Smile Care

Welcome to the World of Braces  

With: Drs. Hoffman, Wolk and Halpern

   

Now that your braces are on, you will play a big role in your orthodontic treatment.  YOU are the only one who can take care of your teeth everyday by keeping them clean and healthy during treatment.

Taking care of your braces requires brushing and flossing daily as well as maintaining regular orthodontic appointments. Following the instructions outlined   in this booklet will allow the braces to do their job and treatment to progress on the prescribed schedule.  Proper dental care will take a little more time and effort making everything worthwhile.  Taking care of your teeth will give you the BEST results and give you the opportunity for a lifetime of dental health.

        

Self-Ligating Brackets

The bracket contains a sliding door which closes to hold the archwires. You do not need elastic “ties” with this type of bracket. Ties may discolor and can present challenges associated with oral hygiene.

 Archwires

These archwires are made of alloys other than stainless steel, which resist bending, and move easily in the bracket to effect tooth movement. There is a series of wires used through your treatment, and will be changed at your office visits.

Stops

Small tubes are crimped on the archwire to prevent the wire from sliding side to side causing a wire poke out the back tubes of the molars. Sometimes a “composite” stop is used; it is a small white bead on the archwire.
   

Elastics

Elastic bands are used to guide your teeth into the correct position. They come in a variety of sizes, and are held on your braces with hooks. If you need elastics, you will be shown how to wear them, and where they attach.

Archwires

Archwires are a series of thin wires that form a horseshoe shape. Archwires guide your teeth as they move into place.  There will be several different sized wires used in your treatment all designed toward aligning your teeth.  The archwires will become larger as the treatment progresses. They will hold your teeth in place allowing for the bone to fill in around the tooth.  The greatest amount of movement will occur with the first archwire.  You will notice that a small white ball has been placed on your archwire.  This is called a “stop,” and has been put in to prevent the wire from sliding around while the teeth are moving.  If the stop comes loose or is sliding, your wire can shift, becoming long on one side or the other.  You can try to re-center the wire by moving it over so that the archwire is not as long and irritating.  If you have discomfort, you may need to be seen.

Discomfort

The pain threshold will vary for each individual and in most cases the discomfort may last two to three days.  We suggest taking Tylenol for any discomfort. You may want to stick to a softer diet in those first few days.  Some of the archwires used in the beginning are temperature sensitive, and will react to extreme hot and cold temperatures.  The heat tightens the wire and can create more discomfort, which should only last 48 to 72 hours. The inner cheeks and lips can be quite sensitive at this time, irritated by the brackets.  We supply packages of wax for this purpose.  Pinch off a small amount and place it on the area (bracket) that is rubbing.  Make sure that the area is dry. This will allow the area to heal and toughen up.  If you run out of wax we are happy to provide more for you. Sugarless gum can be used in an emergency.  A warm saltwater rinse will aid in the tissues healing.

  • Canker sores can occur during your treatment. A solution of 1 part Kaopectate and 1 part liquid Benadryl mixed together can be dabbed on the affected area using a cotton swab for some relief (do not swallow). You can also use Anbesol.

Your Bite

You may find that your teeth can’t quite fit together. Your bite may feel “off” and you may be biting on the brackets themselves.  This is a common occurrence and will work itself out once the teeth respond to the archwire. Do not force the bite as it may cause breakage of the brackets.  A soft diet may be recommended during this time.

Important Information Regarding Breakage

It is common for breakage to occur in the beginning, don’t be discouraged.
Your braces have been attached to your teeth with cement that has been specifically designed for this purpose.  When your treatment is finished, your braces will need to be removed; therefore, the strength of the cement is carefully designed so that the brackets will come off when we are ready for them to be removed.  If the cement is made too strong, then the removal would become difficult, or could damage your teeth.  Therefore, its strength is carefully calibrated, and it does not dissolve.

You must recognize that you have to be careful with your braces and that, beyond a certain amount of pressure, they are designed to come off.  I f you bite down on anything hard or sticky, you are likely to put as much pressure as we put on your braces when we remove them.  Please understand that if the brackets are broken off, it is not only an inconvenience for you to have them reattached, but your treatment will also be delayed since the teeth cannot move unless the brackets are attached to them. Should any brackets come loose or break off, a call to our office would be appreciated prior to the scheduled appointment.

Your brackets have been tested today to confirm that they are firmly attached to your teeth, and this was demonstrated to you.  If you have any questions about the instructions that you have been given, or about caring for your braces, please ask us.  We are always happy to answer your questions.

TOOTH  BRUSHING

Plaque

  • Plaque is a sticky colorless film that can collect on teeth and brackets. Neglecting to remove the plaque can cause bad breath and cavities to form. Swollen and red gums result in bleeding and permanent white marks called “decalcification” may also occur. Possible bracket breakage can occur. Optimum brushing is required because more food and plaque will adhere to and around your braces.

Cavities and Decalcification

Orthodontic appliances do not cause cavities, but they may trap food particles and increase the likelihood of you developing cavities or decalcification marks.

Most patients are able to prevent these problems with a combination of proper diet, good tooth brushing habits and regular checkups with the family dentist. You should brush your teeth immediately after eating, using the proper techniques for brushing with braces.  If brushing right away is not possible, vigorously rinsing with several mouthfuls of water is helpful. Excellent oral hygiene and plaque removal are musts.

Check for loose bands or brackets daily. If any part of your orthodontic appliance becomes loose, call the office immediately to schedule an appointment. A loose band or bracket greatly increases your chance of getting cavities. When you miss appointments and are not seen regularly by your orthodontist, loose bands can go undetected and may result in tooth damage.

