- Plaque trapped around brackets can leave permanent marks on teeth and cause decay and gum problems, so cleaning matters more than usual during treatment.
- Brush with fluoride toothpaste, angling the brush above and below the brackets, and clean between your teeth and under the wire every day with interdental brushes.
- Avoid hard, sticky and chewy foods, cut firm foods into small pieces, and keep sugary and fizzy drinks to a minimum.
- Soreness for a few days after braces are fitted or adjusted is normal. Contact your orthodontist about a broken bracket or wire, a lost or damaged aligner or retainer, or pain that lasts.
- Keep seeing your own dentist for check-ups throughout treatment.
Queen Victoria Hospital NHS Foundation Trust warns that if a brace, the teeth and the gums are not kept clean, permanent marks and stains may develop and the risk of tooth decay and gum disease rises. For the types of treatment, see braces and aligners.
How should I clean my teeth with fixed braces?
How often. Advice varies. The NHS says to brush with fluoride toothpaste in the morning, at night and after meals, and Queen Victoria Hospital says after each meal and before bed. The Better Health Channel (Victoria) says at least twice a day, ideally after every meal. The British Orthodontic Society's leaflet says at least two minutes, twice a day, and the Oral Health Foundation says last thing at night and at one other time. All agree on fluoride toothpaste and careful cleaning around the brace.
Technique. The Australian Society of Orthodontists suggests a soft-headed toothbrush. Brush along the gumline with the brush angled at 45 degrees towards the gums, then angle it downwards over the top of the brackets and upwards underneath them. Queen Victoria Hospital says to angle the bristles under the wire and around the brackets, then check in a mirror: the brace should look clean and shiny, and the gums light pink, not bright red or swollen.
Between the teeth. The NHS advises an interdental brush (a tiny brush that fits into gaps) to clean between your teeth and under your braces every day. The Australian Society of Orthodontists suggests floss threaders as another option, used gently. See cleaning between your teeth.
Extra fluoride. The British Orthodontic Society's leaflet advises an alcohol-free fluoride mouthrinse every day, at a different time from brushing. The Oral Health Foundation says your orthodontist may recommend a high-fluoride toothpaste. Evidence on which kind of extra fluoride helps most is limited: see white spots on teeth.
What should I avoid eating and drinking?
- Hard, crunchy and sticky foods. The NHS says these can break braces and suggests cutting food into smaller pieces. The Australian Society of Orthodontists lists chewy sweets, popcorn, caramel, nuts, and foods you bite into hard, such as whole apples, raw carrots and corn on the cob.
- Chewing gum. The NHS says not to chew gum because it can get stuck in braces.
- Sugary snacks and drinks. The British Orthodontic Society's leaflet advises avoiding them between meals and at bedtime, along with fizzy drinks (including diet drinks) and large amounts of fruit juice.
- Habits. The Australian Society of Orthodontists warns that biting nails or chewing pen lids can break or bend braces. See also sugar, acid and your teeth.
How do I cope with soreness?
The British Orthodontic Society's leaflet says slightly sore teeth for 3 to 5 days after a brace is fitted, and after each adjustment, are common. The NHS says soft food and painkillers can help.
- Rubbing. Queen Victoria Hospital and the Better Health Channel say soft orthodontic wax pressed over a sharp area can make it more comfortable.
- Sore spots. The American Association of Orthodontists (AAO) suggests a warm salt-water rinse (half a teaspoon of salt in about 240 ml of warm water). The NHS says children should not rinse with salt water in case they swallow it, and that children under 16 should not take aspirin.
The NHS says to contact your orthodontist if your teeth are still painful more than a few days after braces are fitted or adjusted, or your gums are very red, swollen or painful. See also toothache.
What if a bracket or wire breaks?
Queen Victoria Hospital advises checking your brace every day and contacting the orthodontic practice if any part breaks or comes loose. The British Orthodontic Society's leaflet says repeated breakages slow treatment, that you may have to pay for replacement braces, and that if breakages keep happening treatment might have to stop. The Australian Society of Orthodontists says teeth may shift in the meantime.
Until you can be seen:
- Loose bracket still on the wire: slide it gently back to the centre of the tooth, hold it with a little wax, and avoid hard or sticky food (AAO).
- Wire poking your cheek: push it flat with a clean pencil eraser or cotton bud, or cover the end with wax (AAO).
- Cutting a wire: the Australian Society of Orthodontists calls this a last resort if you cannot be seen for some time. Clean nail clippers with an alcohol wipe, hold the cheek well away, swallow before you cut, then cover the end with wax.
- Loose band or appliance: do not wiggle it. If it comes off, keep it in a container and take it to your appointment (AAO).
How do I look after clear aligners?
The AAO says aligners can trap drinks and food against the teeth, raising the risk of decay. Its advice:
- Wear them 20 to 22 hours a day, or as prescribed.
