss of teeth. To avoid these problems while you are in orthodontic treatment, take special care of your braces, teeth, and gums to ensure you will have the best possible result.

Brushing Technique Without Braces

Brushing Technique With Braces

Flossing Around Braces

Proxy Brush

Tissue Swelling & Decalcification Due To Poor Oral Hygiene


Patients should brush their teeth a minimum of twice each day: after breakfast and before going to bed. However, we encourage patients to brush after each time they eat for the best possible oral hygiene. We also recommend that each patient floss their teeth a minimum of once per day, preferably before going to bed.

Use a toothbrush with soft bristles and a small strip of fluoride toothpaste. When you brush your teeth, move the brush in small, side-to-side motions with gentle pressure to reach food particles that may be under your gum line. Hold the toothbrush at a 45 degree angle to the braces (both above and below the braces) and brush slowly and carefully, covering all areas between the braces, between the teeth, and the surface of each tooth. It will take you at least 2 minutes to thoroughly brush your teeth, and we highly recommended an electric toothbrush with a built-in brushing timer. It is also helpful to brush the top of your tongue to remove bacteria that accumulate there and cause bad breath.

While in braces, you will need to replace your toothbrush more often due the increased wear on your toothbrush from rubbing against your braces. As soon as the bristles start to wear down or fray, replace your toothbrush with a new one. It may be difficult for your toothbrush to reach some areas under your archwire; therefore, it is essential that you floss daily to remove this buildup and prevent cavities. Do not swallow any toothpaste and rinse your mouth thoroughly with water after you finish brushing. It is important to floss and use an antibacterial mouthwash and fluoride treatment throughout your orthodontic treatment and beyond for optimal oral hygiene.

Dr. Gamache recommends the following sequence for oral hygiene: 1) Floss under your archwire and between all teeth; 2) Brush thoroughly for at least 2 minutes then rinse well with water; 3) Use a fluoride mouthwash for 30-60 seconds, spit out, then do not eat or drink anything for 30 minutes to allow the fluoride time to strengthen the enamel of our teeth.


For areas between the teeth that a toothbrush cannot reach, use dental floss to remove food particles and plaque. Flossing takes more time and patience when you are wearing braces, but it is important to floss your teeth every day.

The easiest way to floss while in braces is to use the reusable floss threader provided by our office. Pull a small length of floss from the dispenser through the 'eye' of the floss threader then tie the floss to the floss threader 'eye' or loop. Once this is complete, slide the floss threader under the archwire, grab the floss as you normally would to floss, and floss through the contact of the teeth you are presently by. Be sure to form a 'C' shape around each tooth to ensure you remove the most amount of plaque as possible. After that tooth contact is clean, finish pulling the floss through the contact and move to the next contact area to floss. Don't forget to floss behind all of your back teeth.

You will be able to feel when the tooth is clean as the tooth will feel smooth as you run the floss against it. In addition, you will hear the squeak of the floss against your clean teeth. Use care around your archwire and do not floss too forcefully around it or put too much pressure on it as you may pop a bracket loose.

Floss at night to make sure your teeth are clean before you go to bed as this is the time when bacteria can cause the most damage to your teeth if they are not very clean, resulting in decalcification (white spot lesions) or even cavities. When you first begin flossing around your braces, your gums may bleed a little. If the bleeding does not go away after the first few times, inform a staff member at your next appointment.