Smiling Bright: Dental Hygiene During Orthodontic Treatment

The aim of braces is a healthy smile, not just a straight one. This guide looks at what protects the teeth and gums while the braces are on.

Key points

The aim of braces is a healthy smile, not just a straight one.
Plaque around brackets is the main cause of decay, gum inflammation and bad breath during treatment.¹
Brush after meals, clean between the teeth every day, use fluoride and cut back on sugary food and drink.¹²
White marks and red or bleeding gums are signs to act on early, and bleeding is a reason to keep cleaning, not to stop.
Keep seeing your regular dentist while the braces are on.

Straight teeth are only part of the goal. A smile with white marks, swollen gums or decay is not a good outcome, however well the teeth line up. The good news is that most of the problems are preventable.

What goes wrong, and why

Decay. Food and plaque collect around brackets, so sugary food and drink can lead to tooth decay.¹ The first sign of tooth decay is a white mark.²

Gum inflammation. Gums can become red, swollen and painful if the teeth are not kept clean.¹ This is called gingivitis, and it is reversible if you improve your cleaning.

Bad breath. Plaque and trapped food can cause a bad taste or smell.

The trust leaflet from NHS hospital orthodontic services warns of a higher risk of decay and gum disease during treatment.²

How diet affects your teeth

Decay depends on how often teeth are exposed to sugar, not just how much. Each sugary snack or drink starts an acid attack that lasts for some time. To protect your teeth:

Limit sugary snacks and drinks to mealtimes, where possible.
Avoid fizzy drinks, sports drinks and juices, which are sugary and acidic.²
Choose water or milk between meals.
Avoid hard, sticky and chewy food that can break brackets.²
Do not sip sweetened tea or coffee for long periods.

Cut back on sugary food and drink, and keep brushing after meals.¹

White marks: what they are and what to do

White marks are patches where enamel has lost minerals around a bracket. They are visible when the braces come off, as the bracket leaves a mark with a different colour from the surrounding tooth. Prevention matters, because some marks remain.

In a Cochrane review, one study found fewer new marks with fluoride foam applied professionally every two months and another with a 5000 ppm fluoride toothpaste, but the evidence was of low certainty.³ Tell your orthodontist if you notice marks. Early marks may improve with fluoride and better cleaning. Later options, such as whitening or cosmetic treatment, are discussed after braces. Our page on teeth whitening explains what whitening can and cannot do.

Gum health

If your gums bleed or swell, do not stop brushing them. Bleeding usually means plaque is there, and thorough cleaning reduces it. If it continues, see your dentist. Our guide to bleeding gums explains common causes.

In a meta-analysis of 7 studies with 368 patients, plaque and bleeding scores were lower with Invisalign than with fixed braces, and gum index and probing depth did not differ.⁴ That may encourage you if you choose aligners, but they need the same care.

What a good routine includes

Brush with fluoride toothpaste in the morning, at night and after meals.¹
Use an interdental brush every day between the teeth and under the braces.¹
Use a fluoride mouthwash once a day, at a different time from brushing.²
Keep seeing your regular dentist.¹

Our guide to oral hygiene during orthodontic treatment gives the technique in detail.

When the braces come off

You will notice a change at once: teeth feel smoother and are easier to clean. You may also see marks or small areas of roughness. Your dentist will check the enamel and advise on any follow-up. Do not be tempted to skip check-ups once the braces are off, since the retainer phase has its own cleaning needs.

Looking beyond the braces

A healthy mouth is the foundation for everything else. Our page on braces treatment describes the treatment itself, and our guide to whether braces can damage your teeth explains the risks and how to keep them low.

A weekly self-check

A short check once a week catches problems early. In good light, with a mirror:

Look at each tooth for white or chalky patches near the brackets.
Look at the gums for redness, swelling or gums growing over the brackets.
Check that every bracket is firmly attached and no wire is poking out.
Notice any bad taste or smell that does not go away.
Look at the rest of the mouth for ulcers and sore spots.

Write down anything unusual and tell your orthodontist or dentist at your next visit, or sooner if it is worrying. Taking a photograph each time helps you see change.

Whitening and braces

Many people ask about whitening during braces. Whitening gel only reaches the exposed parts of the teeth, so the area under the brackets stays the old colour, which can leave a patchy result. Whitening can also make sensitive teeth worse, and teeth are often sore during treatment. Most orthodontists advise waiting until the braces are off, and then asking your dentist about suitable options. If you want to brighten your smile sooner, a professional clean and good brushing can remove surface stain.

A daily checklist for school or work

Morning: brush, clean between the teeth, check the brackets.
After lunch: brush or rinse well, and check for food stuck in the braces.
After school or work: a snack of tooth-friendly food, then clean.
Evening: brush for two minutes, use interdental brushes, and clean between the teeth.
Once a day: fluoride mouthwash, at a different time from brushing.²
Keep a kit in your bag, with a travel brush, interdental brushes, wax and the clinic's number.

