Patients with braces will be urged to avoid eating certain types of foods, as they are likely to stick to the braces and may even cause brackets or wires to become damaged. Prohibited foods include gum, popcorn, and hard or sticky candies. Many orthodontists urge patients to avoid sugary sodas and juices because sugar tends to stay longer on the teeth of patients who wear braces, which can lead to tooth decay. At the very least, patients should brush soon after consuming these drinks.

Chewing on items such as pens, pencils or fingernails also can damage braces. This type of damage requires repair by the orthodontist and often results in extended treatment time for the patient.

Food particles and sugary substances that stick to braces increase the buildup of dental plaque, which encourages tooth decay, gum disease and bad breath. For this reason, patients with braces have to be vigilant about regularly brushing and flossing their teeth. A toothbrush with soft bristles may help patients reach areas within their mouth that are hard to get to due to their braces. Certain types of mouthwash may also help patients with braces to maintain good oral hygiene. However, patients with braces should check with their orthodontist to see if use of mouthwash is appropriate for them.

An orthodontist may provide special flossing equipment that facilitates flossing in and around braces. In addition, an assistant at the orthodontist office will instruct the patient in the proper procedure for flossing around braces.

From time to time, patients may find that a bracket or wire comes loose, or that a wire is poking them. When this occurs, an appointment with the orthodontist should be scheduled. The most common problems associated with braces include:

• Broken or protruding wires. Wires sometimes break or protrude in a way that pokes into the cheek, tongue or gum. If the wire is protruding, a pencil eraser sometimes can be used to push the wire into a less bothersome position until patients can see their orthodontist. Orthodontic wax can also be used to cover the sharp end. Patients should never cut these wires, as bits of metal may be swallowed or inhaled into the lungs and cause additional problems. Patients who develop a mouth sore due to a protruding wire are urged to rinse with an antiseptic solution or warm saltwater until they can see their orthodontist.
  
  
• Loose brackets. The bond of a bracket may loosen, particularly if patients chew on something hard or sticky. A broken bracket may poke at gum tissues or soft tissues such as the tongue or cheek. Patients are urged to cover any sharp ends with orthodontic wax until they are able to see the orthodontist.
  
  
• Loose bands. The metal rings that are cemented around the back teeth sometimes will come loose. Patients are urged to save the band and schedule an appointment with their orthodontist.
  
  
• Loose spacers. These tiny circular spacers are made of rubber and are inserted between teeth to open a small gap between teeth that helps orthodontic bands to slip into place more easily. If a spacer slips out of place, an appointment should be made to have it replaced by an orthodontist.

In addition, some patients with braces may have allergic reactions to the metal or latex used in the braces and bands. Also, people with braces who have certain diseases (e.g., type 1 diabetes) may be at higher risk for periodontal problems.

Patients with braces can participate in most activities, but may have to take special precautions such as wearing mouth guards while participating in contact sports. Other activities may require a period of adjustment. For example, patients who play wind or brass musical instruments will probably need to practice and adapt to any changes in their ability to expel air due to the braces before they feel comfortable playing these instruments.

Patients advised to wear a removable retainer are urged to clean the device daily with a toothbrush and toothpaste. It is particularly important to clean the side that has contact with the roof of the patient’s mouth. Hot water should not be used to clean the retainer, as it can distort the shape of the retainer. Patients are urged to store the retainer in its case and to keep it away from pets.