Expert: Dr. Randolph Myerson - 11/4/2008

Question
I am 18 and had orthodontic appliances from the age of 6 up until I was sixteen.  The last three years of my treatment (13-16) were with braces.  While my smile has turned out excellent, I've had to have three cavities filled since I got my braces removed.  All three cavities were on teeth that had the metal bands on them.  One of them was filled right after the braces were taken off, but the other two developed in "stains" left over from the braces.  Every time I've been to my dentist since my braces were removed, I've asked my dentist if there was any way to fix the stains so that they wouldn't become cavities, but my dentist always said that if I brushed and flossed, I would be fine.  As it turns out, they weren't fine, and this past June I had two more cavities filled.

I'm someone who has always taken good care of their teeth. I brush twice or three times daily, I floss daily, I and I avoid soda.  I just don't understand how I could have gotten cavities on teeth that weren't even exposed for a long time.  Did my orthodontia cause my cavities?  Is there anything else I can be doing to prevent more cavities other than what I'm already doing?

Thanks!

Answer
Patients with braces are at greater risk for decay and decalcification due to the greater difficulty in thoroughly removing plaque from all surfaces of the teeth.  Improved oral hygiene along with daily use of a high potency fluoride gel like Colgate's Prevident 5000 (available only by Rx from your dentist or orthodontist) can help to prevent these problems.  Once decalcification has occurred, as in your case, it may be possible to remineralize those areas by daily use of a preparation called "MI Paste" (also available only by Rx from your dentist or orthodontist).  You can learn more about these products by searching on the internet.