Patient Education
 First Visit
Consultation
Hygiene
Decalcification and Braces
Diet Information
Emergency Information
First Visit
What happens at my first visit?
We look forward to meeting you on your first visit to our office. During this time, we will help you get acquainted with our office and learn about your orthodontic treatment. We understand that each patient's orthodontic treatment is different, and we promise to give you the personal attention you deserve. Your first orthodontic visit will consist of an examination and discussion of potential treatment options. This important visit will address your orthodontic needs to determine if this is the proper time to begin treatment.
What are diagnostic records?
Diagnostic records include x-rays, photographs, and impressions made of the teeth. These “molds” are used to develop models for closer examination of the teeth and how the upper and lower teeth relate to each other. X-rays are taken to look at the root structure of the teeth and how the jaw bones and teeth relate to each other. At times additional imaging of the temporomandibular joints is helpful. Typically facial photographs and intra-oral photographs are taken to evaluate facial proportions, facial aesthetics and the health of the teeth and gums. These diagnostic records collectively enable the orthodontist to develop an appropriate treatment plan for the patient.
After we have evaluated your records, we conduct a treatment consultation to explain all aspects of your treatment in detail. We will provide a complete clinical diagnosis regarding the nature of the problem, a written summary of the findings and a detailed plan that outlines your treatment, goals and estimated fees. We encourage questions from both the patient and the parent, and as such, we provide ample time to answer your questions.
Click here for New Patient Health Forms
We are always excited about meeting new patients
during their first visit to our office. Your initial
appointment will consist of a thorough examination and
a discussion of potential treatment options. This
important 30-minute visit will give us insight into
your orthodontic needs. We know your time is valuable,
so to expedite treatment, we may also reserve time
following the exam for diagnostic records. The records
include X-rays, photos and impressions for study
models and are necessary for developing the
appropriate treatment plan. This additional
appointment will last approximately one hour.
During the initial examination for each patient, we
will address the following questions that cover the
basics of orthodontic treatment. We encourage you to
ask questions as well.
- Is there a condition that orthodontics can address?
- Is treatment needed now, or should treatment be delayed until appropriate growth, tooth eruption, or other factors have occurred?
- What treatment procedures will be used to correct the problem?
- Do any permanent teeth need to be removed?
- How long will treatment take?
- How much will it cost?
- What are my payment options?
While we can often answer these general questions
about treatment during the initial examination, we
will address specific areas after careful analysis of
the diagnostic records. We feel it is important to
analyze each patient's specific needs, because
in-depth planning leads to superior results and higher
patient satisfaction.
We will then schedule a consultation visit to discuss
treatment options, time frames and financial
arrangements. We insist that our patients leave the
office with a clear understanding of their specific
needs, what the treatment will consist of and how long
it will take. Also, we will answer any additional
questions.
Please assist us by providing the following
information at the time of your first visit:
- Any panoramic X-ray taken within the past six months.
- If you have orthodontic insurance, bring your
insurance card. By providing this information at the
first visit, we will be able to give you an estimate
of your costs.
Consultation
After we have evaluated your records, we conduct a
treatment consultation to explain all aspects of your
treatment in detail. We will provide a complete
clinical diagnosis regarding the nature of the
problem, a summary of the findings and a detailed plan
that outlines your treatment, goals and estimated
fees. We encourage questions from both the patient and
the parent, and as such, we provide ample time to
answer your questions.
Hygiene
Extra time is needed with toothbrushing to make sure
that all areas around the braces have been cleaned
properly. Specialized brush tips are available to help
get in between the braces and under the wires.
Floss-threaders are helpful in passing floss under
archwires to facilitate flossing of the teeth. Oral
irrigators are often helpful to dislodge food debris
from around the teeth. Over-the-counter mouth rinses
can be used in conjunction with oral irrigators to
help reduce the level of bacteria around the teeth.
The goal is to remove plaque from around the teeth and
gums. It is the bacteria in plaque that is responsible
for causing inflamed gum tissue (gingivitis),
permanent scarring of enamel (decalcification), as
well as tooth decay. Remember, braces don’t cause
these problems, they just make cleaning the teeth more
difficult.
Decalcification and Braces
Although braces can create many good results, there
can be some negative side effects to the teeth if oral
hygiene is neglected. Chalky white permanent marks or
decalcification can occur if plaque accumulates on
teeth for extended periods of time. Braces require
consistent and thorough maintenance in order to avoid
these problems.
Diet Information
Eating these foods will loosen the braces, but you may
not discover the problem until hours or days later.
Loose bands, broken wires, and detached brackets cause
delays in your orthodontic treatment.
Ice: Never, it will damage your braces.
Pizza Crust: The hard crust can bend the wires.
Hard Pretzels: Bends wires, loosens bands, and loosens brackets.
Hard Rolls & Bagels: Bends the wires and loosens the brackets.
Doritos, Tacos, Tostitos, Cheetos, Fritos etc: Will form a hard ball and break your braces.
Apples: Slice into bite size pieces.
Cord on the Cob: Slice corn off the cob.
Beef Jerky & Slim Jims: Tough as nails.
Lollipops & Hard Candy: You may weaken your braces when you bite into them.
Popcorn: The little kernels get between the gum and the band. This can be very painful.
Raw Carrots: Too hard. Slice them very thinly or avoid them.
Nuts: No nuts of any kind.
Caramel Candy, Bubble Gum, Taffy etc: Are sticky and will pull off wires and feed the bacteria in your mouth.
Pens & Pencils: Favorite exam food; damages wires and brackets.
A. Ligature
The archwire is held to each bracket with
a ligature, which can be either a tiny elastic or a
twisted wire.
B. Archwire
The archwire is tied to all
of the brackets and creates force to move teeth into
proper alignment.
