How to Whiten Teeth with Braces

Just decades ago, almost all braces looked the same -- large metal brackets attached to the exterior of the teeth, with some braces secured on by a metal band that wrapped entirely around each tooth. Glue held individual brackets in place and wire stretched through the brackets, pulling and pressing teeth into alignment with each screw of the orthodontist's tightening tools during frequent office visits.

Braces today come in all shapes, colors, sizes and degrees of invisibility, and even though the stainless steel and metal alloy varieties are still wrapped and glued on, the materials and sizes can be a lot less clunky than those from days past [source: Colgate].

Whether you're wearing removable, clear appliances that go over the teeth -- such as those made by the brand Invisalign -- or sporting metal, ceramic or acrylic brackets on the front or even backs of teeth, tooth and gum care has to be stepped up and is more involved during orthodontic treatment. And although one outcome of wearing braces is that it will be easier to clean and care for your teeth once they are less crowded, braces and other dental appliances get in the way of flossing and brushing.

Removable braces offer some advantages in that they can be rinsed and cleaned frequently -- and they provide access to the whole mouth and all the teeth surfaces. But if wearers aren't keeping up on brushing and flossing, the 22-plus hours these braces are worn can create a lot of bacterial growth, as well as gum irritation.

Attached braces utilize horizontal wires, which make it difficult to floss. And the brackets are applied with glue, which adds spots where plaque can build up on teeth and more places for food to collect and breed acid, which damages enamel. Problems may intensify if mouth sores develop from sharp brace edges or if brushing habits worsen because of mouth pain.

But what about the tooth surface underneath brackets? Is that staying clean and free from stains while braces are in place? Changes in a tooth's color and appearance isn't noticeably different day-to-day, and unfortunately, braces can cause a dramatic before and after in your tooth's enamel.

So what about whitening? Can gradual or intensive whitening while wearing braces change teeth for the better?

You can whiten teeth with some kinds of braces with mixed results, but is it OK? It depends on the type of braces, kinds of stains on teeth and the contents of the whitening products. If you wear removable braces or have metal braces attached only to the backs of your teeth, whitening products will work much as they do for people without braces: They will whiten by delivering concentrations of carbamide peroxide into surface enamel to break up stains.

You shouldn't consider wearing invisible, removable appliances over any type of whitening products, however, without consulting with your dentist, if at all, because as with any whitening regimen, tooth sensitivity and gum irritation can result. If you have braces you may already have sensitivity and soreness, and whitening can intensify this discomfort.

Using whitening products with traditional metal bracket braces is not recommended at all. Traditional braces work well because they are so solidly attached to teeth, providing constant and gentle pressure to the teeth, which helps them move in the right direction [source: ADA]. Because the brackets adhere to teeth with such a strong bond, the enamel underneath is sealed by the glue and bracket overlay. That means the whitening agents will react with the exposed parts of teeth, but the covered surfaces won't receive the same treatment. Instead they will stay the same color they were before the brackets were applied.

If you are considering whitening your teeth while wearing braces, you should discuss it with your dentist or orthodontist first so he or she can advise you based on your specific treatment and the condition of your teeth and gums. Some whitening products may damage braces depending on the materials they are made of. In fact, several companies, including Crest -- the makers of 3D Whitestrips -- advise against using their products while using dental appliances and braces [source: Crest].

Can anything be done to whiten teeth while wearing bracketed braces?

Using intense whitening products such as strips and paint-on peroxides while wearing traditional braces on teeth can lead to uneven results. Dentists and orthodontists can recommend products for keeping uncovered parts of teeth looking their best, though, and some of these may contain whitening ingredients such as low concentrations of hydrogen peroxide. Many oral rinses used for added cleaning and for relieving mild soreness around the cheeks and gums generally contain 1.5 or 3 percent hydrogen peroxide versus the 10 to 35 percent in many over-the-counter and in-office whitening carbamide peroxides [source: ADA]. Salt rinses and gentle baking soda brushing also may remove buildup on teeth and help gums.

Whitening toothpastes marketed for everyday use, and not those designed to whiten drastically in a week or so, also may be just fine, but should not be used without checking with your orthodontist and dentist first. Keeping a thorough and consistent routine of brushing, flossing and getting professional cleanings may be the best way to keep teeth white or to make them whiter.

Being afraid of what your teeth look like beneath the brackets is common as time approaches to remove your braces. For the most part, though, a good in-office cleaning after braces are removed yields excellent results. If your oral hygiene has been good, minor stains from food and drink likely won't be so drastic enough to cause a difference in shades. Any stains that go deeper will most likely react very well to whitening agents, and whether done in the dentist's office, with dentist-recommended strips or home trays or dentist-approved over-the-counter toothpastes or other options, you can have whiter teeth within days or weeks.

If your oral hygiene has been poor, your teeth may be stained around the surfaces that had been covered with brackets and may need whitening to even out the discoloration [source: Hirsch]. Stains can be permanent, so follow the dentist's orders on cleaning and whitening. Teeth and gums also may be especially sensitive after appliances are removed, and you'll need to get used to wearing a retainer to keep newly aligned teeth in place, so adding whitening to all of the changes may not be advisable if you have mouth soreness.

Getting your braces off comes at the end of a long and inconvenient wait and with a lot of anticipation about how you'll look with a metal-free smile. Waiting to whiten may seem like just another sacrifice and inconvenience, but if you wait and get the dentist's OK, whitening the newly straightened teeth may just maximize the wow factor.