- Drink only water while they are in. The Australian Society of Orthodontists adds that hot drinks can warp them and tea and coffee can stain them.
- Brush your teeth before putting them back in after eating or drinking.
- Put them in their case, not a napkin or pocket, and keep them away from pets.
- Contact your orthodontist if one is lost or damaged. Do not keep wearing one that is sharp, painful or badly distorted.
The Australian Society of Orthodontists says teeth often feel slightly loose during aligner treatment; check with your orthodontist if this lasts or gets worse.
Retainers after treatment
The British Orthodontic Society says almost everyone needs a retainer, because teeth tend to drift back and keep shifting with age. How long to wear one differs between sources: see braces and aligners.
Removable retainers. The British Orthodontic Society's leaflet says speech may sound different at first but should settle within a few days. Take the retainer out to brush your teeth, and clean it gently with a toothbrush, but not with toothpaste, which can roughen and discolour it. Keep it in a protective box, and wear a mouthguard instead for contact sports. The leaflet suggests cold water and the AAO lukewarm water with a little dish soap; both warn against heat, which the AAO says can warp plastic. The AAO says to stop wearing a cracked or warped retainer and contact your orthodontist.
Fixed retainers. A wire bonded behind the teeth needs extra cleaning, and the British Orthodontic Society says to seek advice if it comes loose. The Australian Society of Orthodontists suggests interdental brushes and floss threaders under the wire.
Lost or broken retainer. The British Orthodontic Society's leaflet says to ring for an appointment as soon as possible, not wait for your next review, as teeth can move without it. You may be charged for a repair or replacement.
Check-ups during treatment
The NHS, the Oral Health Foundation and the British Orthodontic Society all say to keep having check-ups with your own dentist during treatment; the British Orthodontic Society's leaflet says your dentist checks for decay. Orthodontic visits are separate: every 6 to 8 weeks for fixed braces, according to the NHS and the Oral Health Foundation, or every 4 to 10 weeks, according to the Australian Society of Orthodontists. See dental check-ups.
- A bracket, band or wire is loose or broken, or a wire is poking you (Queen Victoria Hospital, AAO).
- Your teeth are still painful more than a few days after braces are fitted or adjusted, or your gums are very red, swollen or painful (NHS).
- An aligner or retainer is lost, cracked, warped or no longer fits, or a fixed retainer is loose (AAO, British Orthodontic Society).
- The AAO says to seek emergency care straight away for heavy or continuous bleeding, difficulty breathing or swallowing, a suspected broken jaw, a permanent tooth knocked out or badly moved, or sudden severe pain with facial swelling or a fever.
- The Australian Society of Orthodontists says to see a GP or go to an emergency department if you breathe in a piece of wire or swallow a large piece. A very small swallowed piece will probably pass safely.
- For emergency numbers in each country, see dental emergencies.
Frequently asked questions
Can I use an electric toothbrush with braces?
Yes. The Australian Society of Orthodontists says an electric toothbrush is fine.
Can I play sport with braces?
Yes. The British Orthodontic Society's leaflet recommends a mouthguard for contact sports. Ask your orthodontist about this, and see sports mouthguards.
What if I lose an aligner?
Contact your orthodontist for advice. The AAO says that if your previous aligner still fits comfortably, your orthodontist may advise wearing it until you get a replacement.
Sources
- Braces, NHS, accessed September 2026
- Toothache, NHS, accessed September 2026
- Orthodontic treatment with fixed appliances (PDF), Queen Victoria Hospital NHS Foundation Trust, accessed September 2026
- Orthodontic treatment: patient information leaflet (PDF), British Orthodontic Society, accessed September 2026
- Retainers, British Orthodontic Society, accessed September 2026
- Retainers: patient information leaflet (PDF), British Orthodontic Society, accessed September 2026
- Orthodontic treatment, Oral Health Foundation, accessed September 2026
- Orthodontic treatment, Better Health Channel (Victoria), accessed September 2026
- Caring for braces, Australian Society of Orthodontists (Orthodontics Australia), accessed September 2026
- What to do if your braces are broken, Australian Society of Orthodontists (Orthodontics Australia), accessed September 2026
- What to do when your braces wire breaks, Australian Society of Orthodontists (Orthodontics Australia), accessed September 2026
- All about clear aligners, Australian Society of Orthodontists (Orthodontics Australia), accessed September 2026
- How to care for your retainer, Australian Society of Orthodontists (Orthodontics Australia), accessed September 2026
- What is an orthodontic emergency?, American Association of Orthodontists, accessed September 2026
- Clear aligner therapy, American Association of Orthodontists, accessed September 2026
- How to clean your retainer, American Association of Orthodontists, accessed September 2026
This article is general information about oral health. It is not a diagnosis or a substitute for advice from a dentist or doctor who knows your situation. If you have pain, swelling, bleeding that does not settle, or a problem that is getting worse, see a dental professional. In an emergency, contact your local emergency service.