Do I Need a Cleaning Before Braces?

Seen in Midtown Houston, Saturday hours: Book an appointment  ·  (713) 322-7474  ·  Orthodontics in Houston

Why It Has to Happen First

Three reasons, and the first is the one people underestimate.

Brackets are bonded to enamel with an adhesive that needs a clean, dry surface. Tartar or plaque at the bond site means a bracket that debonds in week three, which is a wasted appointment and a delayed treatment.

Decay under a bracket is a genuine problem. If a small cavity is missed and a bracket goes on top of it, treating it later means removing the bracket, restoring the tooth, rebonding and often re-planning that segment. Found beforehand, it is a routine filling.

Gums that are already inflamed get worse with braces, not better. Brackets and wires make plaque control harder for everyone. Starting from inflamed tissue means swollen, overgrown gums by month four, which is uncomfortable, bleeds, and can genuinely slow tooth movement.

The same logic applies to clear aligners, with one addition. An aligner seals whatever is on your teeth against the enamel for 22 hours a day. Starting treatment with active decay is the worst possible version of that.

What the Visit Actually Involves

About an hour, and it is more than a polish.

• A full examination of every tooth, including existing fillings and any old work that is failing.

• Bitewing X rays. Decay between the back teeth is invisible to the eye and to a probe, and this is the only reliable way to find it. It is also where most cavities in teenagers actually are.

• Periodontal charting, measuring the gum pocket depth around each tooth so we know what we are starting from.

• Scaling to remove tartar above and below the gumline, then polishing.

• Fluoride varnish, which takes a minute and measurably reduces decay risk during orthodontic treatment.

• A conversation about what is going to be harder to clean once the brackets are on, with the tools that actually work.

If you are having orthodontic records taken at the same practice, this often happens in the same week, which saves you a trip.

What It Costs

• New patient exam with cleaning: $99. This includes the examination and the cleaning, and it is where the orthodontic plan gets checked against the state of your mouth.

• Routine adult cleaning if you are already a patient: $120.

• Pediatric cleaning: $95.

• Deep cleaning, scaling and root planing, if gum disease is found: $300 per quadrant.

• Fillings, if decay is found: quoted at the visit, because it depends on the tooth and how large the cavity is.

Braces and Invisalign are both $3,500 here, and retainers afterward are $250.

We verify your insurance benefits before treatment. Preventive cleanings and orthodontics are usually handled under different parts of a plan, with orthodontics carrying its own separate lifetime maximum, so we check both and give you your share in writing.

If Something Is Found

Nothing here delays braces by long, and all of it delays them far less than dealing with it mid treatment would.

Small cavity: a filling, one appointment, and orthodontics can usually start the following week.

Gum inflammation: a deep cleaning at $300 per quadrant and a few weeks for the tissue to settle before bonding. Our periodontist, Dr. Shirin Farhadian, sees the cases where the gums need proper attention first.

A tooth needing a crown or root canal: this gets finished first, because doing it around a fixed appliance is considerably harder.

Wisdom teeth: your orthodontist will look at whether they are going to interfere. Sometimes they come out before treatment, sometimes after, and sometimes not at all. Our oral surgeons are in the same building, so this does not mean a referral and a two month wait.

We would rather find a small filling now than remove a bracket to reach a $1,500 root canal in month nine.

Cleaning Teeth With Braces

This is the part that decides how your teeth look when the brackets come off.

Brush after every meal, not twice a day. Angle the brush at 45 degrees to reach above and below each bracket. Two minutes minimum, and an electric brush with a timer removes the guesswork.

An interdental brush, the small cone shaped one, gets under the wire and around each bracket, and it is more useful day to day than anything else on this list.

Floss threaders or orthodontic floss get between the teeth, which the brush cannot reach. Every night, without exception.

A water flosser is not a replacement for flossing but it is very good at clearing food from around brackets, and patients who own one clean better because it is less effort.

Fluoride mouth rinse at a separate time from brushing.

The reason all of this matters: white spot lesions. Plaque left sitting around a bracket demineralizes the enamel underneath it, and when the bracket comes off there is a permanent chalky white square there. It does not brush out. It is the single most common regret from orthodontic treatment and it is almost entirely preventable.

And keep your regular cleanings during treatment, every six months or more often if we say so.

Caring for Clear Aligners

Different appliance, same principle.

Brush your teeth before putting the aligners back in, every time. Sealing sugar or food residue against enamel for 22 hours a day is how a straightening case becomes a case with cavities.

Rinse the aligners in cool water whenever they come out, and brush them gently with a soft brush. Never hot water, a dishwasher or boiling, which warps the plastic permanently and destroys the fit.

Aligner cleaning crystals or tablets, a few minutes a day, keep them clear.

Only water goes in while they are in. Coffee and tea stain them within days and hot drinks deform them. Anything sugary trapped underneath is worse than usual.

Carry the case. Aligners wrapped in a napkin get thrown away, and a replacement tray costs time as well as money.

Booking Before Your Braces in Midtown Houston

You can have the cleaning, the exam and the orthodontic consultation at the same practice here, which means the person planning your braces sees the same X rays as the person who cleaned your teeth.

Our orthodontist is Dr. Bernard Boback, Harvard trained. Our periodontist is Dr. Shirin Farhadian, board certified and a Diplomate of the American Board of Periodontology. The orthodontic consultation is free; the new patient exam and cleaning is $99.

We are at 106 W Gray St in Midtown, minutes from Montrose, River Oaks, Downtown, the Museum District and the Texas Medical Center, with Saturday appointments, which matters for a teenager who should not be missing school every six weeks.

Call (713) 322-7474 or book online.