It is important to maintain a clean mouth at all times, but it is even more important throughout your treatment. The care you take today will ensure a beautiful smile forever. This means that special care must be given to your teeth and your gum tissue. We will show you in detail how to take care of your braces, teeth and gums, and we will provide you with written instructions when you leave our office to help you remember.
Poor oral hygiene can result in permanent “marks” or “scars” on your teeth, due to plaque build-up. These “marks” or “scars” are referred to as decalcification, which is actually the onset of DECAY, and can begin to appear within as little as two weeks of exercising inadequate oral hygiene habits.
Tartar control toothpastes are essential. Flossing on a daily basis is also crucial and can be done using “floss threaders”. Thread the floss into the loop and pass the threader between the teeth under the wire. Hold onto one end of floss and pull the other end through. Floss between the tooth and gum (each space has 2 teeth). Pull straight out when finished. Threaders can be reused. Floss threaders are available at larger drug stores in the dental care display.
Also, your family dentist is an important part of your oral healthcare team. We recommend that you visit your dentist every six months throughout your treatment.
What to Expect with Braces
You may find that your teeth will be tender during the two or three days after you get your braces on. The wire that is attached to the brackets on your teeth applies pressure to your teeth and starts them moving. Nature helps the teeth loosen to relieve the pressure, but there is temporary discomfort while this happens. Gradually, the fibers that support the teeth in the bone get stretched and squeezed. After about three days, the teeth feel much more comfortable.
At each appointment, the process is repeated. However, because the teeth are loosened from their original position, each new adjustment is easier and little or no discomfort follows.
Advil may be needed for some patients over the first few days, because the teeth will be tender. It will be more comfortable if you maintain a softer diet, such as pasta, soups and soft sandwiches. Chewing sugarless gum between meals can also be comforting.
The lips, cheeks and tongue may also feel irritated for a few days as they toughen and become accustomed to the surface of the braces. Warm salt-water rinses can be used along with wax to protect the area. This wax will come off with eating, brushing or drinking cold drinks. Sugarless gum can be used at the back of the mouth if you have run out of wax.
You may notice throughout your treatment that some of your teeth seem to be loose. They are, but don’t worry! In order for teeth to be moved, they must be loosened. Eventually, your teeth will again become firmly fixed in their new and corrected positions (and will stay there with the help of your retainers).
During orthodontic treatment, situations sometimes arise that require a repair to be made to your appliances. We have assigned specific times within our schedule to resolve these issues, and will only see patients who have called ahead to book an appointment. When our offices are closed for vacation, we arrange for another orthodontist to provide urgent care to patients who may require it.
Please see the next section for a discussion of some of the repair conditions that may arise, and how to make yourself comfortable until your scheduled repair appointment.
Tools & Supplies
With these tools and supplies on hand (most of which you may already have), you will be prepared to handle the most common orthodontic emergencies.
- Non-medicated orthodontic relief wax
- Dental floss
- Sterile tweezers
- Small, sharp clipper
- Interproximal brush
- Non-prescription pain reliever (acetaminophen or ibuprofen supplied by the student’s parent/guardian—use only with written permission of the orthodontist and parent/guardian)
- Topical Anesthetic (such as Orabase or Ora-Gel)
Loose Wires, Brackets or Bands
If the braces have come loose in any way, the parents need to be notified, and they should call the orthodontist to determine appropriate next steps.
Occasionally the end of a wire will work itself out of place and irritate the patient’s mouth. Use a Q-tip or pencil eraser to push the wire so that it is flat against the tooth. If the wire cannot be moved into a comfortable position, cover it with relief wax. (See Irritation of Cheeks or Lips above for instructions on applying relief wax.) The patient’s parents will need to make the orthodontist aware of the problem.
Irritation in Mouth
Sometimes new braces can be irritating to the mouth, especially when the patient is eating. A small amount of non-medicinal relief wax makes an excellent buffer between metal and mouth. Simply pinch off a small piece and roll it into a ball the size of a small pea. Flatten the ball and place it completely over the area of the braces causing irritation. The patient may then eat lunch more comfortably. Let the student know that if the wax is accidentally ingested it’s not a problem. The wax is harmless.
Food Caught Between Teeth
This is not an emergency, but can be a little uncomfortable or embarrassing for the braces-wearing student. It is easily fixed with a piece of dental floss. Or use an interproximal brush or toothpick to dislodge food caught between teeth and braces.
Some patients are susceptible to episodes of mouth sores. While braces do not cause them, they may be precipitated or exacerbated by an irritation from braces. One or several areas of ulceration of the cheeks, lips or tongue may appear. This is not an emergency, but may be very uncomfortable for the patient. Prompt relief may be achieved by applying a small amount of topical anesthetic (such as Orabase or Ora-Gel) directly to the ulcerated surface using a cotton swab. Instruct the patient to reapply as needed.
It’s normal for a patient to have discomfort for a day or two after braces or retainers are adjusted. But it can make eating uncomfortable. Reassure the patient that the discomfort is both normal and temporary. Encourage soft foods. Have the patient rinse the mouth with warm salt water. If the patient is allowed to have over-the-counter pain relievers, acetaminophen or ibuprofen may be effective.
Bracket Knocked Off Braces
Brackets are the parts of braces attached to teeth with a special adhesive. They are generally positioned in the center of each tooth. The bracket can be knocked off if the student has eaten one of those hard or crunchy foods orthodontic patients are instructed to avoid, or if the mouth is struck while at play. We encourage all students, especially those with braces, to wear a protective mouth guard while playing sports.
If the bracket is off center, the adhesive may have failed. Call the parents—and recommend that they immediately notify the orthodontist, who will determine the course of action.
If the loose bracket has rotated on the wire and is sticking out, and the patient cannot immediately be taken to the orthodontist, you can do a temporary fix to alleviate discomfort and prevent further damage. But take care to prevent swallowing or other injury.
To put the bracket back in place, use sterile tweezers to slide the bracket along the wire until it is between two teeth. Rotate the bracket back to the proper position, then slide it back to the center of the tooth.