Braces make teeth harder to clean, so your routine needs to change. This guide sets out a practical routine for braces and aligners.
Key points
- Braces make teeth harder to clean, because plaque gathers around brackets and wires.1
- NHS patient information advises brushing with fluoride toothpaste in the morning, at night and after meals, and cleaning between the teeth every day.1
- Use fluoride toothpaste and a fluoride mouthwash once a day, at a different time from brushing.2
- If you wear aligners, brush your teeth before putting the trays back in, and clean the trays with cool water.
- Keep seeing your regular dentist, and tell your orthodontist about white marks, red gums or a tooth that hurts when you bite.
During orthodontic treatment, plaque gathers more easily around brackets and wires. Food and plaque collect around the brackets, so sugary food and drink can lead to tooth decay, and gums can become red, swollen and painful if the teeth are not kept clean.1 A good routine is the strongest protection, and it is not complicated.
If you are still choosing a treatment, see our pages on braces and clear aligners, and our guides to whether braces can damage your teeth and ten tips for living with braces.
Why cleaning matters more with braces
Brackets and wires create new places for plaque to hide. If plaque stays, it can mark the teeth. The first sign of decay is a white mark,2 and plaque left around the brackets can also mark the teeth, which is why daily cleaning matters.1 Cleaning takes more effort, but the payoff is straighter teeth that are also healthy.
Brushing with fixed braces
NHS patient information advises brushing with fluoride toothpaste in the morning, at night and after meals.1 Technique matters.
- Use a soft toothbrush, or an orthodontic brush with a V-shaped notch.
- Angle the bristles towards the gum, then towards the edge of the tooth, so you clean above and below the wire.
- Brush each tooth separately, for two minutes in all.
- Clean the tongue side and chewing surfaces as usual.
- Rinse well and check in a mirror for food stuck in the brackets.
An electric toothbrush can help, and some have orthodontic heads. Ask your orthodontist what they recommend.
Cleaning between the teeth
A brush cannot reach between the teeth or under the wire. Use an interdental brush every day between the teeth and under the braces.1 Floss threaders let you pass floss under the wire, and a water flosser can supplement the brush. These tools take practice, so ask the clinic to show you.
Fluoride
Use fluoride toothpaste, and a fluoride mouthwash once a day, at a different time from brushing.2 In a Cochrane review, one study found fewer new decay 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 Your dentist can advise whether stronger fluoride is suited to you.
Food and drink
Cut back on sugary food and drink, which feed the bacteria that cause decay.1 Avoid fizzy drinks, sports drinks, juices and sugary sweets, and avoid hard, sticky and chewy food.2 If you do have a sugary drink, rinse with water afterwards.
Cleaning aligners
If you wear clear aligners, the aligner and the teeth both need attention.
- Brush your teeth before putting the aligners back in, because they hold food and bacteria against the teeth.
- Rinse the aligners and brush them gently with a soft brush and cool water. Hot water can warp them.
- Take them out to eat and drink anything other than water.
- Keep them in their case when they are out.
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 suggests aligners can be easier to keep clean, but only if you do the cleaning.
Dental check-ups
Keep seeing your regular dentist for check-ups while you have braces,1 because they can spot decay and gum problems early and remove plaque that brushing misses. Ask whether you need professional cleaning more often during treatment.
Signs that something is wrong
- White marks near the brackets.
- Red, swollen or bleeding gums.
- Persistent bad breath or a bad taste.
- A tooth that hurts when you bite.
- Gums growing over the brackets.
Tell your orthodontist or dentist, who can act early. Our page on gum disease treatment explains what happens if gum problems progress.
A routine you can keep
| When | What |
|---|---|
| Morning | Brush, then clean between teeth |
| After meals | Brush, or rinse thoroughly if you cannot |
| Evening | Brush for two minutes, interdental brushes, floss threaders |
| Once a day | Fluoride mouthwash, at a different time from brushing |
| Weekly | Check in the mirror for white marks and red gums |
Mistakes people make
- Brushing too quickly. A minute is not enough around braces. Two minutes of careful brushing makes a visible difference.
