How to Care for Your Braces — and Why It Affects More Than Your Teeth
What patients do between orthodontic appointments has a direct bearing on how long treatment takes. A guide to cleaning, diet, managing emergencies, and keeping the process on schedule.
Braces do most of the work on their own. The appliance is bonded to the teeth, applying continuous pressure according to a treatment plan, requiring nothing from the patient to keep moving. That is part of the appeal of fixed orthodontic treatment.
What patients do between appointments, however, matters more than most expect. Poor cleaning habits, the wrong foods, or an unaddressed broken bracket can each add weeks — sometimes months — to a treatment timeline. The gap between finishing on schedule and finishing late is largely determined by what happens outside the office.
Cleaning Teeth With Braces
Brackets and wires create new surfaces where food and plaque collect — surfaces that standard brushing technique was not designed to reach. The American Association of Orthodontists identifies inadequate cleaning during treatment as a primary cause of white spot lesions, cavities, and gum inflammation that can delay or compromise results.12
White spot lesions — areas of permanent enamel demineralization that appear as dull, chalky marks on the tooth surface — are among the most common complications of orthodontic treatment and are almost entirely preventable with consistent hygiene.34 They are also irreversible. The case for taking cleaning seriously is not merely aesthetic.
The Daily Routine
The cleaning routine with braces is more involved than brushing without them, and that is simply the reality of the treatment period. The core elements:
- Brush after every meal using a soft-bristled toothbrush and fluoride toothpaste, angling the bristles at 45 degrees to clean above and below each bracket
- Use an interdental brush10 to clean between brackets and under wires — the areas a standard toothbrush cannot reach effectively
- Floss daily using a floss threader or orthodontic flosser to pass beneath the archwire and clean between each tooth
- Rinse with alcohol-free fluoride mouthwash to reduce bacterial buildup in areas brushing cannot address
A water flosser is a useful supplement to this routine — particularly for patients who find threading floss under wires time-consuming — though it does not fully replace mechanical flossing.5 Orthodontic wax is worth keeping available for brackets or wire ends that irritate soft tissue.
Diet During Treatment
A broken bracket stops all movement on that tooth immediately. Every day a bracket remains unrepaired is a day that tooth is not progressing. The dietary restrictions that accompany braces exist to prevent exactly that — along with the wire damage and soft tissue injury that certain foods also cause.
The American Dental Association notes that food choices during orthodontic treatment affect both appliance integrity and oral health outcomes directly.6 The foods most likely to cause problems:
- Hard foods — nuts, popcorn, ice, hard candy, raw carrots
- Sticky foods — caramel, chewing gum, chewy candy
- Foods bitten into directly with the front teeth — whole apples, corn on the cob, crusty bread
- Sugary drinks, which significantly elevate decay risk around brackets
The list of what remains available is considerably longer: pasta, rice, cooked vegetables, eggs, yogurt, soft breads, fish, and tender meats all remain unaffected. The adjustment is real for the first few weeks and manageable once the habit forms.
Managing Braces Emergencies
Knowing what to do before something breaks keeps a minor inconvenience from becoming a source of unnecessary anxiety. Most issues that arise between appointments are manageable at home temporarily — but they do require attention.
Loose or Broken Bracket
A bracket that has debonded from the tooth surface is no longer applying force to that tooth and needs to be repaired. It is not an emergency in the urgent care sense, but it should not wait until the next scheduled appointment.8 Cover any sharp edges with orthodontic wax and contact the practice to schedule a repair visit.
Poking Wire
Use the eraser end of a pencil to gently reposition a wire end that is irritating the cheek or gum. If it cannot be moved, orthodontic wax over the end provides relief until the issue can be addressed at the office. In most cases this can wait for a scheduled visit — the practice can advise on timing when contacted.
Lost or Broken Elastic
Replace with a spare if available. Missing elastic wear for even a few days can affect bite correction progress, particularly in cases where elastics are doing meaningful work. Contact the practice if the supply runs out.
When to Call Immediately
Swelling, severe pain, or any injury to the mouth involving braces hardware warrants an immediate call. These situations should not wait.
Appointments and Professional Care
Adjustment appointments — typically scheduled every six to eight weeks — are not optional check-ins. Wire adjustments, elastic replacements, and monitoring of tooth movement are all performed at these visits. A missed appointment does not simply delay the schedule by that increment; it can interrupt the carefully sequenced progression of forces the treatment plan depends on.9
Professional dental cleanings every six months remain important throughout orthodontic treatment. The American Association of Orthodontists specifically recommends maintaining routine cleanings during treatment — cleaning around brackets thoroughly is something that cannot be replicated at home, and the periodontal health implications of neglecting it during a period of increased plaque retention are well documented.79
Alinea Orthodontics is a boutique practice at 2701 Ocean Park Blvd, Suite 110, Santa Monica, CA. Board certified by the American Board of Orthodontics. For braces care questions, broken brackets, or appointment scheduling, contact the practice at (424) 428-0008 or alineaorthodonticsca.com.
References
- American Association of Orthodontists. Oral Hygiene During Orthodontic Treatment. AAO; 2023. Accessed May 2026. https://www.aaoinfo.org
- Zachrisson BU, Zachrisson S. Caries incidence and oral hygiene during orthodontic treatment. Scand J Dent Res. 1971;79(6):394-401. doi:10.1111/j.1600-0722.1971.tb02028.x
- Richter AE, Arruda AO, Peters MC, Sohn W. Incidence of caries lesions among patients treated with comprehensive orthodontics. Am J Orthod Dentofacial Orthop. 2011;139(5):657-664. doi:10.1016/j.ajodo.2009.06.037
- Benson PE, Parkin N, Millett DT, Dyer F, Vine S, Shah A. Fluorides for the prevention of white spots on teeth during fixed brace treatment. Cochrane Database Syst Rev. 2004;(3):CD003809. doi:10.1002/14651858.CD003809.pub2
- Sharma AA, Park JH. Orthodontic considerations in pediatric, geriatric, and medically compromised patients. J Clin Orthod. 2010;44(1):20-27.
- American Dental Association. Diet and Oral Health: Guidance for Orthodontic Patients. ADA; 2022. Accessed May 2026. https://www.ada.org
- Bollen AM, Cunha-Cruz J, Bakko DW, Huang GJ, Hujoel PP. The effects of orthodontic therapy on periodontal health: a systematic review of controlled evidence. J Am Dent Assoc. 2008;139(4):413-422. doi:10.14219/jada.archive.2008.0184
- Proffit WR, Fields HW, Larson B, Sarver DM. Contemporary Orthodontics. 6th ed. Elsevier; 2018.
- American Association of Orthodontists. Clinical Practice Guidelines for Orthodontic Treatment. AAO; 2023. Accessed May 2026. https://www.aaoinfo.org
- Periodontal Health and Residency Program Faculty. Interproximal oral hygiene aids. J Evid Based Dent Pract. 2014;14(suppl):68-79. doi:10.1016/j.jebdp.2014.02.006
