Patient Care Videos

Introduction

Congratulations on getting started with your orthodontic treatment! We’re going to give you the best smile and bite possible!



However, we just can't reach your treatment goals without your help in paying attention to your oral hygiene! Hence, the following instructions will help give you a beautiful smile and a healthy bite at the end of the treatment. Do remember that while you're in treatment, you must continue to see your dentist for regularly scheduled cleanings and check-up appointments!

To prevent damage to your teeth during your treatment, thorough oral hygiene is imperative. Poor or mediocre care of your teeth can and probably will cause permanent and unsightly damage to your teeth. Don't let this happen. Develop a pattern of brushing that covers all the surfaces of all your teeth. Brush the entire surface of each tooth using an oval or circular motion with the toothbrush. Tilt it and brush slowly around the braces. That's where plaque and debris accumulate. Concentrate on the area between the braces and the gums, gently placing the bristles under the gum tissue. Focus on spots that have hooks and attachments because plaque and food particles accumulate there. Brush the chewing or biting surfaces of the teeth and the inside surfaces of the teeth. 

And don't forget your tongue. Your teeth and appliances should shine after each brushing. Bush after each meal or snack, and at bedtime floss between the teeth at least once a day. Use a fluoride rinse at night, and you can always swish water vigorously between your teeth whenever you have the chance.

There is a special kind of brush that's used for those hard-to-reach spaces around your braces – it’s called a proxy brush. A proxy brush is placed under the arch wire and gently cleans around the attachments and under the wire.

If there is space, gently push the proxy brush between the teeth with a rotating motion. Don't force it but try to do this between all the front and back teeth if you can.

Water irrigators may be used to remove large food particles. Remember to direct the stream of water away from the gum tissue.

For areas between the teeth, flossing is important to prevent cavities, infected or swollen gum tissue, and permanent white spots on the teeth. The key to flossing is to get the floss under the arch wire. You can do this several ways. Use a floss shredder with a length of floss, or you can use a type of floss that has a stiff end to make it easier to place between the teeth. If the gum tissue between the teeth is not in the way, you can use plain floss and manipulate it under the arch wire 

When using floss, place it under the arch wire and wrap it around the side of one tooth in the form of a C. Move the floss up and down gently, making sure it goes under the gum tissue. Then, do the side of the adjacent tooth and remove the floss. Repeat the process between the next two teeth and continue around the arch until you cleaned the sides of all your teeth.

It does take a bit of time, but this way you can prevent dental diseases and shorten your treatment time. It’s well worth the effort! Flossing should be done at least once a day, usually at night, after the last snack before bedtime. More often would be even better.

Disclosing tablets or plaque indicatinggel help you identify areas that are not brushed adequately. Either that or you can use an indicating gel. Simply brush thoroughly and this gel will make visible where the plaque remains. The indicating gel is the preferred product since it does not stain your lips or gums. Both products identify areas you are missing and will help you focus your tooth brushing on spots that are more prone to dental diseases. This stain is easily removed by re-brushing the areas you missed.

Patients with clear elastic ties should avoid excessive coffee, tea, mustard, red wine, or foods containing curry because they can stain the clear elastic ties that secure the tooth-moving large wire in place. Smoking is, of course, disastrous. 

There are several basic components that are in one form or another common to most orthodontic systems. Acting together, they deliver the forces that will efficiently straighten your teeth.

Brackets are the individual attachments that are bonded to each tooth. They can be metal or a tooth-colored material.

Bands are metal rings with special attachments that usually are placed around the back teeth.

The arch wire is engaged in each bracket and band and delivers the force that moves the teeth.

This is an elastic tie or O-ring used to hold the arch wire into the bracket. A somewhat stronger type of attachment to hold that arch wire in place is called a ligature wire.

This is called a power chain and is used to link teeth together and close space.

Hooks may be present on your appliances. They are used to attach elastics or special springs or auxiliaries.

Next, an elastic or rubber band that is often used to help adjust the bite, they are placed by the patient and it's imperative that they be worn as your doctor directs.

