Toothpaste and mouthwash for braces — how to care for your enamel to prevent white spots

Braces straighten your teeth, but they also make cleaning them difficult for a year or two. Plaque collects around the brackets and under the archwire, where a toothbrush cannot reach. The effect becomes visible only after the braces are removed: dull, white spots on the enamel, precisely where the brackets were. They can be avoided, but you need to know where they come from and how to stop them.

In this article: what happens to the enamel under braces, which routine really works, which toothpaste and mouthwash to choose, and why we selected PrevDent OrthoCare.

Where do white spots after braces come from?

White spots are enamel demineralization (in literature: WSL, white spot lesions). Bacteria in plaque produce acids, which leach minerals from the enamel, causing it to lose its transparency and turn chalk-white. This is an early stage of decay, without a cavity yet.

With fixed braces, the risk increases because brackets and ligatures create dozens of nooks and crannies where plaque lingers longer. Studies show varying frequency, from a few percent to several dozen, depending on how thoroughly one searches. A 2026 review of 70 clinical studies states clearly: demineralization that occurs during treatment does not disappear on its own after braces are removed and often requires further treatment.

The conclusion is simple. It is easier to prevent spots than to remove them later. Removal is usually a procedure in a dental office (resin infiltration, microabrasion), not a toothpaste.

How to brush teeth with fixed braces?

There is no magic here, just a routine. Orthodontists and hygienists repeat the same set of rules:

• After every meal, for at least two minutes. Use a soft toothbrush, circular motions, and brush the upper and lower edge of each bracket separately. Brushing at night is the most important, as we produce less saliva while sleeping.
• An interdental or single-tuft brush for the spaces under the archwire and around the brackets. This is what makes the difference, not your main toothbrush.
• Floss with a stiffened end (superfloss) or a water flosser for interdental spaces. The water flosser complements brushing, it does not replace it.
• Mouthwash at the end to reach areas you couldn't reach mechanically.
• Check-ups every 6–8 weeks with an orthodontist, and professional cleaning every few months.

If you see pink rings around your brackets after using a plaque disclosing agent (available at a pharmacy), that is exactly the map of future white spots. It is worth doing this test from time to time.

Which toothpaste to choose with braces?

The classic recommendation is: fluoride toothpaste, 1450 ppm. Fluoride has the longest history of research in preventing demineralization and is part of standard orthodontic protocols. If your orthodontist recommends fluoride, stick to that recommendation.

A second path, increasingly present in studies, is nano-hydroxyapatite (nHAp). This is the same mineral that enamel is made of, just in particles small enough to settle into micro-cavities and exposed dentinal tubules. What the data says:

• In a 2026 network meta-analysis (70 studies, over 4,600 participants), nano-preparations were among those that significantly reduced the severity of white spots. For prevention alone, the strongest evidence was for professional in-office fluoride varnish.
• In a randomized study of 50 patients after braces removal (Badiee et al., 2020), nHAp toothpaste used for six months reduced the extent of the spots more than fluoride toothpaste. This is a small study, so we treat it as a signal, not definitive proof.

Honestly: hydroxyapatite is widely studied for enamel remineralization and is a sensible alternative to fluoride, but the evidence for prevention in people with braces is still more modest than for fluoride. A good option if you want to avoid fluoride or if fluoride toothpaste causes irritation: nHAp toothpaste plus in-office fluoride varnish as recommended by your orthodontist. Both methods are not mutually exclusive.

What else to look for in ingredients when you have braces:

• Low abrasivity. Enamel around brackets is weakened; highly abrasive "whitening" toothpastes with high RDA are a bad idea during treatment.
• SLS-free. Sodium lauryl sulfate (a foaming detergent) increases aphthae and irritation in some people, and with braces, the mucous membrane already takes a beating from the brackets.
• Something for sensitivity. Teeth hurt after every adjustment of the braces; potassium nitrate is an ingredient used in toothpastes designed for sensitive teeth. More in the article what for sensitive teeth.

