Yes, you can absolutely get cavities while wearing braces, and in fact the risk of tooth decay increases somewhat during orthodontic treatment. Brackets and wires create small nooks where food particles and plaque can hide, making it easier for cavities to develop if oral hygiene slips. The good news is that cavities with braces are highly preventable with the right brushing, flossing, and diet habits. Here is what to know about protecting your teeth throughout treatment.
Why Cavities Are More Common With Braces
Braces and tooth decay are connected mainly because of how brackets and wires change the surface of your teeth. Food particles and plaque can get trapped around brackets and underneath wires, areas that a regular toothbrush has a harder time reaching. If plaque is not removed consistently, it can lead to enamel demineralization, the early stage of a cavity, particularly around the edges of each bracket.
What Are White Spot Lesions
One specific concern orthodontists watch for is white spot lesions, which are small, permanent white marks that can appear around brackets when plaque builds up over time. These marks represent early enamel damage from prolonged plaque exposure and can be considered the very beginning of a cavity. Unlike a cavity that develops into a hole, white spot lesions from braces are usually a cosmetic concern once brackets come off, but they signal that oral hygiene needs improvement during treatment.
Proper Brushing Technique With Braces
Brushing teeth with braces takes a bit more time and attention than a typical routine, but the core principles are simple:
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Brush after every meal when possible, or at minimum twice a day for a full two minutes
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Use a soft-bristled brush, angled to clean above and below each bracket
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Consider an electric toothbrush, which can be more effective at reaching around brackets and wires
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Use fluoride toothpaste to help strengthen enamel throughout treatment
Flossing and Additional Tools
Flossing is one of the most important, and most often skipped, parts of braces oral hygiene. A few tools make it more manageable:
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A floss threader helps guide floss underneath the archwire so you can clean between each tooth
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Interdental brushes are small, cone-shaped brushes that clean tight spaces around brackets and wires quickly
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A water flosser uses pressurized water to dislodge food particles and plaque that a toothbrush may miss
Using at least one of these tools daily, alongside regular brushing, significantly reduces cavity risk during treatment.
Cavity Prevention Braces Habits That Matter Most
Beyond brushing and flossing, a few daily habits go a long way in preventing cavities:
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Rinse with water after meals if you cannot brush right away
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Use an antimicrobial or fluoride mouthwash as part of your daily routine
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Keep up with regular dental cleanings in addition to your orthodontic appointments
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Avoid letting plaque sit around brackets for extended periods, since this is when decay risk climbs fastest
Foods to Avoid With Braces
Certain foods make dental hygiene with braces more difficult and increase cavity risk, particularly sticky and sugary items that cling to brackets and wires. Foods to avoid or limit include:
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Sticky candy and chewing gum
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Sugary drinks that coat teeth with sugar throughout the day
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Hard foods that can get lodged around brackets, like popcorn kernels
Reducing frequent sugar exposure, rather than eliminating sugar entirely, is one of the most effective ways to lower cavity risk during treatment.
What Happens if a Cavity Develops During Treatment
If a cavity does develop while you have braces, your dentist can still treat it in most cases. Depending on the location of the cavity, your orthodontist and dentist may need to coordinate care, sometimes temporarily removing a bracket to access the affected tooth. This is one more reason why regular dental visits alongside your orthodontic appointments matter throughout treatment.
How Diamond Braces Supports Oral Hygiene During Treatment
At Diamond Braces, our team provides guidance on oral hygiene with braces throughout your treatment, not just at the start. We want your smile to look great both during and after treatment, which means helping you avoid cavities and white spot lesions along the way. If you have questions about your specific hygiene routine with metal braces or another appliance, our team is happy to walk you through it during your visits or a consultation.
Final Thoughts
Cavities with braces are a real risk, but they are also highly preventable with consistent brushing, flossing, and mindful eating habits. Brackets and wires simply require a bit more time and the right tools to keep clean. By staying on top of your oral hygiene routine and keeping up with dental visits throughout treatment, you can protect your teeth and enjoy a healthy, cavity-free smile once your braces come off.
Frequently Asked Questions
Are cavities more common with braces?
Yes, brackets and wires make it easier for plaque to accumulate in hard-to-reach spots, which can increase cavity risk if oral hygiene is not consistent.
What are white spot lesions from braces?
White spot lesions are permanent white marks caused by early enamel demineralization around brackets, typically resulting from plaque buildup during treatment.
What tools help prevent cavities with braces?
A soft-bristled or electric toothbrush, floss threaders, interdental brushes, and water flossers all help clean around brackets and wires more effectively.
What foods should I avoid to prevent cavities with braces?
Sticky candy, chewing gum, sugary drinks, and hard foods that can get stuck around brackets are the biggest contributors to increased cavity risk during treatment.
Can a dentist still fill a cavity while I have braces?
Yes, dentists can typically treat cavities during orthodontic treatment, sometimes coordinating with your orthodontist if a bracket needs to be temporarily removed.
How often should I brush my teeth with braces?
Brushing after every meal is ideal, but at minimum, brushing thoroughly twice a day for two full minutes helps significantly reduce cavity risk during treatment.
Article written by Diamond Braces Clinical Staff, medically reviewed by Dr. Oleg Drut
