Oral hygiene instructions with braces

Instructions For Your Braces by Dr. James Noble

Congratulations on receiving your braces and starting your orthodontic treatment today!

I am excited to work with you as a team in this incredible life altering journey together.

My mission is to provide you with a beautiful smile, along with an excellent aesthetic and functional treatment result in a caring, fun and friendly environment.

Before we begin, there are several important instructions that you need to know in order to care for your braces. Please take the time to read these instructions and do not hesitate to ask any questions.


What to expect

After the braces are placed, there may be some soreness in your teeth and they may feel slightly loose. This is normal and there is no need to be concerned. This is simply the body’s reaction to the pressure and movement of your teeth. In the beginning of treatment soft foods such as soups, mashed potatoes, yogurt, smoothies, pastas and rice are advised until you feel that you are able to eat harder foods. Over the counter Tylenol and Advil can be used as well to relieve some of the soreness. The inside of your cheeks may become irritated and you may feel that your tissue feels rough. This is normal and occurs because the braces are rubbing against your tissue as you talk and eat. To help relieve some of this discomfort we will also provide you with orthodontic wax to cover braces that are causing sore spots in the mouth. Everybody is different and everyone’s body responds to treatment differently; healing time will vary from person to person, it could take a few days to get used to the braces or it could take a few weeks. Some people may also not feel any discomfort at all after their braces are placed or during the entire treatment time.


Oral hygiene

Now that braces have been placed it is extremely important that you are brushing after every meal (at minimum four times daily) for at least 3-4 minutes each time and flossing every night. The most important time to brush is before bed at night. It is important to be very thorough and spend at least 6 minutes or more brushing at this time because while you are sleeping you are at higher risk of having cavities and white spot lesions form.   With poor oral hygiene, white spot lesions will develop on the teeth and this is the beginning of a cavity. These white spots are permanent and they require costly restorative treatment to repair once the braces are removed.


The most important exercise you can do for your teeth and gums is flossing. Flossing removes the food and bacteria between the teeth and under the gums which the bristle of your toothbrush can not access. If the bacteria is not removed gingivitis will occur; gingivitis is an infection in your gums and it will cause them to be swollen, red and they will bleed easily. If gingivitis goes untreated it will lead to periodontal disease and that is when the bacteria start to break down the ligaments that support the roots of the teeth to the bone. Once that tooth is no longer supported in the bone by the ligaments, you may lose that tooth. If there is gingivitis present it will also slow down treatment as the infection blocks the roots of the teeth from moving freely through the bone. Regular dental check-ups and cleanings with your dentist are strongly recommended for the continued health of your teeth and gums.


Brushing Techniques

When using a power toothbrush hold the brush head to one tooth at a time for 30 seconds making sure that you get all areas of the tooth and brace and be sure to get under the gums as well. Do not move the brush back and forth in your mouth; it rotates so quickly that it will miss areas of your teeth. Be sure that you brush your chewing surfaces and the inside of your teeth as well and again concentrate on your gums.

There are times when using a manual brush will be needed; such as after lunch when at school or work. Manual brushing requires more effort. You must make sure that you angle your brush at a 45 degree angle towards your gum and gently but firmly brush your gum and then brush downwards to remove the plaque at the gum line away. Then brush on top of the brace, underneath the brace and a circular scrub around the braces. Again, don’t forget the chewing surfaces and the inside of your teeth.


Brushing with braces
Brushing with braces


Flossing is just as important as brushing. Flossing allows you to remove bacteria that your toothbrush can’t reach. Flossing will be more challenging and will take patience and effort. It will take a lot longer to floss but if it is kept a part of your routine it will become easier and you will become faster at it within a couple of weeks. Floss threaders aid in flossing and make it possible to get between the tooth and the wire. To use the floss threader it is always best the push the floss away from your lip, so for the top teeth drop the floss down underneath the wire and wrap the floss tight around both fingers of both hands and gently floss both sides of each tooth go as far as comfortable or make a “C” shape around each tooth. Release the floss from one hand and repeat in between each set of teeth.


Interdental brushes

For on the go, when a tooth brush is not available interdental brushes can be used to remove any food that may be caught in the braces. They are not meant to replace brushing or flossing but to tide you over until you are able to.


Eating with braces

Being very careful and finding different techniques you can eat most foods without damaging the braces. Some foods have to be avoided during treatment they are foods that will break braces and if braces are being broken on a regular basis it is hard to progress in treatment.


Examples of hard and sticky foods that are strongly discouraged include:

Hard and sticky candies                                        popcorn seeds

Jolly ranchers                                                                 nuts

Starbursts                                                               Ice-cubes

Caramels                                                                Toffees

Peanut brittle                                                        Gum containing sugar

Hard foods such as uncooked fruits and vegetables can be eaten in a modified way for example an apple is hard but if it is cut up into bite size pieces and placed towards the chewing surfaces it can be eaten without breaking a brace. The trick is always bite size pieces placed towards the chewing surfaces and never bite into anything that is hard. Corn on the cob should to be taken off the cob it is too difficult to bite into the cob without breaking a brace. Meats that are on bones can be eaten but the meat needs to be taken off the bone. Biting into a chicken wing or a rib can break a brace off. Foods that have pits can be cut into smaller pieces to avoided biting into the pit.



The success of your orthodontic treatment depends a lot on your cooperation. Keeping your teeth and gums clean and healthy will keep your treatment on track; not breaking braces or appliances on a regular basis will also help with the success of your treatment. There may be a time where you may have to wear elastics or other orthodontic appliances. It is important that you follow instructions exactly to ensure the success of your treatment. If there are any problems or concerns, please do not hesitate to call the office; we are here to make your orthodontic experience as pleasant as possible.



We greatly appreciate at least 72 hour notice before any change in appointments.


Root Resorption

During treatment, the tips of the roots of the teeth may become blunted or shortened. While some patients are prone to this happening, most are not. X-rays will be taken during treatment to monitor for this. Short roots are generally of no disadvantage under healthy circumstances (good oral hygiene), but the life of the tooth may be shortened if oral hygiene is poor.


Problems and solutions

Loose brackets or bands

If a brace or band comes out, leave it in place if it still attached to the wire Place wax on the brace if it is causing discomfort and give us a call at the office to replace it.

Loose wire

Try to place the wire back in with tweezers. If that is not possible, you can try to clip the end of the wire with nail clippers. If neither are possible than cover the end of the wire with wax and give the office a call to have the wire clipped.

Loose Tiewire or Elastics

If it is causing discomfort cover with wax and call the office to have the elastics or ties replaced.

Loose Appliances

If it is causing discomfort cover with wax and call the office to have the appliance repaired.


Take Tylenol/Advil and use a warm salt water rinse to help promote healing.