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SEPARATORS
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Some
orthodontic procedures require the placement of a tiny
rubber band, a separator, between two teeth to
allow these teeth to spread apart (separate) from each
other. This space between two teeth allows us to fit a
metal ring, a band, around a tooth.
The
separators may cause your teeth to become sore as a result
of the movement of the affected teeth. Tylenol or Advil
is almost always sufficient to manage any resulting discomfort.
You
should not eat anything sticky or chewy, as this may pull
the separators from between the teeth. Also, do not floss
between the particular teeth which have separators since
this flossing is likely to remove the separators accidentally.
As
the teeth separate, a separator can come out more easily
than when the separator was originally placed between
the teeth. If a separator comes out, you need to determine
if space remains between the teeth where the separator
was located. You do this by flossing between these
teeth with a double-thickness of dental floss. If the
contact between these teeth is tight using the double-thickness
of floss, then call the office because there is not enough
space between the teeth. We would then need to insert
a replacement separator. If, instead of being tight, the
floss were to go between the teeth easily, then there
is enough space at that particular time. However, teeth
will change positions quickly, so be sure to check daily
that this space is maintained for us to fit the metal
band at your next appointment.
ELASTICS
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The
purpose of wearing elastics is to move the teeth so that
they will fit together better, thus improving the occlusion
(bite). It is important to have a good occlusion because
this will give you a more stable result.
The
elastics are to be worn FULLTIME, 24 hours a day, unless
specifically instructed to do otherwise. The elastics
may be removed to eat, but it is not absolutely necessary
to do so. We advise patients to place the elastics on
their little finger at meals, as a reminder to put the
elastics back on the braces. The elastics are to be changed
daily for the best results. More frequent changes per
day will not benefit treatment.
Research
shows that teeth begin to move after wearing elastics
for 10 continuous hours, without a break of more than
30 minutes. That means, if you wear the elastics 6 hours,
then take the elastics off for an hour, you will have
lost the effect of those 6 hours of wearing elastics.
HEADGEAR
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Why
must a headgear be worn?
Headgears are worn to increase space, to align teeth and
to help adjust the occlusion (bite). Wearing a headgear
will move the upper molars toward the back of the head,
thus giving more space to straighten the teeth and to
help correct the bite.
How
much should a headgear be worn?
Start with a few hours, perhaps two hours, and increase
the wear daily. The patient must become accustomed to
wearing the headgear while awake before wearing it to
bed. Some discomfort is to be expected with the movement
of the teeth. This will prevent the patient from unconsciously
removing the headgear during sleep. The headgear must
be worn consistently at least 12 hours each day to be
effective. Wearing twice as much force on one day will
not make up for not wearing it the day before. Most patients
wear the headgear whenever they are home and always during
sleep. Be consistent. Skipping even one day or night may
result in having to wear the headgear longer. Weekends
are a good time to accumulate extra hours of wear.
When
should the headgear NOT be worn?
Headgears can be dangerous. NEVER wear the headgear when
there is a chance that it might be bumped or pulled off.
This includes many sports, especially contact sports.
The headgear is not a toy, so "horseplay" is NOT allowed
while wearing it.
How
should the headgear be cared for?
Little maintenance is required. Do not wash the strap
or allow it to get wet since this will affect its tension.
You may wipe the wire with alcohol to clean it. Always
store it in a safe place when it is not worn. Do not try
to adjust it yourself if it becomes damaged. When the
padding becomes worn, it can be replaced with lambs wool
applied with double stick tape. Never force the headgear
on or off. Use gentle force and just one finger to remove
it. The headgear should easily slide in and out so that
it can be removed gently from one side, then gently from
the other. Bending the wire up and down when removing
the headgear will break it and possibly break the braces
as well.
What
difference will cooperation make?
The length of treatment will probably depend on how well
our directions are followed. The headgear will only be
worn for the length of time required to get the results
we are looking for. So the better the cooperation, the
fewer the months we will ask that it be worn.
When
should the headgear be checked?