- Skipping the interdental brush. It is the part of the routine most often skipped, and it is the part that reaches where the toothbrush cannot.
- Rinsing straight after brushing. Rinsing with water or mouthwash right after brushing washes away the fluoride. Spit out the foam, and leave the fluoride on the teeth for a while.
- Ignoring early signs. White marks and red gums are easier to deal with early.
- Leaving cleaning until night. Food packed around brackets all day gives bacteria a long time to work.
Tools that help
| Tool | What it does |
|---|---|
| Orthodontic toothbrush | A V-shaped notch fits around the brackets |
| Interdental brushes | Clean between the teeth and under the wire |
| Floss threaders | Pass floss under the wire |
| Water flosser | Flushes food from around brackets, as an addition |
| Fluoride mouthwash | Adds protection between brushing |
| Disclosing tablets | Show where plaque remains, so you can check your cleaning |
Ask your orthodontist or dentist which suit you, and ask for a demonstration.
Cleaning when you are out
Carry a small kit: a travel toothbrush, a tube of fluoride toothpaste, a few interdental brushes and a small case. After lunch, rinse your mouth well, brush if you can, and check the brackets in a mirror. A quick check takes a minute and prevents plaque from sitting overnight.
When to ask for professional cleaning
Plaque can build up where brushing misses, particularly around the brackets and at the gum line. Ask your dentist whether more frequent professional cleaning would help, and keep your regular check-ups throughout treatment.1
Cleaning under the wire, step by step
The area under the wire is where plaque hides, so it needs its own routine.
- Thread a floss threader under the wire, with a length of floss through the loop.
- Pull the floss through so it sits between two teeth, below the wire.
- Curve the floss into a C against one tooth and slide it gently up and down below the gum edge.
- Repeat on the neighbouring tooth, then slide the floss out and move to the next gap.
- Alternatively, use an interdental brush in a size that passes under the wire without force, moving it in and out a few times.
This takes a few minutes when you learn it. Ask your orthodontist or hygienist to watch you and correct your technique once, and you will save time every day afterwards.
What a professional clean adds
Brushing at home removes most plaque, but a hygienist can reach areas that you cannot and remove hard deposits that brushing cannot. During treatment, ask your dentist how often a professional clean is advised, since it may be more often than usual, particularly if you notice red gums or build-up. A clean also lets the dentist check for white marks and early decay while the brackets are in place, when they are easiest to deal with.1
Helping a teenager keep up with cleaning
Many teenagers find cleaning with braces a chore. A few ideas help parents.
- Agree a routine that fits their day, such as brushing after school as well as morning and night.
- Make sure they have a small kit with a brush, interdental brushes and wax at school.
- Use disclosing tablets once in a while, so they see where plaque remains.
- Praise improvement, and avoid nagging about every missed spot.
- Book the dental check-ups and professional cleans, and ask the orthodontist to reinforce the message.
Teenagers tend to respond when they can see the results, so show them white marks or red gums early and explain how cleaning helps.
Frequently asked questions
How often should I replace my toothbrush during braces?
More often than usual, because the bristles splay quickly around brackets. Replace it when it is worn.
Is mouthwash enough?
No. It supplements brushing and cleaning between teeth, but does not replace them.
Can I use a water flosser?
Yes, as an addition, if your dentist agrees. It does not replace the brush.
Why do my gums bleed with braces?
Plaque around the brackets inflames the gums. Better cleaning usually helps, and if bleeding continues, see your dentist.1
How long should I brush for?
About two minutes in all, taking time at each bracket and at the gum line.
Can I use whitening toothpaste?
Many are abrasive. Ask your dentist whether it is suitable, and choose a fluoride toothpaste first.
Should I use a mouthwash with alcohol?
Your dentist can advise. A fluoride mouthwash, used once a day at a different time from brushing, is the usual recommendation.2
How long should I brush with braces?
Two minutes of careful brushing, tooth by tooth, at least twice a day, and after meals if you can. A minute is usually not enough around brackets.1
Do I need a special toothpaste with braces?
A fluoride toothpaste is the main requirement. Your orthodontist may also suggest a fluoride mouthwash once a day at a different time from brushing.2
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 . 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.