Life With Braces

Your Dental Health

It’s not easy to maintain consistent good oral health. That’s because in the invisible but serious battle against gum disease and tooth decay, there’s no neutral ground. You’re either fighting it offensively, or your losing. The moment after you brush and floss, those native oral bacteria are repopulating their favorite playground, your mouth. Our approach includes the professional cleanings that your dentist provides and an emphasis on careful patient education so that you can continue the battle effectively at home.

To Maintain Your Dental Health

  • Achieve a balanced diet. This can be achieved by eating a variety of foods preferably from each of the five major food groups: breads, cereals and other grain products; fruits; vegetables; meat, poultry and fish; milk, cheese and yogurt.
  • Limit the number of snacks that you eat. If you do snack, choose nutritious foods, such as cheese, raw vegetables, plain yogurt or a piece of fruit. Each time that you eat foods that contain sugars or starches, brush your teeth.
  • Brush twice a day with fluoride toothpaste. Clean between your teeth daily with floss or interdental cleaners.
  • Maintain your regularly scheduled check-ups with your dentist.

Proper Daily Dental Hygiene Is Critical

The best way to remove decay-causing plaque is by brushing and cleaning between your teeth every day. Brushing removes plaque from the tooth surfaces. Cleaning between the teeth once a day with floss or interdental cleaners removes plaque from between the teeth and in the areas where your toothbrush cannot reach. It is essential in preventing gum disease.

Plaque Is Ever Present

Many of the foods you eat cause the bacteria in your mouth to produce acids. Sugared foods, such as candy and cookies, and starched foods, such as bread and crackers can all cause acids to form. Plaque produces substances that irritate the gums, making them red, tender and bleed easily. After a while, gums may pull away from the teeth allowing pockets to form and fill with bacteria. If the gums are not treated, the bone around the teeth can be destroyed. The teeth may become loose or have to be removed. In fact, gum disease is a main cause of tooth loss in adults.

Tips for Better Oral Hygiene:

  • Carry a travel toothbrush. This lets you brush after eating, no matter where you are.
  • Rinse after eating. This keeps food from sticking to your teeth when you can’t brush.
  • Try an electric toothbrush. Electric toothbrushes can make teeth cleaning easier.

Appliance Care & Use

Braces

Every day when you brush your teeth, check to make sure you do not have any loose braces by gently trying to slide each one. If a wire or band comes loose, do not be alarmed. If a tie wire is protruding and irritating, use a blunt instrument (the back of a spoon or a pencil eraser) to carefully push the wire out of the way. If you have a broken or loose appliance, please call us to determine if your breakage is urgent and requires immediate repair. If a piece comes loose, save it and bring it with you to the office.

Elastics

Elastics are essentially rubber bands that are attached to brackets, usually between the upper and lower or front and back teeth, applying tension and causing teeth to move. Elastics can be used in many ways depending upon the treatment goals.

Elastics move the teeth in a direction they could not be moved using braces alone. Your teeth and jaws may be tender during the first few days elastics are worn. This is normal, and the tenderness should begin to disappear within a week. If it persists longer, please call our office. Rinsing with hot salt water will help reduce the tenderness.

Your elastics may be difficult to put on at first, but this will become easier with practice. You may remove them only when eating or brushing your teeth. Leave them in during snacking. Be sure to replace the elastics with new ones immediately after meals and brushing. Part-time wear does NOT move teeth, but it does cause prolonged discomfort.

Change the elastics routinely even if they are not broken. After a while, elastics lose their strength. Change them after each meal and before bedtime. If one elastic breaks, replace both sides.

Carry extra elastics with you at all times. If you don’t have enough to last until your next appointment, please stop by our office and pick more up or call us and we can send more to you. We don’t want you to run out.

Before you leave the office, be absolutely sure you understand exactly where to hook the elastics. Hooking them on incorrectly can be worse than not wearing them at all, as your teeth might move in the opposite direction. If you ever have any questions on how to wear your elastics, please do not hesitate to ask.

Removable Appliances

Wear your removable appliances and/or elastics faithfully, as directed by the team and Dr. DiCiccio and Dr. Freeman. Your estimated treatment time is based on full cooperation with wearing appliances and elastics (rubber bands) as directed. A removable appliance is carefully designed to move or hold your teeth in place. It should be worn according to instructions and brought to each appointment. Wear your appliance at all times, even while you are asleep. It may be removed while swimming or engaging in vigorous sporting activities. In two to three days, your speech will return to normal with the appliance in place. Avoid flipping your appliance with your tongue. This can cause damage to your teeth or breakage of your appliance.

