Brushing and Flossing

Two-Way Brushing

I learned of the term Two-Way Brushing from Dr. Mike Nelson of Redding who credits his father, Dr. Leon Nelson, with coming up with the term.  It means that there are two ways of brushing.  One is a thorough mouth cleansing.  The second is brushing for refreshment.  I ask my patient to perform a thorough mouth cleansing only once per day.  This will keep the teeth and gums healthy.  Feel free to brush quickly for refreshment (after meals) as often as you like. The thorough cleansing requires approximately 5 minutes when you have braces.


It is important to be methodical.  A timer, like the one built into most cell phones, is handy.

  1. Break your mouth into 4 sections (upper right, upper left, lower right and lower left)
  2. Brush vigorously for at elast 30 seconds in each section.
    1. With a manual, soft bristled brush, angle the bristles upward in the upper and downward in the lowers to clean thoroughly between the brackets and the gums. Be sure that the bristles get under the gums.  Vigor is a key!  Start in the very back and work your way forward.
    2. If you are using an electric brush, be sure to use the same angulation into the gum tissues between bracket and gums.  You do not need to use vigor with an electric brush, but you must use very firm pressure and some slight movement to clean effectively.
    3. With either type of brush, be methodical from back to front and spend most of the minute on the fronts of the teeth around the brackets. Brush the backs (tongue side) of your teeth well, but more briefly.
    4. Repeat for all four sections.  Then it’s time to clean between the teeth.


We use two methods to clean between the teeth.  One is to use a pick device.  The two interdental pick devices we recommend are both made by G.U.M. company and are widely available in grocery and drug stores.  One is the G.U.M Soft Pick (below left), for patients with small space between the teeth or G.U.M. Proxabrush (also called Go-Betweens) for adult patients with more space.


For patients who cannot use the interdental picks, we recommend the Playpus(TM) orthodontic flosser. (Above right)  They are not so readily available but at the time of this post could be purchased at Chico Pharmacy and at Safeway.  It is difficult to describe the use of the flosser, but instruction will be given at the time the braces are placed.  Many floss-fork devices in groceries appear similar to the Platypus(TM), but will not work. One, less expensive alternative is called a Packer OrthoPick(TM) and is widely available online.

There are many other devices such as water piks and water flossers on the market that are helpful, but must be used in addition to the thorough cleansing regimen and not instead of it.

You will be assigned a mouth rinse to use following your 5 minute cleansing.  This will vary from person to person depending on your specific dental health needs.


American Association of Orthodontists American Board of Orthodontics The Pacific Coast society of Orthodontists invisalign