Metal or rubber separators, or spacers are only used before your banding appointment in order to create very slight space between the teeth. This created space makes it easier to place the metal bands, usually around the back teeth.

When flossing, avoid the spaces between the teeth where these separators have been placed - they'll be dislodged. For the same reason, avoid chewy and sticky food. If the separator comes out more than a day or two before your next appointment, call your dentist to have it replaced.

Certain foods have to be avoided or changed in order to avoid damage to your braces - this can help save unwanted cost for repairs and delays in your treatment time.

No gum or sticky foods such as caramels, licorice or Skittles. Avoid hard foods such as nuts, hard candy, hard pretzels, hard taco or tostada shells, crusted bread, and tortilla chips.

Minimize your sugar intake. This means avoiding cookies, candy, soda laced with sugar and high-sugar fruit juices. These foods, in combination with braces and without scrupulous oral hygiene, are disastrous.

Remember to brush your teeth, or at least rinse vigorously with water after eating or drinking anything sugary. Cut apples and carrots into bite sized-pieces. Cut corn away from the cob and meat away from the bone.

Habits that can be harmful to your appliances include chewing on ice, pens or pencils, fingernails and picking at your braces. They not only knock bands and brackets loose, they also bend and distort the arch wires, which results in your teeth moving in the wrong direction and greatly increasing your treatment time.

A good rule of thumb is not to play with your braces and when it comes to food, if it's hard or even sort of hard, don't chew on it.

If you have to wear a headgear, don't ever engage in any athletic activity or horseplay when it's in place. This can be extremely dangerous.

Mouth guards that fit over your braces should be worn while participating in any contact sport. Your orthodontist can provide these protective devices or tell you where you can purchase them.

A bracket or band can become distorted or displaced, and it's usually because of eating the wrong foods, chewing on something hard or picking at your braces. It's not an emergency unless discomfort is involved. However, you need to call the office to schedule an appointment to replace the damaged loose band or bracket. You'll be seen as soon as possible. These appointments require some extra time and usually can't be done after school or work hours. If a rubbery elastic ring or tie comes off, we can get you in for a short visit to have it replaced. In areas where there is a long span of wire, it may come out of the back too. If this happens, you may try to reinsert it into the tube using a pair of tweezers or place wax to hold it into place. As a last resort, you may cut the wire next to the closest bracket using a nail clipper or a small wire cutter. Remember to call your orthodontist before attempting this! For a poking tie wire or a wire poking out of the back braces, we suggest that you use the back of a pencil eraser to tuck it out of harm's way.

If that's not possible, use a piece of wax to cover the area, causing the irritation until you can get in for a quick visit. Apply by pinching off a small portion and rolling it into a small ball. The key to getting the wax to adhere is to dry off all saliva around the irritation. Then, place a small ball of wax where it's needed and gently mold it with your fingers until it's comfortable. Remove the wax to eat or brush and reapply if necessary. The doctor will give you an ample supply of this wax when you get your braces. And remember, whenever you have difficulty, feel free to call the office so that your questions can be answered, and the appropriate appointment can be scheduled.

It is not unusual to experience some soreness or discomfort from orthodontic movement, especially after an adjustment appointment. This usually lasts from one to four days. Over-the-counter analgesics such as Advil, Motrin or aspirin will help to alleviate this discomfort. For children under the age of 12, use the dosage recommended for children indicated on the label. Warm saltwater rinses are also helpful in reducing the swelling of irritated gums or cheeks. One teaspoon of salt to eight ounces of warm water is recommended. Also, topical anesthetics are useful in relieving the discomfort from fever blisters, cold sores, irritated cheeks, or sore gums. Use them according to the label instructions. They are available at your local drugstore.

Always follow your doctor's instructions about the best way to clean your retainer. For example, the use of a Q-Tip with soapy water, cleaning with a toothbrush and water or using a commercial retainer cleaner such as Retainer Brite is common. However, never clean the appliance with toothpaste. It dulls the surface of the appliance and seriously compromises the aesthetic appeal. Don't hesitate to ask your doctor any questions you may have. We hope the information you've seen and heard will help you in working with your doctor to obtain that beautiful smile you deserve!