The Role Dental Hygiene Plays in Orthodontics

by Rachel Roberts, BS, MS, RDH

So today is the big day! The one you’ve been waiting two years for, and now it’s finally here! But after all that excitement and anticipation, you’re left wondering where you went wrong...What happened to the perfect teeth that you were supposed to have after braces? You wore all the bands, the headgear, never missed an appointment at the orthodontist. You want your teeth to be white, not covered in white spots - spots that don’t brush off! So you go to the dentist to find out what can be done. They tell you that you could try whitening but it may only make the white spots look more noticeable. Or worse, they tell you the spots are cavities and now you need fillings on several of your teeth. On top of that, your latest x-rays show that you have cavities in between the teeth that also needs to be addressed. AND you have gingivitis! How could this have happened?! And what could you have done to prevent it??

Unfortunately, these types of scenarios happen too often to orthodontic patients, but it doesn’t have to happen to you. What’s the trick you ask? I believe it's more frequent dental hygiene visits. For ortho patients, I typically recommend 3 month recare appointments for the duration of their orthodontic treatment.

For a typical healthy dental patient that is not in ortho, dental professionals generally recommend seeing them once every 6 months. However, with all the appliances creating food traps and places that are even harder to reach than normal (especially when it comes to flossing), I believe it’s necessary to see patients more frequently. We know that cavities can form on an otherwise healthy tooth in as little as under 1 year, which is why yearly radiographs are the standard of care. So, it makes sense to think that ortho patients are at a greater risk of developing cavities in a shorter time frame, and why we should monitor them more closely.

More frequent dental hygiene appointments for orthodontic patients will obviously allow for the patient to have their teeth professionally cleaned more often. Even more importantly, these hygiene visits are essential for assessing the patients’ oral home care and, thus, providing feedback and patient education based on how the patient is presenting. Hygienists can help provide tips and information that is most pertinent to address what the patient needs most and do it more often. This way, if patients are headed down the wrong course, they can be redirected sooner and before permanent damage is done.

I firmly believe that 3 month dental hygiene frequency (combined with diligent home care) for orthodontic patients is the key to insure, not only straight teeth, but also healthy teeth and gums. At the end of ortho treatment - after all the appointments, mouth soreness, embarrassing photos and money spent - you shouldn’t have to worry about having unhealthy teeth and gums. So take this advice so that when the big day comes, patients will have something to smile about.

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