Cleaning Your Teeth with Braces
For adults with fixed braces: why cleaning is harder, the bracket margin, a daily routine, tested tools, fluoride rinse and check-ups. NHS guidance says to brush with fluoride toothpaste morning, night and after meals, and clean under the brace with an interdental brush daily. Trials of extra cleaning tools are limited.
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Medical disclaimer: This page is for general information only. It does not replace an examination or treatment by a dentist.
Dr Ibraheem Ijaz, principal dentist, reviewed this page. He is a General Dental Practitioner: BDS, BSc (Hons), MSc (Leeds), PG Dip Implant Dentistry, PG Cert Restorative and Aesthetic Dentistry.
Why do braces make cleaning harder?
A fixed brace cannot be removed for cleaning, and brackets and wires make teeth harder to keep clean, British Orthodontic Society (BOS) leaflets say. Eating and comfort have their own pages: browse this section.
Our page on white spots and decalcification with braces covers early decay marks. North Cumbria's 2025 NHS leaflet says plaque left on teeth and brace causes gum disease and tooth decay, white marks being an early sign of decay; if you notice marks on your teeth, show them to a dentist.
What is the bracket margin, and how do you brush it?
Here, the bracket margin means the tooth surface between each bracket and the gum line, which NHS trust and BOS leaflets single out for brushing.
Plaque collects where tooth meets gum, BOS says. North Cumbria's leaflet advises tilting the bristles at 45 degrees against the gum line, brushing in small circles above and below the brackets. Queen Victoria Hospital's 2021 leaflet adds brushing on the brace and gently on the gums, minding where tooth meets gum.
What does a daily cleaning routine with braces look like?
NHS guidance says to brush with fluoride toothpaste morning, night and after meals, and clean under the brace with an interdental brush daily. Trust leaflets add:
- Brush the bracket margin and every tooth surface with a pea-sized amount of fluoride toothpaste, watching in a mirror (Queen Victoria Hospital, 2021).
- Clean around each bracket and behind the wire with an interdental or single-tufted brush (North Cumbria, 2025), pointing interdental brushes away from the gums to avoid injury (Queen Victoria Hospital, 2021).
- Spit out the toothpaste and do not rinse, as rinsing washes the fluoride away (NHS; Dorset County Hospital, 2026).
Queen Victoria Hospital's 2021 leaflet, past its review date, says to wait at least an hour after eating or drinking before brushing, as brushing straight after could cause erosion damage.
Which cleaning tools help with braces?
Interdental and single-tufted brushes reach around brackets and behind wires where a toothbrush does not, North Cumbria's 2025 leaflet says. An archived BOS guide adds special floss. Trials are limited:
- Interdental brushes: a 2026 review (searched to August 2025; 6 trials, 442 brace wearers, mostly under 18) found low-certainty evidence over 4 to 24 weeks that they may reduce plaque and gum inflammation against brushing alone or floss, though one trial found no difference against brushing alone. It found no consistent edge over single-tufted brushes or water flossers; one 8-week trial favoured a water flosser.
- Single-tufted brushes: in a 2024 Turkish trial of 36 adults with braces and gingivitis, all given gum treatment first and using interdental brushes, the single-tufted group had lower plaque and bleeding scores at 3 months than ordinary or orthodontic brush groups, and lower gum scores than the orthodontic group; the authors call for more research.
- Disclosing tablets: their dye shows missed plaque, BOS says. Queen Victoria Hospital and Dorset suggest weekly use; the dye can stain lips. Queen Victoria Hospital says not to swallow the tablet and to follow the packet instructions.
Brush sizing is on our page about interdental brushes and floss.
Questions about this treatment? Book online or call the practice.
Should you use a fluoride mouthwash with braces?
BOS and NHS trust leaflets advise a daily alcohol-free fluoride mouthwash at a different time from brushing; trials of its added benefit disagree. Fluoride in general is on our page about how fluoride protects teeth.
UK Delivering Better Oral Health guidance (September 2025) says a daily rinse of 0.05% sodium fluoride can be considered from age 8, with twice-daily brushing using at least 1,350ppm toothpaste, at a different time, and is likely most useful at higher decay risk.
A 2025 review (searched to September 2024) covered 7 trials in 704 adolescents and young adults with braces, all using fluoride toothpaste and at moderate or high risk of bias. Three trials found a benefit and four no significant benefit; pooling 5 trials (491 people) gave a small reduction in early decay beside the bracket base. It found insufficient support for recommending a rinse to everyone regularly using fluoride toothpaste, without ruling out benefit for some after a risk assessment.
Do you still need check-ups with braces, and does professional cleaning help?
For check-ups, yes: NHS guidance says to keep having regular dental check-ups during treatment.
BOS's 2019 leaflet stresses continuing check-ups throughout treatment so teeth can be checked for decay. On professional cleaning, a 2015 review of 10 studies published before June 2013, which rated six controlled trials at unknown risk of bias, found regular motivation sessions and professional mechanical tooth cleaning help maintain good oral hygiene with fixed braces.
When should you speak to a dentist about your gums or braces?
NHS guidance lists three reasons to contact whoever is treating your braces, as non-urgent advice:
- your teeth are painful for more than a few days after your braces are fitted or adjusted
- you have braces and your gums are very red, swollen or painful
- your braces are broken
The NHS says to see a dentist if your gums bleed when you brush or eat hard foods, or are painful and swollen, if you have bad breath, or if a child has sore, bleeding gums. It says to ask for an urgent dentist appointment if gum disease comes with symptoms such as very sore and swollen gums, loose teeth or teeth falling out, ulcers or red patches in the mouth, or a lump in the mouth or on the lip.
In an emergency or out of hours, call your dentist; if you do not have one or cannot get an emergency appointment, call 111, or find a dentist and ask for an emergency appointment.
Frequently asked questions
How long should you brush your teeth with braces?
At least 2 minutes, going by BOS; one NHS guide suggests longer. An archived BOS guide for brace wearers says to brush thoroughly for at least two minutes morning and evening, and after meals. Dorset County Hospital's 2026 guide suggests 3 minutes, three times a day.
Does a water flosser help with braces?
Trials disagree. A 2023 York NHS trial of 40 people aged 10 to 20, stopped at an interim analysis, found adding a water flosser to manual brushing made no significant difference to plaque, gum or bleeding scores up to 56 weeks. One 8-week trial of 30 people aged 12 to 18, in a 2026 review, favoured it over interdental brushes.
Does an electric toothbrush work better than a manual one with braces?
Possibly, on low-quality evidence. A 2026 review (searched to November 2025; 23 papers, ages 10 to 53, part-funded by industry) found no difference in most comparisons, though pooled analyses suggested powered brushes may do better on plaque and gum scores. A 2020 review (searched to December 2019; few studies, low quality) found no significant difference at 4 or 8 weeks.
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Reviews of Deepcar Dental Care are on our patient reviews page. Our page on orthodontics at Deepcar Dental Care covers orthodontic treatment at the practice.
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