How to Prevent Gum Swelling with Braces

November 21, 2023

When I perform an exam on a kid in braces during their cleaning appointment, unfortunately I am surprised when their gums don’t have significant swelling. At least a few times each week, I see gums that are so swollen that they are touching the tops of the braces brackets. As a dental profession, we need to do a better job of educating kids in braces (and their parents) on proper home care. My worst day of work ever as a dentist was when a beautiful 13-year-old girl came into my office as a new patient. She had just gotten her braces off and her orthodontist recommended that her parents bring her to see me. After doing a thorough exam, I had to share the unpleasant news with her and her parents that there was a large cavity on EVERY. SINGLE. TOOTH. IN. HER. MOUTH. Here, these parents thought they were doing the best thing for their child by straightening her teeth, and the end result was severely compromised teeth that will result in a lifelong oral health battle for her. That night, I went home and looked at each of my five kids and I honestly just broke down.

So, what is the oral health routine that I teach to kids in braces and their parents? First of all, I tell them that brushing and flossing before braces is like driving a car with an automatic transmission, whereas brushing and flossing with braces is like driving a car with a manual transmission where you have to shift gears. They are completely different machines. If your child only knew how to drive an automatic car, you wouldn’t just toss them the keys to a brand new manual car and say, “take her for a spin.” They would completely wreck the transmission. In a similar fashion, when a kid gets braces, you shouldn’t just send them to bed and shout up the stairs, “make sure you brush your teeth!” They need to be instructed on the technique required to “drive this new vehicle.”

One of the best ways to help your child in their quest to avoid swollen gums during braces is to purchase an electric Sonicare toothbrush. While electric brushes used to be very expensive, you can now get a quality Sonicare on Amazon for $30-50. The sonic vibrations of an electric brush stimulate the gums way better than a manual brush ever could. This stimulation increases blood flow in the gums which decreases swelling, redness, bleeding, and tenderness. But like I said earlier, not only should your child use a better toothbrush, they also need to brush differently. I always tell my own children to brush twice; once below the brackets, and once above the brackets where the goal is to brush the upper surface of the brackets while massaging the gums at the same time.

The other main practice to employ to help prevent swollen gums with braces is to floss at least once a day. Twice is even better. The best tool available for flossing with braces is the Slate Electric Flosser with the blue braces head. The thin tip of the floss arm fits in between the brackets and under the braces wire. The sides of the floss arm have blue rubber bristles that simultaneously brush the sides of the brackets as the floss is passing between the teeth. Flossing with braces used to be such an intense and time-consuming chore, but the design of the Slate Electric Flosser braces head combined with the sonic vibrations make it so much easier, and so much more effective than any other tool.

Finally, the last thing that I recommend to my patients who are in braces is a good mouth rinse. The brackets, wires, expanders, and rubber bands harbor all kinds of food and debris. Proper brushing and flossing is obviously imperative to break up and remove this debris, but sometimes you just miss a spot or you properly break up the debris but it re-settles in other areas of the mouth. So, a vigorous swiss with a non-alcoholic fluoride rinse can help to free up any last bits of food, which aids in the pursuit of healthy gums free of inflammation. On the budget side, I recommend ACT fluoride rinse which can be found at most drug stores. The rinse that I personally like, which is a little more expensive, is CariFree Maintenance Rinse.

If you have a child in braces, or who will soon be in braces, please take the time to talk over the home care responsibilities that come with them. Braces are critical in order to put the teeth in a healthy relationship that is conducive to lifelong oral health, but we don’t want to compromise the health of the teeth while the braces are on.