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If your child has just gotten braces, chances are it’s a good time to brush up on dental hygiene! Why now? What’s different? And how can you help? Let’s take a few minutes and explore these timely questions.

Brushing and Flossing Are Especially Important with Braces

There’s no getting around it, it’s harder to clean teeth with brackets and wires. But it’s essential to pay attention to dental hygiene. When bacteria and plaque start building up, your child is at risk for gum disease, cavities, and tooth discoloration.

• Gingivitis

This early stage of gum disease is the result of gum irritation caused by plaque. The gums become red, swollen, sore, and can bleed or start to recede. With proper brushing and flossing, gingivitis can be eliminated, along with the risk of developing more serious gum disease.

• Tooth Decay

One of the major reasons for cavities is the erosion of enamel caused by oral bacteria. These bacteria feed on sugars from our diet and produce acids that attack the tooth’s surface. Plaque, formed by a mass of these bacteria, sticks around brackets and the gum line, putting your child at risk for cavities near his orthodontic work—which might require removing wires and brackets to treat.

• Demineralization

When acids attack teeth, they remove the minerals from our enamel. This demineralization eventually leads to cavities, but in its early stages can cause white spots to appear where the mineral structure has been weakened. Braces wearers are at special risk for demineralization, especially around brackets and near the gums, where plaque can be missed while brushing.

Time for New Brushing and Flossing Techniques

Even if your child has always done a wonderful job of brushing and flossing, braces provide a new challenge for getting teeth their cleanest. Unfortunately, plaque buildup around the brackets and the gum line is all too common in orthodontic patients. Dr. Negaar Sagafi can recommend some tools that make the cleaning process easier and more effective.

• Toothbrushes

Manual brushes are available with small, soft-bristled heads designed especially for braces wearers. If your child still has problems getting rid of plaque and food debris, an electric toothbrush might be helpful. And remember, encourage your child to be thorough but gentle for the sake of both braces and gums.

• Flossing with Braces

Flossing can be challenging for children at any time, but especially with braces. We’ll show you how floss threaders work, and how special flosses designed just for braces can fit under wires. This might also be a good time to invest in a water flosser. Your help demonstrating how to floss even with brackets and wires blocking the way will be appreciated by your child and your dentist!

• Products Just for Braces

Interproximal brushes are tiny cone-shaped brushes designed to fit around brackets and wires and between teeth. We can also suggest special toothpastes and rinses to help fight plaque and prevent cavities from developing. Ask us about what to shop for to make both of your lives easier.

You Can Help!

• Teamwork—Works!

When your child first gets braces, practice brushing and flossing together. Our Bethesda team will be happy to show you both the very best techniques for keeping teeth their cleanest and healthiest. Especially for young children, your help will make sure those techniques are learned and used.

• Make Time for Cleaning

Your child’s before-braces routine might have meant brushing two minutes each morning and two minutes at night. But thorough cleaning around brackets and wires might take a bit longer. (And, with braces, it’s best to brush after every meal rather than the common twice-a-day routine). Be available, at least at first, for a quick check to make sure braces and teeth are their cleanest. And you may have to help with removing and replacing bands until your child gets the hang of it.

• Be Prepared!

Whether it’s a day at school or an overnighter with friends, be sure your child has a kit filled with cleaning supplies ready to take along. A toothbrush, floss, an interproximal brush, toothpaste, a mirror—with these necessities, your child can keep on top of any cleaning emergencies.

For younger children especially, learning how to keep teeth and braces their cleanest can take some time. Be patient, be prepared, and be willing to help, and you and your child will have a new routine mastered—in no time at all!

By Dr. Negaar Sagafi

Serendipity.

The textbook definition of this word is “the development of events in a happy or beneficial way.” Some people might simply call this concept “good timing.”

In March 2020, when state and local health orders (and common sense) dictated that I stop serving patients, it seemed like particularly awful timing. I was relatively new to the Washington, D.C. area and was trying to build not one, but two practices. Dentists and orthodontists are small businesses. We have employees who depend on us and we are also trying to support our own families. It is estimated that employment in dentists’ offices in April 2020 was less than half of what it had been just three months earlier. There was no revenue because we could not serve the community.

I fretted about whether my practices would survive. I worried about keeping my wonderful staff. But I also knew I had to push toward the future. I had to believe that events would unfold in a way that would benefit my patients and employees.

