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Dealing with the Aftermath of Braces

Teeth Maintenance After the braces come off

It's the day your child has been anticipating for almost two years. She is finally getting her braces off! As her name is called from the waiting room, she can hardly hold back her excitement, knowing that within the hour she will have a straight, metal-free smile. What could ruin this day?

If your child has been taking care of her teeth, then all should go according to plan. However, Dr. Herbert Hughes of Hughes Orthodontics in Alexandria, Va., says that too often when the braces come off, marks or "white scars" are left behind. "Most of the time, these white scars can be prevented by practicing good oral hygiene," says Dr. Hughes. "As an orthodontist, I try to be very proactive in notifying patients that they can take an active role in making their smile as beautiful as possible."

What Are White Scars?

White scars look like little white squares that outline the area where braces once were. "It's important for people to know that braces do not cause staining," says Dr. Hughes. "Food left on teeth comes in contact with bacteria, which causes acid. This acid robs teeth of calcium and phosphate, causing decalcification or 'white scars.'"

According to Dr. Hughes, anyone who does not practice good oral hygiene can have white scars – it's not limited to orthodontic patients. "However, people with braces are more prone to getting this decalcification because the braces act as a 'food trap,'" he says. Unfortunately, these stains are usually permanent. Although teeth can be whitened to hide the stains, who wants the additional expense after investing in braces?

Hygiene Habits

There are certain steps everyone should perform daily to ensure a white smile and healthy teeth: brushing, flossing and eating healthy foods. "Establishing an oral hygiene routine is critical when wearing braces, both in the morning and evening," says Susan DesPain of St. Louis, Mo. She and her daughter, Maggie, both wear braces.

When wearing braces, the American Association of Orthodontists (AAO) makes the following suggestions to help you and your child keep your braces and teeth as clean as they can be:

  • Be sure to brush at least four times a day (after every meal and before bed).
  • If you are away from home and unable to brush, try rinsing your mouth after eating.
  • Brush until your teeth and braces are spotlessly clean at least once a day. This includes flossing!
  • Don't forget to schedule cleanings twice a year (or more, if needed) with your general dentist. "Patients often think seeing the orthodontist is enough, but that's not true," says Dr. Hughes. "It's very important to visit your regular dentist for professional cleanings while wearing braces. Before having your teeth cleaned, your orthodontist can remove your wires, which helps the dentist clean your teeth more effectively."
  • Wash the plaque away with a fluoride rinse. "Rinsing allows the fluoride to penetrate all of the nooks and crannies created by braces and gets to the surface of the teeth," says Dr. Hughes. When asked if parents should be concerned about their children receiving too much fluoride, he says to not be worried. "I've never seen problems with patients using both a fluoride toothpaste and a rinse," says Dr. Hughes. "It's when they do not use both products that problems occur." Your orthodontist can prescribe a rinse for you, or you can purchase brands such as Colgate Phos-Fur over the counter.
  • As always, eating healthy foods is a plus for great teeth. With braces, there are foods that should be avoided. Hard, sticky or chewy foods (popcorn, jellybeans, taffy, nuts, etc.) can cause damage to braces and lengthen the treatment time.

Your orthodontist may recommend other tools to help keep your teeth clean and healthy. "We have added a floss threader to help us floss under the archwire," says DesPain. "We also now have electric toothbrushes and interproximal brushes, which look like mini bottle brushes and slip under the archwire to clean."

Dr. Hughes also recommends having your child brush his or her gums with a toothbrush, which can be done while reading or watching TV. "The stimulation to the gums will make them healthier and prevent dental decay in the future," he says.

These tips not only keep your teeth white, they will also keep your gums healthy. In addition to white scars, bad oral hygiene habits can cause gum diseases such as gingivitis and periodontitis.

Money Well Spent

DesPain says that her daughter is eager to take care of her braces and oral hygiene, but Mom performs periodic checks to make sure she is getting the job done. "Also, Maggie was inspired by her orthodontist," she says. Upon getting braces, Maggie signed a contract with the orthodontist to follow the rules of taking care of her teeth and not eating certain foods.

So make sure the money you spend on your child's braces adds up to a straight, beautiful, white smile. Keep up the good hygiene habits and make "Braces Off Day" everything your child anticipates it to be.

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