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June 2, 2009 | DentalProductsReport.com
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Working around orthodontics

At home care and treatment to reduce the risk associated with orthodontics

by Lauren Bryant, Associate Web Editor

The benefits of braces and other orthodontic appliances are undoubtedly essential when it comes to restoring function and producing beautiful smiles, but the rewards don’t come without risk. Due to the challenges of proper cleaning around the appliances, increases in decay, gum disease and the development of white spots on teeth can occur.

Researchers at the Oregon Health & Science University School of Dentistry claim that the acid-producing bacteria that surrounds orthodontic appliances can lead to tooth enamel breakdown and potential discoloration of the tooth surface that can produce esthetic changes for years after the orthodontic treatment. While the newer bonded orthodontic brackets offer many advantages over the old metal bands that were fitted around each tooth, they still impede on good oral hygiene, resulting in plaque accumulation and increased tooth enamel breakdown.

So what sort of care and treatment can be done to reduce the risks associated with orthodontics?

Sturdy Floss

The built-in bendable rigid tip is attached to a length of plain unscented unflavored floss. It’s especially great for kids who have trouble grasping other types of slippery floss threaders or maneuvering floss under an arch wire.

Photo and information: Sturdy floss

Joann Daugherty RHA said that she begins by stressing proper homecare to her patients. As the inventor of Sturdy Floss, a one unit flossing device that features a plastic bendable tip for easier flossing, she claims that the difficulty that orthodontic appliances cause is a reduction in the amount of interproximal cleaning, thus increasing decay.

Sturdy Floss works by bending the plastic tip to slide in and around the wires. The tip can be angled in any direction and can be bent over and over again in order to clean the areas closest to the brackets (an area that is often unreachable through brushing and regular flossing). Daugherty said, “Not flossing is not cleaning and that is when decay starts.”

Toothbrush
In addition to proper flossing, removing plaque through proper brushing is also crucial. Manual brushing works well if done properly and for this Daugherty likes to recommend the Curvex II toothbrush sold by Patterson Dental Supply. She said, “The angle of the brush head gets down and on top of the bracket” and that it is “very helpful” in terms of increasing brushing effectiveness. The brush head features a curved shape with tapered bristles and an angled handle to minimize damage to enamel and soft tissue. Individuals with brackets or other fixed orthodontic devices may also want to try a power or sonic brush.

Fluoride rinse
ACT fluoride rinse is another “go to” product Daugherty said. Especially in reducing incipient decay from forming and turning into caries. “Home fluoride rinses help neutralize plaque and the ACT rinse is inexpensive, tastes good and isn’t thick like some prescription rinses.” In her own personal experience Daugherty remembers using a fluoride rinse when she began developing a spot of incipient decay and said that the rinse helped recalcify her tooth and prevented a cavity from forming. Actflouriderinse.com also claims that their fluoride rinse will strengthen tooth enamel and prevent white spot lesions in teens with braces.

Brace Relief Kit
Daugherty’s other favorite product is the Brace Relief Pocket Kit by Infalab, a self-administered patient aid that is said to provide fast relief from the discomfort of braces. Daugherty first learned about the kit at the AAO (American Association of Orthodontics) show. Available in a convenient plastic organizer, the kit includes: six rods of Brace Gard™ Silicone Bracewax and one 1/8 oz. tube of Brace Relief Orthodontic Gel.

Unlike other orthodontic waxes, Brace Gard is simply pinched over the offending bracket, pushing material under and behind the bracket, to form a grip-like configuration. Daugherty claims that the antiseptic gel is the “best gel for sores” and it reportedly delivers fast overnight healing of raw gum or cheek lesions to promote callusing.

Conclusion
So next time a patient with an orthodontic appliance sits in your chair, be sure to stress the importance of brushing and flossing around the brackets to avoid an increase in decay that could lead to caries or tooth discoloration. Advise them to use a fluoride rinse to reduce insipient decay and to use brace waxes and antiseptic gels to heal sores that aggravate soft tissue and cause discomfort.

related articles

• Power v. Manual: Toothbrushes
• Modern Hygienist: Brace yourself