PrevDent OrthoCare: toothpaste designed for braces

Dutch company PrevDent has made nano-hydroxyapatite its specialty, and OrthoCare is their line for people undergoing orthodontic treatment: with fixed braces, retainers, or aligners. The manufacturer recommends replacing your current toothpaste with it during treatment and brushing 2–3 times a day; in practices that use it, the patient receives a new tube at every check-up.

What is inside and what does it do:

• Nano-hydroxyapatite: a mineral equivalent of the enamel building block, supports remineralization of demineralized areas around brackets.
• Potassium nitrate: an ingredient used in sensitivity toothpastes, useful after brace adjustments.
• Fluoride-free, SLS-free (using sodium lauroyl sarcosinate as a detergent, which is gentler on the mucosa), mild mint flavor.

The manufacturer does not provide the percentage concentration of nHAp, so neither do we. In the INCI, hydroxyapatite is in sixth place, after water, silica, sorbitol, glycerin, and potassium nitrate.

To complement the toothpaste, PrevDent offers OrthoCare mouthwash: alcohol-free (does not sting, which matters when the mucosa is irritated by brackets), fluoride-free, and SLS-free, based on xylitol and glycerin. Xylitol supports the pH balance in the mouth. It is a "finishing" rinse to reach what the interdental brush missed. Note: the mouthwash does not contain hydroxyapatite; remineralization is handled by the toothpaste.

Who is this a good choice for?

OrthoCare makes sense if you wear fixed braces or aligners and want a fluoride-free toothpaste that simultaneously mineralizes enamel and soothes sensitivity. If you don't mind fluoride and your orthodontist is treating you with a classic protocol, stick with it; optionally, add OrthoCare as an evening toothpaste after consulting your doctor. If you are primarily looking to whiten your teeth, wait until the braces are removed: nothing will whiten under the brackets anyway.

How much does it cost and how long does it last?

An 80 ml tube used three times a day lasts for about 5–6 weeks, or roughly from one visit to the next. A 300 ml bottle provides about 12 rinses of 25 ml each. In our store, we have:

• PrevDent OrthoCare nHAp, 80 ml toothpaste: 149 PLN
• PrevDent OrthoCare, 300 ml mouthwash: 89 PLN
• Set of 2 × OrthoCare toothpaste: 269 PLN (29 PLN cheaper)
• Set of 2 × OrthoCare mouthwash: 159 PLN (19 PLN cheaper)

This is not a cheap toothpaste. You are paying for nHAp and a formula without compromises in the ingredients. If treatment lasts 18 months, that's a dozen or so tubes; white spots removed in a dental office usually cost more.

Frequently asked questions

Will hydroxyapatite toothpaste remove white spots I already have?

It can reduce and partially remineralize them, especially fresh and shallow ones; in the study by Badiee et al., the extent of the spots decreased over six months of use. Deep, old demineralization usually requires an in-office procedure.

Can I use OrthoCare with aligners?

Yes, the manufacturer mentions aligners and retainers alongside fixed braces. Brush your teeth before each re-insertion of the aligner so as not to trap plaque underneath it.

Will OrthoCare mouthwash replace an interdental brush?

No. The mouthwash reaches where a brush doesn't, but it does not remove plaque mechanically. Order: toothbrush, interdental brush, floss or water flosser, mouthwash at the end.

Is OrthoCare safe for children with braces?

The toothpaste does not contain fluoride, so there is no risk of fluorosis if swallowed, but it does contain potassium nitrate and is intended for brace users, which in practice means teenagers and adults. For younger children, leave the decision to the orthodontist.

Sources: orthocare.world and dentaltix.com (PrevDent OrthoCare manufacturer materials); Hussain U. et al., “Efficacy of various interventions for the management of white spot lesions associated with fixed orthodontic treatment”, BMC Oral Health 2026 (network meta-analysis of 70 RCTs); Badiee M. et al., “Comparison of the effects of toothpastes containing nanohydroxyapatite and fluoride on white spot lesions in orthodontic patients”, Dental Research Journal 2020; Lopes P.C. et al., “White spot lesions: diagnosis and treatment – a systematic review”, BMC Oral Health 2024.