Patients and parents very often do not realize the importance of excellent oral hygiene and meticulous care of orthodontic appliances during treatment. Brackets themselves do not cause decay, but they do act as food traps making it more difficult to keep the teeth clean. The area of the tooth between the metal bracket and the gum tissue is prone to form a "white line" if not brushed properly. This is the first stage of decay. This scarring of the tooth is permanent and occurs most frequently on the upper front teeth.

The teeth should be brushed after each meal and snack. A soft-bristled toothbrush should be used in a rotary motion, cleaning not only the bands and teeth, but the gums as well. Dr.O recommends that you use a soft bristled toothbrush with moderate force and a toothpaste that contains fluoride. Place the toothbrush at an angle so that you feel the bristles under your gum line and use small circular motions. Completely clean each surface of every tooth in your mouth, including the areas above, below and between each brace. Each surface of every tooth should be scrubbed with 10 strokes of the toothbrush. This should take 2-3 minutes.

Dr. O recommends that you brush at least 4 times per day: after breakfast, after lunch (or as soon as you get home from school), after supper and at bedtime. Your toothbrush will wear out faster because of your appliances, so be sure to replace it whenever the bristles start to fray.

1. Use a soft toothbrush with a small amount of toothpaste. Completely clean each surface of every tooth in your mouth, including the areas above, below and between each brace.	2. Use circular, vibrating motions around the gum line. Scrub each surface of every tooth with 10 strokes of the toothbrush. This should take 2-3 minutes.
3. Brush every tooth slowly. Brush the upper teeth down.	4. Brush the lower teeth up. Also brush your tongue and the roof of your mouth

Remember that a toothbrush might not reach the areas under the archwire properly. Proper oral hygiene also involves flossing and the use of an interdental toothbrush (Proxabrush), an antiseptic mouth rinse (Peroxyl) and a topical fluoride (Phos-Flur)!