Your new appliance may make your teeth sore for a day or two, especially after an adjustment. If you have a sore spot on your gums, call our office so we can arrange to adjust the appliance. Clean your appliance by brushing it daily with toothpaste. Denture cleaner can also be used for a more thorough cleaning. Never wrap your appliance in a paper napkin or tissue and set it down on the table. You or someone else may throw it away. Don’t put it in your pocket when playing, or you may break or lose it. Whenever it is not in your mouth, it should be in its plastic appliance case.

Keep your appliance away from dogs or cats, as they love to chew on them. Avoid storing it near any source of heat. Do not boil your retainer to sterilize it! If needed, bring it to the office, and we will be happy to disinfect it for you. Do not soak your retainer in mouthwash. An additional charge will be incurred for lost or broken appliances. Please bring your retainers to all appointments.

Please do not eat any foods that could damage your appliances and delay your treatment. Wear a mouth guard for any activities that might injure your teeth, gums, or cheeks. Repairing broken braces requires longer appointments during school hours.

Retainers

Retainers are made from wires, clasps and plastic and are constructed for the purpose of holding the teeth. They are placed after the appliances have been removed. A removable retainer consists of colored plastic that goes behind the teeth and a wire that goes along the front. At first, your retainers will feel bulky, and speech may be a problem. The retainer may cause a slight lisp, but don’t be alarmed: speech usually returns to normal within a few days. The day after you receive your retainer, your teeth may be a bit sore. This won’t last long. The tissue on the roof of your mouth may become a little tender. You should get used to this in two to three days. Since retainers are removable, you must be responsible to use and care for them properly. Strict attention to instructions is essential. Your retainer should be worn at ALL times except when eating at home, brushing, participating in contact sports, or swimming in a lake (or ocean) where they could not be retrieved if lost. When your retainer is not in your mouth, it should be kept in the case. Do not put it on a table where it might get knocked off or in a pocket where it may be easily cracked. Keep it away from dogs, which like to chew on retainers if given the opportunity.

If you must remove your retainer, NEVER wrap it in a paper towel, napkin or tissue. This is the most common way of losing a retainer. ALWAYS put it in the plastic retainer case we give you and always keep it in a safe place.

Your retainer should be cleaned after each meal and before going to bed. Retainers can be cleaned with your regular toothbrush and toothpaste. You may use a denture brush and denture toothpaste if you wish. Fill the sink with cool water to cushion the fall in case you drop it. Do not use hot water; it will cause warpage. Clean the retainer gently, being careful not to bend the wires. Before placing the cleaned retainer in your mouth, be sure you thoroughly brush your teeth. If the retainer or teeth are not kept clean, an irritation of the gums may result, and this can be serious.

If plaque builds up on the retainer over time, it will dry and harden like tartar and be difficult to remove with a brush. Denture cleaners like Efferdent or Polident are effective in removing this tartar. Follow the directions on the package. Leave the retainer in the cleaner no longer than 10 minutes; you can do this once a week if needed. To economize, try lemon juice first to dissolve and loosen the tartar before brushing.

Retainers are made to withstand normal use, but they crack or break if handled roughly. Retainers also can break if they are stepped on, dropped or placed in pockets. If yours breaks, be sure to bring in the pieces to your appointment. If your retainer becomes cracked, DO NOT wear it. Call our office immediately.

Oral Hygiene With Braces

Having a clean mouth is important. It gives you fresh breath and a nicer-looking smile. Brushing and flossing removes a thin sticky film of bacteria that grows on your teeth. This sticky film, called plaque, is the main cause of tooth decay and gum disease.

Brushing

You will notice that it is much harder to keep your teeth clean with braces. Food becomes caught in the brackets and between your teeth. Brushing after meals and flossing will help prevent plaque from forming and should become part of your daily schedule. Use a soft toothbrush and brush at a 45-degree angle to the tooth in small circles above and below the brackets. Your toothbrush will wear out faster because of your appliances, so be sure to replace it whenever the bristles start to fray.

If plaque remains on the teeth for any length of time, it can leave a permanent white scar on the surface. A waterpik or an electric toothbrush can be a useful addition, however, please continue to see your dentist at least every 6 months for regular dental cleanings.

Eating Habits

Please do not eat hard foods, including nuts, ice, crisp taco shells, whole apples and carrots (cut them into pieces first), hard French bread crust and rolls, spare ribs, corn on the cob (cut the corn off the cob before eating) and popcorn! These foods can cause breakage of the brackets and wires. Also avoid nail-biting and pen- or pencil-chewing habits, since these can damage your braces. Do not eat sticky foods like taffy, caramels, bubblegum or sticky candy of any sort. Excessive broken appliances due to careless eating habits may result in additional charges for repair.

