Mauricio Berco, DDS, DMSc, FRCD(C)

Stephelynn DeLuca, DDS, DMSc, FRCD(C)

Specialists in Orthodontics & Dentofacial Orthopedics


Orthodontic treatment is a wonderful investment in your future.  To obtain the best possible result, it is essential that you properly care for your teeth, gums and orthodontic appliances.  Your beautiful, healthy smile is easily achievable by following the 10 Steps to Optimal Oral Health below.  Poor oral hygiene, irrespective of orthodontic treatment, can cause gum problems, tooth decay and permeant tooth staining.  It is important to understand how teeth and gum problems develop since they are entirely preventable.  Also, you should know that orthodontic appliances will not adversely affect your teeth and gums if cared for properly.

Healthy teeth and gums:  Important information on how teeth and gum problems develop

Permanent tooth staining (white-spot lesions), tooth decay and gum problems are caused by dental plaque.  Plaque is a thick, colourless, sticky film made up of bacteria and residual food particles that constantly forms on your teeth.  When plaque is allowed to sit on your teeth, more oral bacteria grow and produce acid.  Since the bacteria that live in our mouths eat when we do, the more sugar we ingest, the more acid they produce.  Acid erodes the hard outer surface of the tooth (demineralization) and causes white-spot lesions (early tooth decay) and cavities (late tooth decay).  The accumulation of plaque on teeth also acts as an irritant to the adjacent gum tissue.  At first, gums respond to plaque by becoming red, swollen and inflamed (gingivitis).  Gingivitis is a mild form of gum disease and is reversible with diligent oral hygiene.  If gingivitis is allowed to progress, irreversible gum disease may develop (periodontitis). 

Brushing and flossing prevent dental disease by removing plaque.  Plaque that is not removed will harden and form tartar or calculus that brushing cannot clean off.  Only a professional cleaning by a dentist or dental hygienist can remove calculus. Other important steps to protect your teeth and gums are outlined bellow.  The most important thing to remember is that dental disease is preventable with diligent home care.  In fact, the best treatment for both tooth and gum problems is prevention!

Ten steps to optimal oral health:  Healthy habits to protect your teeth, gums and braces

  1. 1.Brush your braces, teeth and gums after every meal and before bed.  Use a soft toothbrush and fluoridated toothpaste.  If you can not brush right away after a meal, rinse your mouth with water.

  2. 2.Floss at least once a day.  If you have braces use a floss threader to get the floss under the archwire.

  3. 3.Eat a well balanced tooth-friendly diet.  Promote a non-acidic environment by limiting the amount, frequency, and duration of dietary sugars and highly acidic foods and drinks.

  4. Do not suck on oranges, lemons or limes.  The acidity in these fruits can erode your teeth.

  5. Avoid unhealthy highly acidic beverages such as soft drinks, sports drinks or other metabolite replacement drinks (contain mono-potassium phosphate or phosphoric acid).  Choose water when playing sports or sipping drinks between meal time.

  6. Limit drinks high in sugar or acid content such as milk and fruit drinks to meal times.  Don’t snack or sip on sugary foods and beverages over a prolonged period of time.

  7. 4.Get a dental checkup and professional cleaning every 6 months unless otherwise recommended by your dentist

  8. 5.Don’t smoke.  Smoking cigarettes, cigars or pipes, or using smokeless tobacco increases your risk of periodontal (gum) disease and other systemic health problems, including, dental decay, tooth staining, mouth and throat cancer, and lung cancer.  Smoking can also delay or reduce the success of your orthodontic treatment by accelerating gum disease, delaying tooth movement, and slowing healing after tooth extractions, jaw surgery or placement of dental implants.  If you do smoke and are contemplating quitting, the American Lung Association has great resources to help you quit.

