It has come to our attention that you have not been brushing enough times per day or spending enough time brushing or massaging the gums with your toothbrush sufficiently to keep them stimulated. You must brush after every time you eat. Twice daily is not enough when you are wearing braces. If you brush your gums with the soft toothbrush and you see blood on your toothbrush, it does not mean you have brushed too hard or that you should not brush there anymore. You must brush on those gums more vigorously and more frequently until they are a healthy pinkish-white color and not red and swollen. The plaque that forms under your swollen gums from not brushing adequately will eventually put white or brown stains on your teeth. Your dentist will have to drill holes in your teeth and fill those areas with white tooth-colored plastic. The bacteria that live in the plaque produce an acid by-product that eventually may eat into your teeth. We cannot tell if you will be one of the unlucky patients that does not brush well and get stains on your teeth because your gums are so swollen that we cannot see the stain until the braces have been removed and you start brushing better, causing your gums to shrink back to normal size. Puffy, swollen gums also slow down tooth movement and do not allow the bracket to stick as well. If you want to floss once daily, this will help your gingival health immensely. The easiest floss to use is the Glide Threader that can be purchased anywhere toothbrushes are sold. In severe cases of poor oral hygiene, we will remove your braces.