Here is the regimen that my wife advises her patients in treatment to follow(obviously there is a HUGE degree of acceptance of these suggestions <img border="0" title="" alt="[Eek!]" src="eek.gif" /> )
First and foremost what you're trying to prevent is the whole decay, white spot decalcification around the gingival margin of the brackets, and perio issues)
Basic care, first off a rotary or preferably an ultrasonic tooth brush is strongly advised (face it, most teenagers aren't the best brushers anyway and the more help you can give them the better!) Then supplemental flossing aids (i.e. superfloss, floss threaders, proxa brushes, rubber tip stimulators) are given to the patient and they determine which one works best for their dexterity.
Supplemental fluoride application is also standard in my wife's protocol. Her patient's are either given a tube of Prevident 5000 or a bottle of ACT at each regular visit. The patients decide whether the brush and leave it (Prevident 5000) technique or the rinse and leave it (ACT) technique works best for them.
Lastly and probably most importantly, the hygiene contract that is signed by the patient, the patient's parents, and my wife(the doc) stating that if a continued period of poor oral hygiene and non compliance with brushing/supplemental cleaning instruction is not followed, the treatment will stop immediately, the bands and brackets are removed, and the responsible party the patient or the parents (if the patient is a minor) are responsible for completion of payment plan for the treatment and then if and when treatment is resumed it is considered a new case and a new payment plan starts <img border="0" alt="[Wowie]" title="" src="graemlins/wowie.gif" /> You'd really be suprised how the parents get on their kids oral hygiene habits when this contract is signed. BTW for records purposes, digital photos are taken at each regular visit and compared against a series of photos that my wife has showing various levels of excellent, fair, poor, and miserable levels of hygiene.
Let's just say that this "scare tactic" seems to work as only about 1 patient out of the 1200 or so in the office gets a premature debracketing/ debanding each year