  9. 6.Consider use of a daily fluoride rinse or other oral hygiene aids. Fluoride works by promoting tooth remineralization (replacing minerals that are lost in the early stages of tooth decay), making the tooth more resistant to decay and inhibiting oral bacteria from making acid.  Additional oral hygiene aids include, dental irrigation devices, power toothbrushes, and interdental brushes.

  10. 7.Wear a mouthguard when participating in contact sports.  Mouthguards help to prevent and minimize both tooth and jaw injuries.  If you have braces, a special mouthguard must be worn that fits over your teeth and orthodontic appliance.

  11. 8.Avoid habits that can hurt your teeth and loosen or break your appliance(s).  Do not play with brackets, wires or appliances.  Applying pressure with fingers, pens, pencils or the tongue can bend or break your orthodontic appliances. 

  12. 9.Avoid foods that can hurt your teeth and loosen or break your appliance(s).  

  13. Do not eat sticky or chew foods that can loosen, bend or break your appliances.  Chewing gum, caramel, fruit roll-ups and liquorice are some of the foods that should be avoided.

  14. Do not bite into hard foods such as apples, raw vegetables, toasted bagels, granola bars, pizza crusts and nuts.  Instead cut these foods into bite size pieces and carefully chew them with the back teeth.  

  15. Avoid eating meat on the bone.  Rather, cut the meat off the bone and chew it carefully with your back teeth.

  16. Avoid eating corn on the cob.  Rather, slice the corn kernels off the cob before eating.

  17. Do not eat popcorn.  Kernels can get caught between the gum tissue and the brackets or bands causing tissue irritation.

  18.       Please note:  This is not an exhaustive list.  Use common sense when caring for your braces.

  19. 10. Loose bands, brackets or wires should be reported as soon as possible in order to address the problem in a timely manner.  Do not wait until your next scheduled appointment to report a problem.  When a band or bracket is broken and not attached to a tooth, it is not moving the tooth in the proper direction.  This will extend treatment time.  

Remember:  Poor oral hygiene, excessive breakage of orthodontic appliances, missed appointments and not wearing your appliances or elastics as instructed will significantly lengthen your total time in treatment and may affect the quality of your results.


Home Care




  1. 1. Apply a pea size amount of fluoride toothpaste to a soft toothbrush.

  2. 2.Place the bristles of your toothbrush at a 45 degree angle against the gum line where your gums meet your teeth.   Use a circular, vibrating motion to brush along the gum lines.  Then brush the upper teeth down and the lower teeth up.  Brush your braces and in and around all the wires.  Spend 10 seconds on each tooth and use a set pattern when brushing so you don’t miss any spots.

  3. 3.Use a firm back and forth motion to clean the chewing surfaces of your teeth.

  4. 4.Repeat this process for the back side of every tooth in both arches.

  5. 5.Brush the top of your tongue and the roof of your mouth




  1. 1.Loop floss into floss into floss threader.

  2. 2.Carefully insert floss behind the archwire.

  3. 3.Gently clean the sides of the teeth and under the gums with an up-and-down motion.

  4. 4.Repeat steps 1-3 for all teeth once a day.




  1. 1.Remove the appliance from your mouth.

  2. 2.Gentle brush the appliance using your toothbrush and toothpaste.

  3. 3.Rinse appliance with water.

  4. 4.Gently brush the gum areas that are normally covered by your appliance. 

  5. 5.Brush and floss before reinserting your removable appliance.


Interdental brushes have small heads of fine bristles.  They may aid cleaning under wires and between teeth.


Power toothbrushes can help to remove plaque from teeth.  Some are especially designed to be used with braces.


A pressurized stream of water to clean around braces and along the gum line.


Fluoride works by promoting tooth remineralization and making teeth more resistant to decay.

Excellent oral hygiene:

Healthy, beautiful teeth & gums

Poor oral hygiene:

White spot lesions and swollen gums

Poor oral hygiene:

Swollen, inflamed gums (gingivitis)

Photos courtesy of the American Association of Orthodontists