Bring the headgear to every appointment for the doctor
to make necessary adjustments. Having the headgear at
every appointment will allow us to adjust the tension
of the strap, bend the wires for comfort, or maybe…just
maybe…decide that it be discontinued!
RPE
(Rapid Palatal Expander)
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The
RPE, or Rapid Palatal Expander, works by using the teeth
as anchors to widen the upper jaw. You will see only a
separation between the two front teeth which is sometimes
very large. This space will close again in a few weeks.
The
appliance is to be turned nightly prior to bedtime the
specified number of times. Tylenol or Advil 45 minutes
prior to this may help alleviate the discomfort, which
will be primarily around the two front teeth and the bridge
of the nose. After turning the screw the total number
of times prescribed, please do NOT turn anymore. STOP
TURNING after reaching the number of turns that were recommended.
The RPE stays in place 3-6 months to hold the separation.
Please KEEP YOUR KEY when finished with the turning as
we may ask you to make additional turns later.
The
roof of the mouth needs to be brushed around the back
of the teeth as well as possible to prevent food from
irritating the gums. In order to prevent irritation during
sleep, you may place wax on the cheek-side of the teeth
that have metal bands.
You
should not drink any carbonated beverage because the carbonation
can dissolve the cement used to affix bands to the teeth.
We also ask that you NOT eat anything which fits into
the category of "hard, sticky or chewy." Below we have
listed some foods which we would like for you to avoid.
This list does not include all foods to avoid.
It is only a guideline to help you become more selective
about the foods to be eaten to prevent damage to the appliance.
In addition to these foods, pens, pencils, ice or anything
hard which you put into your mouth can also damage
the appliance or your teeth.
| Hard Foods: |
Popcorn, Nuts, Peanut brittle, Hard taco shells, Doritos,
Nachos, Pizza crust, Breath Mints, Ice, etc. |
| Sticky/Chewy Foods: |
Caramel, Chewing Gum, Bubble Gum, Taffy, Jolly Ranchers,
Skittles, Gummy Bears, Licorice, etc. |
There
are still many things that you CAN eat with your orthodontic
appliance. For example, fruit, raisins, Hershey Kisses,
Nestle Crunch bars, Three Musketeers, M&M's (not peanut
or almond), Reese's Peanut Butter Cups or Pieces, Peppermint
Patties, Cotton Candy, Ice Cream, Frozen Yogurt, Brownies
(without nuts), etc.
It
is a good idea to brush your teeth soon after eating a
meal or snack to remove the food from around your teeth,
gums and appliance. If you are unable to brush, then rinse
well with water. Remember that one excellent toothbrushing
is also required daily, preferably prior to bedtime.
NANCE
APPLIANCE
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The
Nance appliance serves to stabilize the back teeth while
we are going through a phase of treatment involving the
movement of specific teeth. This appliance will not remain
in place for the full course of treatment, and will be
removed as soon as possible.
It
is important that an extra effort be made to clean the
appliance in the roof of the mouth. This will prevent
the gums around the Nance appliance from getting inflamed
and swollen.
Speech
will return to normal after the first few days. In order
to prevent irritation during sleep, you may place wax
on the cheek-side of the teeth that have metal bands.
You
should not drink any carbonated beverage as the carbonation
can dissolve the cement used to cement bands to the teeth.
We also ask that you NOT eat anything which fits into
the category of "hard, sticky or chewy." Below we have
listed some foods which we would like for you to avoid.
This list does not include all foods to avoid.
It is only a guideline to help you become more selective
about the foods to be eaten to prevent damage to the appliance.
In addition to these foods, pens, pencils, ice or anything
hard which you put into your mouth can also damage
the appliance or your teeth.
| Hard Foods: |
Popcorn, Nuts, Peanut brittle, Hard taco shells, Doritos,
Nachos, Pizza crust, Breath Mints, Ice, etc. |
| Sticky/Chewy Foods: |
Caramel, Chewing Gum, Bubble Gum, Taffy, Jolly Ranchers,
Skittles, Gummy Bears, Licorice, etc. |
There
are still many things that you CAN eat with your orthodontic
appliance. For example, fruit, raisins, Hershey Kisses,
Nestle Crunch bars, Three Musketeers, M&M's (not peanut
or almond), Reese's Peanut Butter Cups or Pieces, Peppermint
Patties, Cotton Candy, Ice Cream, Frozen Yogurt, Brownies
(without nuts), etc.
