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Ortho patient

My office doesn’t have an air polisher. What instruments do you use to clean around braces? I’m having trouble finding an instrument that adapts good especially when the tissue is spongy and overgrown. I’m using 204S mainly. Should I be using ultrasonic for those patients with heavy plaque?



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6 Answers

Ultrasonic all the way. I use that first then polish with a pointed prophy cup, then floss and then scale LAST. That way I’m not wasting alot of time tediously scaling plaque off around the brackets because most of the plaque is gone by the time I even pick up a scaler.

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Generally speaking if I have an ortho pt come in w/ half their lunches stuck in their brackets, I’ll grab the toothbrush and toothpaste I was going to give them @ the end of the apt and ask them to brush their teeth for me for @ least 2-3mins. Then I’ll ultrasonic, scale, then I’ll use my regular prophy angle on the linguals and an occlusal brush on the facial/buccal aspects around brackets. Last I’ll grab my super floss and floss, after a really thorough rinse I’ll check to make sure I didn’t miss anything if I do I’ll go back and touch up any missed areas. If worse comes to worse grab a tooth brush and use it to brush out the plaque and food debris stuck around the brackets yourself while educating the pt on proper brushing technique. I do this w/ pt that come w/ teeth covered in heavy plaque and food debris regardless if they have ortho or not.

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yes! you can adapt all around the brackets and the gingiva! i use ultrasonic on all ortho patients because they most likely aren’t doing a great job at taking care of their teeth (just an observation)

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I love the ultrasonic for ortho. It not only removes plaque, food debris and calculus…you can irrigate under and around those puffy tissues.

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Agreed with Hoosier cavitron all the way and pointed prophy angle even the pointed brushes for polishing. A lot of the times we ask that the pt have the wire removed by the orthodontist prior to their appt for more effective exams and cleaning.

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All of the above. I also use Butler Gum Go Between with prophy paste and scrub the top, bottom, between and under wire of each tooth. I have pt hold mirror to watch while I use the go between. It massages the gums better too. I also instruct pt to order Floss Fish to aid in flossing. Past experience I sat in front of a mirror on back of my bedroom door and threaded reg floss. Sitting helped not to get tired and frustrated trying to lean over the sink. At first it took me 15 to 20 minutes to floss, but after I got the hang of it it took me 5 minutes top. Floss fish would have been awesome when I had braces though.

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