Children need to brush differently and more often to avoid problems with plaque.

Q: My son just got braces, and brushing his teeth has become a struggle. How can I help him keep his teeth healthy and clean?

A: It is important to keep teeth clean while braces are on, but sometimes it can be hard to get into all the places braces may be blocking.

Paying careful attention to dental hygiene is especially important for kids with braces because teeth can be more prone to plaque buildup. Plaque is a sticky, colorless film of bacteria that constantly forms on the teeth. It contains germs that make acid, which attacks the teeth and breaks down the enamel if it stays on too long. Plaque causes white spots on the teeth that will remain after the braces come off and over time, those spots can turn brown and need fillings if not cared for properly. Proper brushing and flossing removes plaque so that teeth can stay healthy and clean.

Use a toothbrush head that is small enough to reach around the braces to clean all teeth edges. Teach your child to brush at an angle, over and under the braces, aiming right at the tooth to get underneath the bracket and band. There are special toothbrushes designed to clean around braces, and you can ask which type your child’s orthodontist or dentist recommends. While your child has braces, they should brush their teeth, gums and tongue five times a day for at least five minutes.

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Using a fluoride toothpaste helps make teeth stronger, prevents cavities and can even reverse early tooth decay. Prescription toothpastes with a higher concentration of fluoride can benefit older children and teenagers with braces and can be prescribed by a dentist or orthodontist if appropriate.

Flossing is also an essential step in keeping teeth clean because it gets in all the small creases where a toothbrush can’t reach. Your child will need to floss underneath the arch wire and between the teeth.

Be sure to visit your dentist regularly while in braces to check for cavities. Following all instructions, such as not missing appointments, not breaking appliances and wearing any appliances or rubber bands recommended, will shorten the time braces must be worn and reduce the risk of cavities.

Always consult your child’s pediatrician concerning your child’s health.

For more pediatric health news parents can use, visit our blog: 700childrens.nationwidechildrens.org.

Janice Townsend, D.D.S., M.S., is chief of pediatric dentistry at Nationwide Children’s Hospital.