Take a walk down the toothbrush aisle of any store, and you may be overwhelmed by the sheer amount of choices on display. Sensitive toothpaste, whitening toothpaste, alcohol or alcohol-free mouthwash, manual or electric toothbrush, no one could blame you for simply grabbing the first item you see.
Good oral hygiene can sometimes be a challenge for orthodontic patients in braces because food can be easily trapped around the brackets and under the archwires. So the question comes up at almost every appointment. Does a regular toothbrush still work, or is it time to buy an electric one?
The short answer
Yes, a manual toothbrush still works with braces. Plenty of our patients keep their teeth in great shape with a regular soft-bristled brush and good technique. What matters far more than the type of brush is how long you brush, how carefully you work around each bracket, and whether you do it consistently.
That said, an electric toothbrush makes it easier to do those things well. In a study comparing electric toothbrushes with manual toothbrushes, the American Journal of Orthodontics & Dentofacial Orthopedics found that there was significantly greater plaque removal with an electric brush over a manual brush. If you tend to rush, brush too hard, or have trouble reaching the back teeth, an electric brush closes that gap for you.
Either choice can work. The rest of this post covers how to get the most out of whichever one you pick.
The basics of brushing with braces
Before we get into the merits of electric brushes over manual brushes, here are the fundamentals of brushing and flossing with braces. To get the best results from your dental hygiene routine, you should be:
- using fluoride toothpaste and a toothbrush with soft, rounded bristles
- brushing after every meal, including after breakfast and dinner as well as after getting home from school
- brushing gently at a 45-degree angle toward the gumline and around the top and bottom of the braces, moving the toothbrush in a small circular motion across all surfaces of the teeth in order to effectively remove bacteria, as well as any trapped food particles
- replacing your toothbrush or brush head every 3-4 months, or sooner if it shows signs of wear, or if you have a cold or any other illness
- making it a point to look for clean and shiny braces, with the edge of the brackets clearly visible, as fuzzy or dull-looking metal can indicate poor brushing habits
- flossing at least once per day to remove bacteria and any food that has accumulated, taking advantage of tools like floss threaders and water flossers if you are having difficulty getting into the tighter spaces
- using antimicrobial and fluoride mouthwashes
Daily brushing and flossing help to prevent tooth decay, gum disease, and bad breath, whether it is done with a manual toothbrush or an electric one. Our brushing tips for braces patients go into more detail on technique.
What gives electric toothbrushes an advantage?
Multiple studies have shown that electric toothbrushes remove significantly more plaque and do a better overall job of cleaning than manual brushes. What is it about these brushes that gives them an edge over manual toothbrushes for patients in braces?
Deeper and more effective cleaning. Electric toothbrushes are designed to drive fluids between the teeth, providing the best efficiency in cleaning possible. The brackets and wires used in braces treatment create many nooks and crannies that are hard to reach, and these brushes are often able to get to all of them. Most models also produce thousands of movements per minute, which is impossible to achieve with any manual toothbrush.
Built-in timers. Most electric toothbrushes have a built-in 2 minute timer that alerts the patient when it is time to stop brushing. Many kids and adults who use a manual toothbrush use it for just a few seconds and think that the full 2 minutes has passed. A timer removes the guesswork, and some models even track how long you spend in each quadrant of your mouth.
Pressure sensors. Brushing too hard is one of the most common mistakes we see, and it wears enamel and irritates gums. A sensor tracks your pressure and lets you know the moment you are pushing too hard. This is a genuinely helpful feature for anyone with sensitive teeth or weak enamel.
Cleaning modes. Many electric toothbrushes have customized cleaning modes that are designed specifically for a certain purpose. There are sensitive modes for sensitive teeth, whitening and polishing modes for the removal of stains, tongue cleaning modes, and more.
How to choose an electric toothbrush for braces
If you decide to go electric, a few things matter more than the rest when you have brackets and wires to work around.
Soft bristles, always. Firm or medium bristles are hard on both your enamel and your brackets. Look for soft or extra soft.
A small brush head. Smaller heads maneuver around brackets and reach back molars far better than large ones. This matters more with braces than it does without.
