Brushing & Flossing

Brushing-and-FlossingBrushing & Flossing - Braces Best Practices

Once you've made the decision to share another beautiful, healthy new smile with your Washougal and Woodland, WA, area neighbors, the real work begins. But the work is not only accomplished by Dr. Cai and her team of professionals as they begin your braces or Invisalign treatment, it requires you. Your treatment will be most successful if you work with your orthodontic staff and follow Dr. Cai's instructions, especially properly brushing and flossing on a regular basis.

Why Is Brushing Important With Orthodontic Treatment?

Brushing your teeth regularly is one of the most important things you can do for great oral health. But it is even more important when you begin your braces or Invisalign Teen clear aligner treatment. Orthodontic treatment relies on a healthy mouth to keep your planned treatment on track. While your orthodontic appliances work great to move your teeth and jaw into their proper position, they also make it easier to trap food particles and bacteria in your mouth.


Plaque can invade and attack your overall oral health. When food particles are left in your mouth, they develop the bacteria that is plaque which coats your teeth and gums. Having braces makes it more difficult to reach all surfaces of the tooth. When the bacteria in the plaque mixes with the sugars in foods or drinks in your mouth, it creates an acid that can eat away at your enamel, the hard coating that protects your teeth. This can erode the teeth and irritate your gums, causing cavities, white spots on your teeth, gum disease, and bad breath. Besides gum swelling and bleeding, the pressure from gum disease will slow down your tooth movement, delaying your goal of a straight, beautiful smile.

How Do I Brush With Braces or Invisalign?

Your most important job on the team is to keep your mouth clean. It's a little more difficult with braces or Invisalign aligners, but we know you can do it and we will help by showing you how to properly brush your teeth. Dr. Cai recommends brushing after every time you eat, which could be up to four or five times a day. That means you should keep a travel toothbrush and fluoride toothpaste with you at school or when you travel away from your home and then take the time to brush after meals or snacks. Here are the steps to successful brushing:


  1. Use a soft-bristled brush with a round head and a fluoride toothpaste approved by the American Dental Association (ADA). Studies have shown that multi-level bristles or angled bristles perform better than flat-trimmed bristles.
  2. First, begin on the outside of one side of your upper teeth and brush back and forth from the wires to your gums to break loose any food that might be lodged there. Go around to the other side of the upper teeth.
  3. Repeat #2 on the inside of your upper teeth.
  4. Next, brush a second time on your upper teeth, like you would normally if you didn't have braces, in a circular motion, two to three teeth at a time, using eight to ten strokes at a 45-degree angle. Be sure to brush every surface, outside, inside, and chewing surfaces.
  5. Repeat #2, #3 and #4 on your lower teeth.
  6. Then brush vertically on the inside front teeth, upper and lower, to make sure you brush those inside surfaces well.
  7. Look in a mirror to see if you have missed any places. Your teeth, brackets and wires should be free of any food particles and plaque.
Invisalign Wearers: With Invisalign clear aligners, you won't have to worry about brushing around your braces, but you should still brush every time you eat, by removing your aligners and brushing normally as described in steps #4 through #7 above.

Brushing Note: If you are new to great oral health, your gums may bleed at first. Don't let that stop you from continuing to brush regularly. Just keep stimulating the gums with the bristles of your brush, making sure you angle your brush so that under your gum line is cleaned and eventually your gums should stop bleeding and be healthy again.

How Do I Floss With Braces or Invisalign?

Flossing with braces can be challenging, but can be a huge step in dislodging those food particles that can develop into gum disease and tooth decay. The orthodontic staff at Lauren Cai Family Orthodontics recommends that you floss at least once every day. Here's how:


  1. Dr. Cai recommends her Washougal and Woodland, WA, area patients use a wax-coated floss and a special floss threader to floss with braces on.
  2. With a 12" to 18" piece of floss, wrap the ends around your pointer fingers and pull it tight.
  3. Tuck in one end of the floss about four inches into the loop of the threader.
  4. Pass the floss threader under or over your braces, retainer or any other dental appliance you may have for your customized treatment.
  5. Remove the threader from the floss, wrap the floss around your fingers, and floss gently back and forth and up and down into the gum line between the teeth.
  6. Repeat the process.
  7. Flossing with a threader does take a little longer, but it's the easiest way to get the floss up under your gums.
  8. Invisalign Wearers: Just follow the instructions, skipping #2 and #3 to floss like you would normally at least once per day when you have removed your clear aligners.

Additional Care Tips


  • Fluoride Rinse or Gel. Dr. Cai may recommend that you add a fluoride rinse to your oral health care routine to help build enamel and clean bacteria from your mouth.
  • Aligner & Retainer Care. If you are wearing clear aligners or a retainer, be sure to clean these appliances every time you remove them by rinsing them with cool water and brushing gently with your soft-bristled brush and non-abrasive toothpaste. You can also soak them in a denture-type mixture. Ask Dr. Cai and her staff for their current recommendations. Avoid flipping your retainer with your tongue to avoid damage to your teeth. Keep your retainer and your Invisalign aligners in the plastic case you will be given anytime they are not in your mouth. We don't want to have to replace your appliance that someone threw in the trash when you wrapped it in a napkin or because it broke in your pocket or backpack. Remember that temperatures that are too high can warp or melt these appliances so never leave them in a hot car or other hot location.
  • Elastics Care. Sometimes during braces treatment, Dr. Cai may ask you to wear elastics or rubber bands to help "shock" the teeth back into a quicker movement. This may cause more soreness, but it should subside if you follow the instructions given, attaching them as directed and wearing them at all times. You can take off your elastics while brushing, and should change them at least once or twice every day.

Call Dr. Cai With Any Oral Hygiene Questions You May Have

Dr. Cai and her team of professionals are not only skilled, they are friendly and supportive members of your orthodontic team. We are here to answer any questions you have and to make your orthodontic treatment an enjoyable one, so don't be afraid to ask! If you are just deciding what type of orthodontic treatment you may need, make your first appointment today! Our patients from Woodland to Washougal, WA, and all up and down the Columbia River, tell us how much they love the results from their braces and Invisalign treatment at Lauren Cai Family Orthodontics. With two convenient office locations, you're sure to find one that is most convenient for your family. Call today and get started on your best smile.