It
is a good idea to brush your teeth soon after eating a
meal or snack to remove the food from around your teeth,
gums and appliance. If you are unable to brush, then rinse
well with water. Remember that one excellent toothbrushing
is also required daily, preferable prior to bedtime.
TONGUE
GUARD
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The
Tongue Guard serves the purpose of keeping the tongue
from between the front teeth. It is usually kept in for
ten months of treatment, long enough to correct the habit
of pushing the tongue forward (tongue thrusting) or thumb
sucking. Most patients report that these habits are worse
during sleep, and they may notice some irritation of the
tongue upon awakening.
The
biggest adjustment for patients will be with speech. This
will take some patience and practice, but be assured that
it will improve. The patient should practice reading aloud
during the first day or two to adjust to the appliance
faster. A special effort will need to be made to clean
around the wires in the roof of the mouth to prevent irritation
of the gums.
You
should not drink any carbonated beverage because the carbonation
can dissolve the cement used to affix bands to the teeth.
We also ask that you NOT eat anything which fits into
the category of "hard, sticky or chewy." Below we have
listed some foods which we would like for you to avoid.
This list does not include all foods to avoid.
It is only a guideline to help you become more selective
about the foods to be eaten to prevent damage to the appliance.
In addition to these foods, pens, pencils, ice or anything
hard which you put into your mouth can also damage
the appliance or your teeth.
| Hard Foods: |
Popcorn, Nuts, Peanut brittle, Hard taco shells, Doritos,
Nachos, Pizza crust, Breath Mints, Ice, etc. |
| Sticky/Chewy Foods: |
Caramel, Chewing Gum, Bubble Gum, Taffy, Jolly Ranchers,
Skittles, Gummy Bears, Licorice, etc. |
There
are still many things that you CAN eat with your orthodontic
appliance. For example, fruit, raisins, Hershey Kisses,
Nestle Crunch bars, Three Musketeers, M&M's (not peanut
or almond), Reese's Peanut Butter Cups or Pieces, Peppermint
Patties, Cotton Candy, Ice Cream, Frozen Yogurt, Brownies
(without nuts), etc.
It
is a good idea to brush your teeth soon after eating a
meal or snack to remove the food from around your teeth,
gums and appliance. If you are unable to brush, then rinse
well with water. Remember that one excellent toothbrushing
is also required daily, preferable prior to bedtime.
HERBST
APPLIANCE
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The
Herbst appliance is delivered in two stages. First the
metal crowns are cemented, which require a few days for
the patient to adjust to their new bite. Wax may be needed
initially for comfort. The second stage, usually several
weeks later, is the delivery of the arms, which attach
the upper crowns to the lower crowns by rod-like arms.
The
purpose of this appliance is to maintain a forward position
of the lower jaw, thereby improving the bite and the profile.
The Herbst appliance requires care in avoiding hard foods
such as ice and candies. Hard or sticky food may damage
or dislodge the appliance.
It
is important that an extra effort be made to clean the
appliance where it is close to the gums. This will help
prevent the gums around the appliance from getting inflamed
or swollen.
You
should not drink any carbonated beverage because the carbonation
can dissolve the cement used to affix crowns to the teeth.
We also ask that you NOT eat anything which fits into
the category of "hard, sticky or chewy." Below we have
listed some foods which we would like for you to avoid.
This list does not include all foods to avoid.
It is only a guideline to help you become more selective
about the foods to be eaten to prevent damage to the appliance.