When To Brush

It is important to brush after every meal and before bedtime (2-3 times a day for approximately 3-5 minutes). If brushing can’t be accomplished after a meal, a rinse with water will suffice until you can get to a toothbrush.

A good tooth brushing technique is very important. In fact, one patient using an effective method may have a better result in a shorter period of time than a patient using an ineffective method in a longer period of time.


How To Brush

First of all you should be using fluoride toothpaste.  With the new braces you will find that the toothbrush wears out much faster than normal and that it should be replaced every three months or as the toothbrush starts to deteriorate.  It is important to brush around the brackets, backsides of the teeth, the biting surfaces as well as the tongue.  Be sure to angle your toothbrush around each bracket and concentrate on just a few teeth at a time. That way a more thorough job can be done.  Try to brush in a circular motion.  Be sure to rinse your mouth with water afterwards.  

Flossing

Floss Threader

This is a re-usable tool that allows you to floss under the archwire.  Cut off approximately 18 inches of floss and tie it to the loop part of the floss threader with enough floss remaining to be able to floss properly.

With the straight end of the threader, insert under the wire from the bottom up on the lower teeth and the top down on the top teeth. Using that approach will enable you to not poke yourself in the lip.  Once you have threaded the straight end under the wire pull the floss through and commence flossing between the teeth.  When finished, pull the floss out and repeat on the next tooth.  This can be very time consuming at the beginning when you are not accustomed to using the threader. So, you may try flossing one arch one day, and the other arch the next day until speed permits you to do both arches each day.  We recommend you do this daily.

          

Super Floss

This is another option we recommend.  Superfloss has a stiff end like the threader, a spongy floss in the middle and regular floss at the end. The spongy area is only used for areas that have larger spaces.  Just as the threader, you use the stiff end to go under the wire and continue to pull it through until you reach the regular floss.

  • Don’t get discouraged!  Flossing your molar teeth will be more difficult than the front and will become easier with time.  Flossing your teeth is an important part of good dental health.

Types Of Toothbrushes

Sulcus Brush (if recommended to use)

This is a narrow toothbrush that has only two rows of bristle, specifically focusing on massaging your gums and cleaning around the gum line area. The massaging allows for good blood flow into the tissue and keeps that healthy pink hue.  Wet the brush with warm water to soften the bristles, hold the brush at a 45 degree angle and gently massage the gums for 15-20 seconds.  Using the sulcus brush may be time consuming so use it while you are doing something like reading or watching television.

Sulcus Toothbrush

Oral B

This is just your regular toothbrush that you will use for all surfaces of the teeth.

Inter Proximal Brush (if recommended)

This is a brush designed to slip under the archwire and between the teeth.  It helps remove the plaque and food debris between the teeth and near the braces.  No toothpaste is required with this brush. Simply wet the brush with warm water to soften the bristles.

Travel Toothbrush

We recommend that you carry this toothbrush with you while you are at school or out for a meal. Using the brush while away from home will enable you to eliminate embarrassing food particles left behind in your braces.

Electric Toothbrush

We do not suggest that you run out and buy one. If this is something that you already use please continue to do so but do it with caution as you are moving near and over your braces.

  • Optimum health care requires all types of the recommended brushes to be used.

Dental Cleaning

Dental Hygiene is very important to us as well as to yourself.  We recommend that you schedule regular dental appointments during your orthodontic treatment. Once it is time for a teeth cleaning, we suggest that you make an appointment with us first to have your wires removed so that the dentist can do a more thorough cleaning. After your cleaning is completed, we will see you again to replace your archwires.  For those patients who don’t like to miss work or take time away from school, we suggest that you schedule a regular office visit the same time you have your dental cleaning.

Food Recommendations

  • Avoid Hard/Sticky/Crunchy
    Hard candies, toffee, licorice, fruit rollups, ju jubes, popcorn kernels, hard granola bars, nuts, corn on the cob, ice cubes, tough meats: e.g. beef jerky, pepperoni sticks, chewing meat from the bone, chewing on pens, pencils and fingernails 
  • Use Caution
    All Chips: potato, taco, nacho, hard cheezies, and crackers, baguettes, bagels, crusty rolls, hard pizza crust toast, whole raw fruits and vegetables (cut apples, carrots, etc. into bite size pieces), sugarless gum, popcorn and slurpees.
  • Tougher foods may need to be cut up into smaller pieces to make chewing easier.  It is important that a sufficient amount of food be eaten even during these times of discomfort. Slurpees and other pop drinks have high sugar content and can ultimately lead to decalcification.  Less breakage will occur by following the food recommendations and using your common sense when you think about how the foods you eat will affect your braces.

CHECKLIST                

Today have you:

  • Removed every trace of plaque and food particles trapped in and around your braces as well as brushed the fronts, backs, tops and in between your teeth.
  • paid very close attention to the gum line
  • used dental floss, special brushes, and mouthwash (recommended by the orthodontist)
  • rinsed thoroughly after brushing with water
  • Inspected the teeth and braces for any breakage.
  • Smiled......             


If you have any questions or concerns about your braces you can call us at 403-286-2402 and we would be glad to answer your questions.  If you call during non-business hours please leave a message and someone will return your call as soon as possible. For those people who live out of town, we provide a toll free number. 1-888-414-4540.        

We also have e-mail as an option:

This is checked and answered daily. Please review the pamphlets/and booklets received in your kit and in a few weeks, as a refresher, review them again.

Check out our website for further information on orthodontics.

http://www.hwhorthodontics.com

Just think after all of this hard work from you and your orthodontic team, you will have a terrific smile, more self confidence, a better ability to chew, and will less likely develop gum disease..

Go Ahead, Show us YOUR SMILE!

Alberta Dental Association & College Canadian Dental Association CADA Damon System
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