Orthodontic Tips May 27, 2014
Cavities under braces are a real danger.
What can we do about it?
There are three things to do about it: and there are three times to do it.
The three things are the same as the three actions for pediatric dentistry: Tell, Show, Do.
The three times to do it are when the braces go on, during the orthodontic treatment, and again during the orthodontic treatment.
Tell: Instruct the new orthodontic patient how to brush their teeth. The danger area is gingival third of the tooth so the bristles of the brush need to be pushed into that area to get rid of plaque there.
Show: Show a picture such as the one above what can happen if they do not remove the plaque effectively.
Do: Brush the patient’s teeth for them using the method of pushing the bristles of the brush under the wire and into the gingival area between the brackets and the gingiva.
The second time to do something is when they return for their retie appointment. Give the patient a grade (out of 5 is easy) for oral hygiene. 4 out of 5 is acceptable. If the grade is 3.7 or lower then another tooth brushing demonstration is necessary.
The third time to do something is when they return for their next retie appointment. If the grade is still 3.7 or lower then consider a fluoride varnish every three months to protect them as much as possible during their orthodontic care.
Life is not perfect so we can only try our best when the oral hygiene at home is less than what we would like.