Once you're in treatment, you will be well aware of the responsibilities regarding the maintenance of your teeth and braces and progressing your treatment so that you can finish as soon as possible.
You will have received plenty of instructions from your orthodontist when your braces were fitted, whether fixed or removable, but this section will act as a reminder and a reference for you. Fixed or bonded braces are dealt with first and removable appliances and retainers later.
Your braces have just been fitted
Most people experience discomfort until they adjust to their braces. You may equire the use of over-the-counter pain-killers similar to those used for a headache or sore throat. After about three to five days, the teeth will have settled down and be much less uncomfortable.
Your braces will also rub against the lips and cheeks. You will be given some wax and instructions on how to use it to cover any particular part of the braces that irritate. After a few days, your mouth will have toughened up and the rubbing will have improved.
After each adjustment appointment, the teeth will be stirred up again but this won't be as bad as the initial stage.
Eating and biting
The mouth is a very tough environment for braces which must be strong enough to stick on the teeth throughout all the biting and chewing that teeth are designed for.
Instructions are given at the beginning of treatment regarding what can be eaten or not and various techniques for eating the harder foods that may damage the braces. As time goes by you will adapt and cope very well.
When your braces are first fitted you will be asked to check them very carefully every day. The best time is when you have brushed your teeth at night (which should be the best brushing of the day). You should stand in front of the mirror and carefully check your toothbrushing and check that all the parts of the braces are in place. If something is broken, it's important to let us know as soon as possible and we will arrange a time to see you promptly. Please don't just come into the practice on the chance that we will be able to see you straight away as we may be too busy at that time and may be unable to see you until later.
Something is sticking in!
As your teeth move the ends of the wires at the back of the mouth may become long and start to dig into your cheek. While this is a sign of progress, it's not something you should have to put up with. Please contact us for an appointment time and we can usually make you comfortable quite quickly. Before the appointment, you may find the use of wax over the wire gives it some temporary relief.
It's helpful for us when arranging an emergency for a breakage if you can give us a clear indication as to what part of the braces is causing the problem.
It's more difficult to clean your teeth with braces on, so instruction about brushing and flossing will be given.
Brush at least twice a day, certainly after breakfast and after dinner, before going to bed. This night-time brushing, along with flossing must be the best brushing of the day. Your toothbrush should be soft and quite plain, without any fancy bits in the middle or shaping.
The most important part to brush is the gum line, top and bottom, inside and out. Use short strokes and do not press hard, ensuring that the bristles get between the teeth and underneath the archwire. Then do the same action from the other side of the archwire. Don’t forget the biting surfaces and the inside of the teeth. You may have to use one of the fine interdental brushes to get between the teeth.
Rinse your mouth and then stand in front of the mirror and check that, in particular, the gum line is clean and the braces are shiny. Also, make this the time that you check that all the braces are in place and that nothing is broken.
We recommend that you use a mouthwash like Savacol or Listerine (which comes in a non-alcoholic solution) twice a day. Follow the instructions on the bottle, including not rinsing your mouth after using the mouthwash as this will reduce its effectiveness. If you notice that your teeth are getting a slight brown stain from the Savacol, stop using it and change to Listerine.
Now that you have braces on, flossing your teeth is, even more, important than before! You will be given instructions that involve threading the floss underneath the archwire between each of the teeth. The floss must be moved up and down the side of each tooth up into the gum. Because flossing is more time-consuming with braces, we recommend that you do this five nights per week and have two nights off.
Elastic bands are used to move the top teeth against the bottom teeth in order to coordinate and correct the bite. When we ask you to wear them, it's because they're essential and, unless instructed otherwise, they must be worn 24 hours a day.
When worn consistently, the teeth start to move and continue to move in the desired direction. When the elastics are only worn intermittently, the teeth start to move and then when the force is no longer applied, they quickly move back to where they were and the productive movement has been totally lost. If the elastics are left off for one hour, you may lose four to six hours worth of actual elastic wear. If you leave the elastics off for a day or so, you may lose a week’s worth of wearing them.
Sometimes you will be asked to wear the elastics part-time which usually means that we are trying to maintain an achieved position. Usually you will be asked to change the elastics twice a day and you should carry a bag of elastics with you all the time as they can break. If you accidentally swallow an elastic, don't stress as these are totally safe.
If you lose your elastics or have any problems like a broken hook or even because you think that your bite is going funny, contact us straight away and we will send you more elastics or arrange to see you promptly.
As with any adjustment, you may get sore teeth with the elastics at first but, over time and with consistent wear the teeth will settle and no longer be uncomfortable.
When a removable appliance has been fitted, it will feel like a mouth full particularly if it has a posterior bite plane, which only allows the back teeth to make contact on the plate. As the teeth start to move, there will be some discomfort, requiring the use of pain killers. After a few days, the plate will have settled in and the teeth will no longer be sore. It is essential that the plate is worn 24 hours a day and is only taken out for cleaning, sports requiring a mouth guard or swimming.
If it is taken out for sports or swimming, it must be placed in a safe container and not simply put in a pocket. We strongly suggest that the plate is worn during eating because as soon as it is out of the mouth, it's at risk of being broken or being thrown out. Also, the longer the plate is out of the mouth, the more the teeth will relapse to their previous positions.
The appliance must be cleaned well at least twice a day and, if something has been eaten, it should be removed and rinsed, the mouth rinsed and the plate replaced in the mouth. Cleaning only requires the use of a toothbrush and toothpaste and don’t forget to keep the teeth and roof of the mouth that are in contact with the appliance well-brushed also.
If any part of the appliance breaks or you have trouble wearing the appliance, contact us as soon as possible so that we can repair the appliance or make any adjustments.
Adjustment appointments are usually three to four weeks during active tooth movement. When the desired result has been achieved, the appliance may be worn at night only as a retainer. Appointments at this stage will be at much less frequent intervals. When you are only wearing the appliance part-time, it should be cleaned when removed from the mouth and put in a glass of cold water during the day.
When your active treatment has been completed and your braces have been removed, it's important to hold the teeth in this corrected position until they have settled. The teeth are still under influences from the surrounding bone, gums, tongue, lips and cheeks which may try to move the teeth slightly. Some pre-treatment features of the original tooth positions are prone to relapse.
Retainers are used to allow natural settling of the bite and to resist adverse or unsightly movement or relapse towards the original problem. It is not possible to guarantee that your teeth will remain in a perfect position for the rest of your life. Every part of the body changes with growth and ageing and the teeth are no exception. Retainers are very important and consist of flexi-wires bonded behind the upper and lower front teeth and a removable appliance for the top teeth and sometimes for the bottom teeth.
The upper retainer will be worn 24 hours a day for three to six months and then at night time only for an extended period. If a lower retainer is provided, this will be worn at night time only.
Retainer appointments are three to six-monthly, initially, and then at longer periods as the teeth show good settling.
If the retainer is lost or broken, contact the practice as soon as possible for a repair or replacement. There will be a charge for this.
When the retainer is being worn part-time, it should be cleaned when removed from the mouth and placed in a glass of cold water when not being worn. Remember that dogs like these appliances and will chew them if given the opportunity
The retainer must be worn 24 hours a day, even when eating. It should only be removed for cleaning, sports or swimming. If removed for sports, it must be placed in a safe container to prevent loss or breakage. The appliance should be cleaned with your toothbrush and toothpaste at least twice a day. After eating, the appliance should be rinsed in cold water and the mouth rinsed before replacing the appliance.