They did. Just 16 months after shutdown orders went into place, I’m opening the second of two renovated offices.

When the pandemic began, I was in the middle of rehabbing my Spring Valley location. I also had secured permits for the renovation of my Bethesda office. Instead of shutting down construction (which was an essential industry during COVID), we proceeded.

It was scary. Not only did we not know when we would be allowed to serve patients again, we ran into the same rising costs and supply chain delays that families who were building and renovating homes did. Are you still waiting for that couch you ordered back in January? Ikea’s division in the United States ran out of the cabinets we had selected. The manufacturer that made component parts for my patient chairs went out of business.

While the headaches were real, the gamble also was serendipitous.

The Spring Valley site was ready almost to the day in May 2020 that officials in Washington, D.C. lifted restrictions on nonessential medical and dental care. My staff and I could welcome patients back into a brand new, spotless environment. I am so grateful for the patients and families who started out in Bethesda, but trekked across the Maryland-D.C. line to see us.

The Bethesda office renovation was originally estimated to take just five to six months. Instead it took 14. But this month we open the doors to our beautiful space near Bethesda Row. It is light and bright and I hope it reflects the optimism that most of us are feeling at this moment.

When patients and parents walk into these spaces I not only want them to feel welcome. I want them to feel energized. That is why you will see a lot of pop art and primary colors (red, blue, and yellow) in my offices.

The red represents my passion for what I do and my love for my patients. Yellow is associated with joy. Most people probably would not list the orthodontist’s office as their “happy place,” but we definitely take pride and joy in what we do. The blue? While some people associate this hue with sadness, interior designers regard it as one of the most soothing shades on the color wheel.

You will also see that painted over the doors of my personal office are the words “Creativity in Action.” This space is where I do everything from answer email to puzzle over tough cases to discuss best practices and new innovations with colleagues over Zoom. This phrase really is my mission statement. I approach orthodontics as a scientist and a researcher. I always want to stay active and engaged. I am always trying to learn something new. I believe people must always ask themselves if there is a better way to do our work and that we must push ourselves to be creative when times are tough.

I cannot wait to welcome you to our these beautiful spaces. The last year and a half has not been easy, but we persisted through it so we could serve you better. Come see us!

Your teeth are precious. Once your permanent teeth come in, they need to last you a lifetime. Extensive tooth decay can lead to dental caries and the need for fillings, crowns, bridges, and dentures.

While these fixes can go a long way toward maintaining your quality of life, they cannot compare to your natural teeth. Getting braces is no excuse to let up on your thorough oral health routine: You need to take good care of your teeth before, during, and after braces to benefit completely from the gains you get from newly straightened teeth.

Why You Should Maintain Good Oral Health for Life

Begin a complete oral health regimen as early as possible in life, and maintain this routine throughout your life. Keeping your (or your child’s baby) teeth clean establishes a routine. It preserves healthy baby teeth whose function is to save space for the permanent teeth when they are ready to come in. Care of your permanent teeth helps preserve the enamel and prevent decay.

Take Special Care with Braces

It is important to pay attention to oral health when you have braces. If you do not take special care of your teeth during the months or years that you have braces, you risk irreversible damage to your teeth. Care is more difficult with braces because food can easily get stuck. In addition to brushing twice daily and flossing each day, Dr. Negaar Sagafi and our staff suggest avoiding sticky foods.

Thanks for asking! It really depends on the dental age of the patient rather than their chronological age. Usually a good time to have your child evaluated by an orthodontist is after the front permanent teeth have erupted into the mouth or if there appears to be extreme crowding of the teeth.

The American Association of Orthodontists recommends that children between the ages of seven and nine should be evaluated by an orthodontist. There are times when an early developmental treatment is indicated to correct situations before they become major problems. In these circumstances the patient will most likely benefit from a second phase of orthodontics when all of their permanent teeth have erupted.

Most full orthodontic treatment begins between ages nine and 14, and lasts from one to three years, with two years being the average. It’s important, however, that children be screened at an early age for Dr. Negaar Sagafi and our staff to assess if your child can benefit from orthodontic treatment and when treatment should begin.

We hope this helps, and invite you to give us a call if you have any questions about your child’s treatment at Bethesda Orthodontics.