Oscillating or sonic. Oscillating heads rotate back and forth and wrap around individual brackets well. Sonic brushes vibrate at high frequency and tend to be gentler on sensitive gums. Both work with braces, so pick whichever feels more comfortable, because the one you actually use twice a day is the one that helps.
Orthodontic brush heads. Several manufacturers make brush heads shaped specifically for braces, with a notch or V-shaped bristle pattern that sits over the bracket. If your brush has one available, it is worth using.
The ADA Seal of Acceptance. Whether you choose electric or manual, look for the American Dental Association seal. Brushes carrying it have been studied and tested for safety and effectiveness, and are guaranteed to perform as promised.
Battery-powered or rechargeable?
Electric toothbrushes generally come in two types, and both have their place.
Battery-powered toothbrushes normally run on an AA or AAA battery. They are handheld and work similarly to a manual toothbrush as far as technique is concerned. The difference lies in the brush head, which has bristles that spin or pulsate, putting extra power behind your brushing. This model may still require a brushing motion, since the power is only meant to enhance its cleaning ability. Many models have replaceable brush heads that you can change out when they wear down, while keeping the same base. Just be sure to replace the batteries as soon as they run out, because dead batteries left in the handle can leak and ruin the brush.
Rechargeable toothbrushes generally recharge in a base that plugs into a wall outlet, so there is no need to replace batteries. These tend to offer the more advanced options, such as timers, pressure sensors, and replacement reminders. They may also have a variety of brushing motions, like oscillation or vibration. The electric power of these brushes provides all the brushing you need, so you will normally only have to guide the brush across your teeth.
What about orthodontic and interdental brushes?
A regular toothbrush, electric or manual, cannot reach everywhere once brackets are on. Two small tools fill the gaps.
Interdental brushes are tiny cone-shaped or cylindrical brushes on a thin handle. They slide under the archwire and between brackets to clear out what your main brush missed. Most patients find them faster and easier than floss threaders.
Orthodontic toothbrushes have a bristle pattern with a groove down the middle that straddles the bracket, cleaning above and below it at the same time. They are small enough to keep in a backpack or a locker as a backup.
Neither replaces your main toothbrush. They work alongside it. We keep a list of other helpful products for orthodontic treatment if you want to build out a full kit.
Why this matters during treatment
Plaque left sitting around brackets does more than cause bad breath. It can lead to decalcification, the permanent white marks that appear on teeth after braces come off. Those marks are avoidable, and avoiding them comes down to the same routine every day. Our guide to oral health during orthodontic treatment covers what to watch for.
It is also wise to replace any toothbrush or brush head more often when you are undergoing orthodontic treatment. Braces are tough on bristles and can wear them out more quickly.
Ask us at your next appointment
Whether you choose an electric toothbrush or stick with a manual one, our team is happy to look at how you are brushing and show you what you are missing. That takes two minutes at an adjustment and it is far more useful than any list of features, because we can point at your actual teeth.
If you are not a patient yet and you are considering orthodontic treatment in Lexington, you can schedule a free consultation and we will get you set up with the right tools before treatment even starts.
Frequently asked questions
Can I use a normal toothbrush with braces?
Yes. A soft-bristled manual toothbrush cleans braces effectively when you brush after every meal, angle the bristles toward the gumline, and work carefully around the top and bottom of each bracket. Technique and consistency matter more than the type of brush you use.
Is an electric toothbrush better for braces?
Research published in the American Journal of Orthodontics and Dentofacial Orthopedics found significantly greater plaque removal with electric brushes than with manual ones. An electric brush is not required, but it makes good technique easier, particularly for patients who rush or brush too hard.
Are there manual toothbrushes designed for children with braces?
Yes. Orthodontic toothbrushes have a V-shaped groove in the bristles that fits over the bracket and cleans above and below it at once. They come in child sizes and work well as a backup brush to keep in a backpack or a locker.
What should I look for in an electric toothbrush for braces?
Soft bristles, a small brush head that reaches the back molars, and either oscillating or sonic action. A pressure sensor helps prevent brushing too hard. Look for the American Dental Association Seal of Acceptance on whichever brush you choose.
How often should I replace my toothbrush with braces?
Every three to four months, and sooner if the bristles look worn. Brackets and wires wear bristles down faster than teeth alone, so patients in braces usually need to replace a brush or brush head more often than they did before treatment.