Flossing

Flossing with braces takes a few minutes to master, but the effort is well worth it. The first step to flossing is getting the floss under the wire that connects the braces together. A floss threader will help you get the dental floss underneath your archwires. Dental floss with a stiff end is also available. It is pre-cut and is very easy to insert underneath archwires.

Once the floss is under the archwire it can be wrapped around the tooth on one side. The floss is then pushed up toward the gum line and then pulled down toward the wire. This should be repeated four to five times to ensure all plaque is removed. Be careful not to put too much pressure on the wire as you pull down. Then wrap the floss around the neighboring tooth. Once both teeth are done, the floss is pulled out and the process repeated for the next two teeth.

Foods to Avoid

For most situations, common sense will tell you what to avoid. Hard foods, sticky foods and foods high in sugar must be avoided. Hard foods can break or damage wires and brackets. Sticky foods can get caught between brackets and wires. Minimize sugary foods; they cause tooth decay and related problems. Nail biting, pencil and pen chewing and chewing on foreign objects should be avoided.

Examples of Sticky Foods to Avoid:

  • Gum (sugar-free or regular)
  • Licorice
  • Sugar Daddies
  • Toffee
  • Tootsie Rolls
  • Caramels
  • Starburst

Examples of Hard Foods to Avoid:

  • Ice
  • Nuts
  • Hard taco shells
  • French bread crust/rolls
  • Corn on the cob
  • Apples and carrots (unless cut into small pieces)
  • Bagels
  • Chips
  • Jolly Ranchers
  • Pizza crust
  • Uncooked carrots (unless cut)

Minimize Sugary Foods like

  • Cake
  • Ice Cream
  • Cookies
  • Pie
  • Candy

It’s important to regularly check your braces for bent or loose wires and brackets. In the event of a loose/broken wire or bracket, call our office immediately to arrange an appointment for repair.

Caring for Your Invisalign Aligners

Proper upkeep and good oral hygiene are essential in keeping your Invisalign aligners clean, invisible, and odor free. The aligners can be easily removed for eating and drinking, however, failing to properly clean your aligners afterwards can result in discoloration and a buildup of bacteria.

To maintain clarity, it is good to periodically clear debris from your aligners with a soft toothbrush and water, but do not use toothpaste due abrasives that can create micro abrasions that make your aligners cloudy and dull.

DO NOT use denture cleaners to clean aligners or soak them in mouthwash. These products can damage the surface of the plastic, causing it to become more visible, sometimes making the teeth look somewhat yellow.

  • Rinse your aligners when you remove them: Dry saliva and plaque create a perfect breeding ground for foul smelling bacteria.
  • Brush and floss your teeth before reinserting your aligners: Proper oral hygiene is key in maintaining healthy teeth and avoiding cavities and decay.
  • Brush your aligners gently: Vigorous brushing can scratch your aligners and leave visible etchings. Brush carefully!

Do not eat or drink (anything but water) while wearing Invisalign. Many foods and drinks can stain or discolor your aligners. And remember…using toothpaste to clean your aligners will scratch the plastic and dull your aligners. These scratches can also create small traps in your aligners for bacteria to dwell.

Orthodontic Emergencies

Even though you are careful, you may occasionally damage your appliances. We want our patients to be informed of problems that may occur, and understand how to solve them, at least temporarily, until it is possible to return to our office.

Loose band or bracket – If a band or bracket comes loose from the tooth, call our office for an appointment. While a tight band or bracket actually protects a tooth from decay, a loose band or bracket is extremely dangerous and decay can occur under it very rapidly. If the band or bracket is still attached to a wire, leave it in place and apply wax if there is discomfort. If the band or bracket comes completely out, place it in an envelope and call for an appointment.

Broken archwire – If a main archwire breaks (the one that goes all the way around the outside of your braces), call our office for an emergency appointment.

Loose wire – Try to place the wire back in the tube. Place wax over it if there is any discomfort and call for an appointment.

Poking wire – Sometimes a poking wire can be safely turned down so that it no longer causes you discomfort. Try to tuck the wire back in and out of the way with the blunt end of a toothbrush, or some other smooth object. If you are unable to take care of a poking wire, apply wax and call our office for an appointment.

Lost tie-wire or elastic tie – This is not a real emergency, but please notify an assistant at your next appointment.

Soreness – Soreness during treatment is to be expected. Warm salt-water rinses and Advil are helpful in relieving soreness.

Accidents involving teeth – Contact our office immediately, or contact your general dentist.

Please remember: If you are involved in contact sports, a regular mouth guard can be fitted over your braces for added protection.

 

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