The presence of orthodontic bands, brackets, and wires make it very difficult for a person to brush their teeth effectively. Because adequate brushing has not been achieved, it is common that the person's gums will be inflamed. Another type of dental problem that may occur is when thorough dental plaque cannot be properly removed and white spot lesions form. Even if a white spot lesion doesn't turn into a cavity, its mere presence can spoil the smile of a person's whose braces have been removed. A way of preventing gum disease and white spot lesions is effective plaque removal. One study has shown that using electric toothbrushes showed substantial improvements in the health of their gums, while wearing braces.