Habits like these add up. The teeth that come out of braces healthy are usually those that were cleaned carefully every day.

Myths and facts about cleaning with braces

Myth: brushing harder removes more plaque. Hard brushing does not clean better, and it can irritate the gums and wear the enamel. Gentle, careful brushing at the right angles removes plaque more effectively than force.

Myth: if my gums bleed, I should leave them alone. Bleeding usually means plaque is sitting along the gum line, and thorough cleaning is what reduces it. If bleeding continues despite good cleaning, see your dentist.¹

Myth: sugar-free means harmless. Sugar-free drinks can still be acidic, and sipping them often keeps the mouth acidic for long periods. Water is the safest everyday drink during treatment.

Myth: once the braces are off, the risk is over. The brackets are gone, but marks from earlier plaque can remain, and the retainer phase needs its own cleaning habits.

Fact: small changes add up. Brushing after meals, an interdental brush every day and fewer sugary snacks each make a measurable difference.

Special situations

Teenagers. Habits matter more than anything else. Teenagers often need reminders, a travel toothbrush for school and a clear agreement about sugary drinks. Our page on braces for kids explains how treatment is planned for younger patients.

Adults. Adults are more likely to have fillings, crowns or gum recession, and any of these can make cleaning around braces trickier. Tell your orthodontist about earlier dental work.

People who snack a lot. If you cannot avoid snacking, choose tooth-friendly options such as cheese, plain nuts cut small or raw soft vegetables, and rinse with water afterwards.

Smokers. Smoking stains teeth and affects gum health. Reducing or stopping helps both your teeth and your braces.

A quick summary

Plaque around brackets is the main cause of trouble.
Cleaning, fluoride and fewer sugary drinks are the three habits that count most.
Early white marks and red gums are signs to act on.
Keep seeing your dentist while your braces are on.

Frequently asked questions

Will braces stain my teeth?

The brackets themselves do not, but plaque left around them can mark the teeth, which is why daily cleaning matters.¹

Is it normal for my gums to swell?

It is common if cleaning is incomplete, and it usually improves with better cleaning. Tell your dentist if it persists.¹

Do I need extra dental visits?

Ask your dentist. Many people benefit from professional cleaning during treatment.

Can I whiten my teeth during treatment?

Usually this is left until the braces are off, because whitening around brackets is uneven. Ask your orthodontist.

What if I forget to brush after lunch at school or work?

Rinse your mouth thoroughly with water and brush when you can. A habit of carrying a small brush makes it easier.

Are electric toothbrushes better with braces?

They can help some people clean more consistently. The technique and the time spent matter more than the type of brush.

How do I clean elastic bands and brackets?

Brush around each bracket and the elastics, and use an interdental brush under the wire. The clinic can show you.

Can I use a whitening toothpaste with braces?

A whitening toothpaste can remove surface stain, but it does not change the colour of the tooth under the brackets. Choose a fluoride toothpaste, and ask your orthodontist if you are unsure.

What if I forget to brush at school?

Rinse your mouth thoroughly with water after eating, and brush as soon as you can. Keep a small kit with your things so cleaning is easy to do.

About the author

Dr Anupam Sinha, BDS, MDS – Orthodontics. BDS (2002), KLE Vishwanath Katti Institute of Dental Sciences, Belgaum. MDS in Orthodontics (2006), SDM College of Dental Sciences, Dharwad. His thesis work won a national research award in 2005, and he holds a certification in aesthetic dentistry. He sees patients at Orion Dental Clinic in Greater Kailash 1, South Delhi. Read the full profile of Dr Anupam Sinha.

Sources

NHS website. Braces and orthodontics (patient information). Page review date 29 June 2026. https://www.nhs.uk/conditions/orthodontics/
North Cumbria Integrated Care NHS Foundation Trust. Orthodontics: fixed brace instructions (patient information). https://ncic.nhs.uk/patients-visitors/patient-information-leaflets/orthodontics-fixed-brace-instructions
Benson PE, Parkin N, Dyer F, Millett DT, Germain P. Fluorides for preventing early tooth decay (demineralised lesions) during fixed brace treatment. Cochrane Database of Systematic Reviews, 2019, CD003809. https://doi.org/10.1002/14651858.CD003809.pub4
Lu H, Tang H, Zhou T, Kang N. Assessment of the periodontal health status in patients undergoing orthodontic treatment with fixed appliances and Invisalign system: a meta-analysis. Medicine (Baltimore), 2018;97(13):e0248. https://pubmed.ncbi.nlm.nih.gov/29595680/

Medically reviewed by Dr Anupam Sinha, BDS, MDS – Orthodontics, on 23 October 2026. General information for patients from Orion Dental Clinic, last updated 23 October 2026. It is not advice for one person, so ask a dentist what suits you. To report an error, contact us.