I am often asked if having braces causes cavities. The short answer is no. However, poor oral hygiene while you have braces on your teeth could lead to cavities if you’re not careful.
Patients who have traditional metal or ceramic brackets know this point firsthand: there are lots of nooks and crannies that can capture bits of food. Brushing and flossing between meals, or at least rinsing thoroughly with water or mouthwash can help dislodge bits of food that can lead to plaque, which is a sticky layer of bacteria. When plaque meets up with sugars in the foods you eat, an acid is formed that causes tooth decay.
Those of you who are in orthodontic treatment with Invisalign have a slight advantage, in that you must remove your aligners before eating. That eliminates the situation of food getting stuck in appliances while eating, but it doesn’t eliminate the need for brushing or at least rinsing between meals. Let’s say you eat a meal and promptly pop those aligners back in your mouth and continue on with your day. Any bits of food between your teeth are likely to remain firmly in place, locked in by your aligners, until the next time you brush and floss. Yuck.
It’s a given that if you are in some form of orthodontic treatment, you and/or your parents want to see you with a beautiful smile at the end of treatment. You can protect your investment in your smile and avoid getting cavities by knowing the other potential problems you could face while in treatment.
Demineralization occurs when sugars and acids erode minerals from your teeth surfaces, which results in lowered pH levels in the mouth. Enamel demineralization is considered to be the most prevalent and significant side effect associated with fixed orthodontic treatment and can jeopardize the life of your teeth, as well as aesthetics, according to a 2013 article in “Orthodontics”. You can learn more about demineralization in a post I wrote on the topic last year.
Demineralization can cause white spots to form on teeth and eventually can lead to cavity formation.
Also known as calculus, tartar forms when plaque is left on your teeth surfaces and hardens. Tartar can trap stains on teeth and cause discoloration. It’s also fast-acting. It begins to develop after just 24 hours, and can form around your brackets or other orthodontic appliances, along your gum line and just beneath the gums.
Once tartar is present, only your dentist or dental hygienist can remove it.
Cavities and Orthodontic Treatment
In case you didn’t pick up on it already, there are two common denominators regarding demineralization and tarter: they both are fairly common among those in orthodontic treatment, and they both can lead to cavities. So let’s play worst-case-scenario and share what could happen if you get a cavity while you’re in orthodontic treatment.
In cases where the cavity is located in an area that is easily accessible – on the biting surface of a molar, for example – it is likely that filling the cavity won’t set you back on your orthodontic treatment schedule. However, getting a cavity in an area near a band or bracket could become a labor-intensive and time-consuming repair. Your dentist could require us to remove a band or bracket to get to the cavity and adequately fill it. That will result in you having to schedule an appointment at our office to remove the appliance; getting the cavity filled by your dentist; and then coming back to our office to have the appliance replaced.
In a perfect world, you would be able to schedule these appointments close together to minimize the time you’re out of active orthodontic treatment. But when you have to work around our schedule, your dentist’s schedule and your personal schedule, this can be challenging.
How to Prevent Cavities While in Treatment
By now, I hope I’ve made it clear that you want to avoid cavities when you’re in orthodontic treatment and beyond. Doing so is easy when you know the proper oral care techniques and have the right tools at your disposal. I am proud to say that we equip each and every one of our patients with a variety of instruments to help make hygiene easier with braces. These are a few of the tools you’ll want in your home care arsenal:
Floss threaders: These little plastic loops make it easier to thread your dental floss behind your arch wires and between your teeth. Flossing may take a bit longer when you have braces, but it is an important step in your daily dental care.
Soft-picks: These tools have a pliable, rubberlike “brush” on the end and are great for dislodging bits of food from around your brackets and between teeth.
Proxabrushes: A bit sturdier than soft-picks, interdental brushes also are designed for cleaning around brackets and between teeth.
Water pick: This is a great tool to have at home. A water pick uses water bursts to remove bits of food between teeth and around your orthodontic appliances.
Sonicare Airfloss: This instrument is like a cordless water pick. You can fill it with water (or mouthwash) and each press of the button releases a burst of air and water. You use it between teeth and around your appliances.
Plaque-detecting rinse: This is a great tool to let you know how you’re doing in the oral care department. Products such as Inspector Hector and Listerine’s Agent Cool Blue tint plaque blue when swished around in your mouth. This shows you the areas that need your special attention.
Electric/sonic toothbrush: There are several options from which to choose, and OralB and Phillips make great toothbrushes. These high-powered tools are excellent at removing food and plaque, reducing gingivitis and improving gum health. Their built-in timers help ensure you brush your teeth for the appropriate length of time.
Retainer cleaners: These products can be used if you’re in Invisalign treatment, as well as after you’ve completed treatment and have moved on to retainer use. There are various brands of retainer cleaners on the market, such as Retainer Brite, for example. You also can use denture cleaner, or soak your appliances in hydrogen peroxide. It’s important to keep Invisalign aligners and retainers clean so they don’t harbor bacteria.
I hope you’ve found this information helpful, and it has inspired you to keep up that oral care regime to prevent cavities and protect the investment in your smile.