In addition to these foods, pens, pencils, ice or anything
hard which you put into your mouth can also damage
the appliance or your teeth.
| Hard Foods: |
Popcorn, Nuts, Peanut brittle, Hard taco shells, Doritos,
Nachos, Pizza crust, Breath Mints, Ice, etc. |
| Sticky/Chewy Foods: |
Caramel, Chewing Gum, Bubble Gum, Taffy, Jolly Ranchers,
Skittles, Gummy Bears, Licorice, etc. |
There
are still many things that you CAN eat with your orthodontic
appliance. For example, fruit, raisins, Hershey Kisses,
Nestle Crunch bars, Three Musketeers, M&M's (not peanut
or almond), Reese's Peanut Butter Cups or Pieces, Peppermint
Patties, Cotton Candy, Ice Cream, Frozen Yogurt, Brownies
(without nuts), etc.
It
is a good idea to brush your teeth soon after eating a
meal or snack to remove the food from around your teeth,
gums and appliance. If you are unable to brush, then rinse
well with water. Remember that one excellent toothbrushing
is also required daily, preferable prior to bedtime.
REVERSE-HEADGEAR
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Wearing
the reverse headgear will move the entire upper jaw (called
the maxilla) forward, thus improving the occlusion (bite)
and correcting the discrepancy between the upper and lower
jaws. Some discomfort is to be expected with the movement
of the upper jaw.
Only
a single elastic is to be worn at first on each side of
the appliance, and later more elastics will be added.
The first month is your opportunity to become accustomed
to wearing the reverse-headgear prior to increasing the
number of elastics. Sometimes the skin around the chin
becomes irritated, so it is important to keep this area
clean and periodically change the lambs wool insert that
is placed in the chin-cup.
The
length of time (hours per day) and the consistency of
wear is more important than the number of elastics. Wearing
the headgear should consistently be 12-14 hours daily.
This can include wear during sleeping hours and does not
have to be continuous, i.e. wear can be a few hours followed
by a break, then a few hours of wear. Please bring the
reverse headgear to each appointment so we can adjust
it for comfort and the correct tension.
SPLINT
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A
splint can serve several purposes including limiting the
range of movement in the jaw-joints, creating an artificial
bite to facilitate movement of teeth, diagnosis of a jaw-joint
problem, or repositioning the lower jaw to a more comfortable
position. It is important to learn to wear the splint
all the time, including while eating, which may be the
most difficult task. Speech will gradually improve until
it returns to normal. The only time to remove the splint
is while brushing, and then you should not allow the back
teeth to touch. This appliance is similar to a splint
worn on an arm. The splint would not be removed from an
arm to lift weights, so please do not remove the splint
to eat.
You
may wish to try eating softer foods for the first few
days and not to open extremely wide, for example when
yawning. Application of cold packs to the jaw-joint is
good for acute pain, but you may wish to use heat when
the severe discomfort has ended to ease muscle spasms.
Tylenol or Advil is almost always sufficient to manage
any resulting discomfort.
There
is a wide range of responses to wearing a splint. There
will be at least a short adjustment period of 2-3 weeks.
Be patient and inform us if there are problems which you
feel cannot be overcome. The appliance should be brushed
with toothpaste when the teeth are brushed, and cleaned
with Efferdent or Polident twice a week.
NOW
THAT YOUR BRACES HAVE BEEN REMOVED
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There
are several things we want you to review…
BLEEDING
GUMS:
The bleeding around your gums has been caused by the removal
of glue, which was slightly beneath the gums - inflamed
gums in some areas. Your gums will take a couple of
days to heal. Some mild soreness may be expected. To make
brushing less painful, you may run hot water over your
toothbrush to make the bristles soft. Brushing and good
hygiene are essential to achieve attractive and healthy
teeth and gums. return
to "when your braces have been removed"
X-RAYS:
We will take an x-ray when the braces are removed and
give you a copy which you may take to your dentist. We
will keep a copy for your records. We are pleased to provide
you this free service. return
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WISDOM
TEETH:
We recommend that you discuss this with your dentist or
your oral surgeon. They are better qualified to assist
you with this decision since he/she may actually perform
the procedure. We will provide you with an x-ray free
of charge which you may take to your dentist. Generally,
the removal of wisdom teeth is recommended at an early
age (15-17). The risks of keeping wisdom teeth include:
- Gum
disease or cysts damaging adjacent teeth
-
Pain from infection
- Crowding
of lower front teeth without retainers
-
Jaw-joint (TMJ) discomfort
-
Difficult removal after complete formation of teeth
return to "when your
braces have been removed"
RETAINERS:
Your bite will change quickly in the next few weeks. When
braces are first removed, teeth are loose and will move
quickly. If you are having any crowns, bridges, or bonding,
please delay this work for at least six weeks, which is
the minimal length of time for your bite to stabilize.
