Braces and Gingivitis

Here at Shaw Orthodontics, we want every part of your treatment process to go as smoothly as possible.  Be aware, though, that patients wearing braces have a greater tendency to collect food and plaque on their teeth. If plaque isn’t removed daily through an effective dental hygiene routine, it can build up into an invisible, sticky film, producing bacteria that can lead to a minor gum disease known as gingivitis.

Gingivitis is common, and anyone can develop it, not just those wearing braces.  The good news is that gingivitis is reversible and you never need to wait until the end of orthodontic treatment to get rid of it.

We don’t want to see any of our patients end up with gingivitis, so we’ve put together this guide for you to learn more about gingivitis and how you can avoid it.

Braces and Gingivitis

Normally, regular brushing and flossing, along with the use of mouthwash, is enough to stop gingivitis in its tracks. However, when you’re wearing braces, brushing and flossing can be difficult.

Gingivitis is a condition caused by the buildup of bacteria in the gums. There are many types of bacteria involved, but they all go by the universal name of plaque. Plaque is made up of bacteria, mucus and small particles of food. If the bacteria remain for more than two days, it begins building a wall between the teeth and gum tissue called tartar. Only a dental professional can remove the tartar from your teeth.

While oral hygiene is usually the cause of gingivitis, there are some conditions that make a person more prone to developing it:

  • Heredity factors
  • Diabetes
  • Frequent allergy sufferers
  • Smoking
  • Birth control pills
  • Lack of Vitamins
  • Hormonal changes

Some of the symptoms that can accompany gingivitis are:

  • red, irritated, swollen gums
  • minor bleeding after brushing and flossing
  • tenderness in gums
  • noticeably bad breath
  • loose teeth

Since your gums will already be inflamed when you’re in braces, it makes it even easier for bacteria to irritate them. If gingivitis is not treated, a condition called periodontitis can develop. Periodontitis is the more severe form of gum disease. Over time, the body will attempt to naturally fight off the byproducts of the bacteria by breaking down the bone and connective tissues that hold the teeth in place. The gums will begin to recede and pockets will form in between the teeth, leading to potentially serious damage.

Preventing gingivitis while wearing braces


You will need to brush at least three times per day (after meals and before bed) and floss once per day. Replace your toothbrush every three months or as soon as the bristles start to wear down or fray.

It is best to use a toothbrush with soft bristles or an electric toothbrush and a fluoride toothpaste. There are three areas that are frequently missed when brushing: behind the archwire, behind any hooks that are on the braces, and along the gumline between the braces and the gum tissue.


Flossing takes more time and patience when you are wearing braces, but you must floss once per day in order to clean the areas between your teeth. It is best to floss at night to make sure your teeth are clean before you go to bed.

When you first begin flossing around your braces, your gums may bleed a little. If the bleeding does not go away after the first few times, let us know.

Guide the floss between all teeth to the gum line, pulling out food particles or plaque. Unwrap clean floss from around your fingers as you go. Also floss behind your back teeth. We will show you how to use a reusable floss threader to help you floss under your archwire.


Since there are quite a bit of mouthwashes on the market, here’s what to consider:

Antibacterial Mouthwashes

Antibacterial rinses are the most effective kind of over-the-counter mouthwash to fight gingivitis. Many contain antibacterial ingredients that can help prevent gum disease when combined with proper brushing and flossing.

Bad Breath Eliminator Mouthwashes

Some mouthwashes focused on eliminating bad breath have chlorine dioxide as a primary ingredient. These may be effective at neutralizing the kind of bacteria that can cause bad breath, but won’t do much to fight the bacteria that cause plaque and gingivitis.

Prescription Mouthwashes

Mouthwashes containing chlorhexidine last longer inside the mouth than over-the-counter mouthwashes.  But chlorhexidine mouthwashes are only available with a prescription, because they can cause staining of the teeth. If you choose this route, your teeth should be monitored by your dentist or orthodontist.

There are other products available to help orthodontic patients as well.

Interdental Brush

Studies have shown that using an interdental brush is one of the best ways a patient in braces can remove plaque. Interdental brushes are thin, round or cone-shaped brushes with a small head of bristles held on by wire. Some of these brushes have short or specially shaped handles to make them easier to grip, while others have long handles that are similar to toothbrushes. They’re designed to be inserted between the teeth gently, reaching those tight spaces where plaque is likely to build up, and can be reused several times as long as you brush after each use just like a regular toothbrush. Make sure you choose a size that can comfortably fit in between your teeth without being forced.

Other Actions You Can Take

  • scrape your tongue with a tongue scraper or the back of your toothbrush.
  • have your teeth professionally cleaned on a regular basis
  • drink water with meals in order to help wash food particles away
  • use a Waterpik, a product that utilizes water pressure to “floss” teeth
  • gargle with warm salt water to reduce any irritation
  • eat a healthy diet

Shaw Orthodontics keeps your smile straight and healthy

We know this is a lot to process. But by following our advice and keeping a close eye on your oral hygiene habits, you’ll be able to spot any troublesome signs before they get out of hand, and act on them accordingly.

At Shaw Orthodontics, we want your time with us to not only be one of the most comfortable dental experiences you could imagine but one of your best customer experiences, too! If you notice any of the gingivitis symptoms we’ve talked about today, or if you’re feeling any major discomfort with your braces, don’t hesitate to get in touch with us for help. We’ll schedule an appointment for you at our conveniently located Rockwall office. We’re here to keep you smiling!