Retainers will "retain" your teeth in position and these
retainers will be ready in 1-2 weeks. It is important
that you keep your next retainer delivery appointment
so that your retainers will be delivered without delay.
Enjoy your beautiful smile! return
to "when your braces have been removed"
RETAINERS…
what you should know.
Please read ALL of this information.
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Congratulations
on having your braces removed! Wearing retainers is the
final phase of your treatment. Your teeth will settle into
more stable positions and your retainers will "retain" the
alignment of your teeth during this process. Your bite will
change over the next month. (links to the paragraphs below)
- Inserting
Retainers
- Retainer
Wear
- Caring
for Retainers
- Dental
Care
- Retainer
Check-ups
- Your
Feedback Counts
INSERTING
RETAINERS
Insert retainers with finger pressure ONLY. Do NOT use
your teeth to insert retainers or they will break. Removal
should be with BOTH hands to prevent cracks from occurring
in the front of the clear retainer. The life expectancy
of a retainer depends on the care you give it. Speech
and salivation will return to normal after wearing your
retainer for a few hours. return
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RETAINER
WEAR
Wear your upper retainer FULL TIME for the next
6 weeks. If you have a lower flexible retainer, you
are to wear it at nights only. Wear your retainers or
your teeth will go back to where they were. Braces will
then be needed to straighten your teeth again. If you
leave your retainers out for a few days, do not expect
to correct the resultant problem by then wearing your
retainers. Retainers are to be worn a minimum of 3 years
AND/OR until age 21. Even after this, retainer wear
2-3 nights per week may be necessary to keep your teeth
in proper alignment. You should always have retainers
that fit accurately. return
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RETAINER
CARE
A retainer is often lost when it is wrapped in a napkin
at a meal and then thrown away. Place your retainers
in a safe place when they are out of your mouth. Brush
your retainers with toothpaste daily and use Efferdent
or Polident (denture cleaners) for best results. Use
of warm tap water with the denture cleaner has been
shown to clean the retainers well. Soaking in bleach
may also be used to dissolve stains. NEVER boil your
retainers. WARNING - retainers with wires should remain
in the denture cleaner NO longer than 15 minutes. return
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DENTAL
CARE
Swollen gums occur sometimes while in braces, but this
will usually reverse to a normal, healthy, pink appearance
after approximately one month once braces have been
removed. Make certain to brush your gums and between
your teeth with firm pressure. Bacterial plaque on teeth
is the cause of swollen, red gums and bleeding around
teeth. See your family dentist within a few weeks to
have a cleaning and exam. You should consult your dentist
or oral surgeon regarding removal of
your wisdom teeth. Even if you keep your wisdom teeth,
your teeth will remain straight as long as you wear
retainers. There are other reasons to have wisdom teeth
removed. We have information available upon your request
to help you make that decision, but your dentist or
oral surgeon is best qualified to help you weigh the
risks versus the benefits of having wisdom teeth removed.
return to retainers
RETAINER
CHECK-UPS
Retainer check-ups will be at six weeks and six months
following brace removal. After the six month retainer
check-up, the original orthodontic treatment will be
completed. return
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YOUR
FEEDBACK COUNTS
Thank you for selecting us to provide your orthodontic
treatment. We appreciate your comments (especially written)
of how we can better serve our patients. If you have
a friend who may be interested in improving his/her
dental appearance or health, we would appreciate the
chance to help. May you enjoy many years of healthy,
attractive smiles and have pleasant memories of your
orthodontic experience with us. return
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