C. Brackets
Brackets are connected
to the bands, or directly bonded on the teeth, and
hold the archwire in place.
D. Metal Band
The band is the cemented ring of metal which wraps around the
tooth.
E. Elastic Hooks & Rubber Bands
Elastic hooks are used for the attachment of rubber bands, which
help move teeth toward their final position.
Emergency Information
Many common orthodontic “emergencies” can be handled
easily at home. To help you accurately describe an
emergency situation to the orthodontist, use the
diagram at the end of this section, which illustrates
and names each part of a typical set of braces. A
list of supplies to keep on hand is also posted at the
bottom of this section.
Trauma to tooth – tooth came out
If a tooth has been knocked out, do not clean off the tooth.
- Call your orthodontist or your dentist immediately to inform them of what has happened.
- Upon locating the tooth, hold the enamel end of the tooth, not the pointed end/root.
- Do not rinse the tooth in water. Do not scrub the
root. You may remove large debris. If possible, put
tooth back in socket where tooth was and hold in place
with gauze or washcloth. If it is not possible to
replace the tooth in its socket, put the tooth into
cup of milk or saline solution, or put the tooth
between the cheek and gum. Do not put the tooth in
plain water.
- Apply an ice pack to the affected soft tissue area to reduce swelling
- Do not let the tooth dry out. A tooth can often be saved if cared for properly and reimplanted within an hour.
Broken tooth
- Clean the injured area and apply an ice pack to the
effected soft tissue area to reduce swelling.
- Save the tip of the tooth (for possible
reattachment) and call your dentist right away.
Piece of the Orthodontic Appliance is Swallowed or Aspirated
If you are able to see the piece, you may
carefully attempt to remove it. But do not make the
attempt if you would cause the patient harm.
Encourage the patient to remain calm. If the patient
is coughing excessively or having difficulty
breathing, the piece could have been aspirated (drawn
into the lung).
If there is no coughing or difficulty in breathing,
and you suspect the piece has been swallowed, call the
patient’s orthodontist for advice and instructions.
If you are unable to see the piece and believe it may
be have been aspirated, call 911 (or the appropriate
emergency number for your area) and the orthodontist
immediately. The patient should be taken to an urgent
care facility for an x-ray to determine the location
of the piece. A physician will have to determine the
best way to remove it.
A Bracket is Knocked Off
Brackets (see diagram) are
the parts of braces attached to teeth with a special
adhesive. They are generally positioned in the center
of each tooth. If the bracket is off center and moves
along the wire, the adhesive has likely failed. Call
your orthodontist, who will determine the course of
action.
If the loose bracket has rotated on the wire and is
sticking out, attempt to turn it back into its normal
position and call your orthodontist to schedule an
appointment to have it reattached. You may wish to
put orthodontic wax around the area to minimize the
movement of the loose brace. If you are in pain,
please call your orthodontist and inform them of the
circumstance. If you are not in pain, this is not a
true emergency. Please call the orthodontist at your
earliest convenience to schedule an appointment to
reattach the brace to the tooth.
Remember, brackets can become loose as a result of
chewing on hard, sticky or chewy foods or objects as
well as from physical contact from sports or rough
housing.
Be sure to wear a protective mouth guard while playing
sports!
The Archwire is Poking
If the end of an orthodontic
archwire (see diagram) is poking in the back of the
mouth, attempt to put wax over the area to protect the
cheek. Call the orthodontist to schedule an
appointment and have that clipped. If you are
uncomfortable, make sure you inform the
orthodontist.
In a situation where the wire is extremely bothersome
and the patient will not be able to see the
orthodontist immediately, as a last resort, the wire
may be clipped with an instrument such as fingernail
clippers.
Reduce the possibility of swallowing the snipped piece
of wire by using folded tissue or gauze around the
area to catch the piece you will remove. Use a pair
of sharp clippers and snip off the protruding wire.
Relief wax may still be necessary to provide comfort
to the irritated area.
“Ligature Wire” is Poking Lip or Cheek
Use a Q-tip or
pencil eraser to push the wire (see diagram) 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” below
for instructions on applying relief wax.) Make the
orthodontist aware of the problem.
Loose Brackets, Wires or Bands
If the braces have come
loose in any way, call the orthodontist to determine
appropriate next steps. Save any pieces of your
braces that break off and bring them with you to your
repair appointment.
Irritation of Lips or Cheeks
Sometimes new braces can
be irritating to the mouth. A small amount of
orthodontic wax makes an excellent buffer between the
braces and lips, cheek or tongue. 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. If
possible, dry off the area first as the wax will stick
better. The patient may then eat more comfortably.
If the wax is accidentally swallowed it’s not a
problem. The wax is harmless.
Mouth Sores
People who have mouth sores during
orthodontic treatment may gain relief by applying a
small amount of topical anesthetic (such as Orabase or
Ora-Gel) directly to the sore area using a cotton
swab. Reapply as needed.
Discomfort
It’s normal to have discomfort for three to
five days after braces or retainers are adjusted.
Although temporary, it can make eating uncomfortable.
Encourage soft foods. Have the patient rinse the
mouth with warm salt water. Over-the-counter pain
relievers, acetaminophen or ibuprofen, may be
effective.
Lost Ligature (Rubber or Wire)
Tiny rubber bands known
as alastic ligatures (see diagram), are often used to
hold the archwire into the bracket or brace. If an
alastic ligature is lost, contact the orthodontist,
who can advise you whether the patient should be seen.
The same holds true for wire ligatures.
What if the Lip Gets Caught on a Brace
- Call your orthodontist immediately.
Apply ice to the affected area until you have the
opportunity to been seen by your orthodontist or
family dentist.
I Can’t Open My Mouth
Potential causes – problems with
lower jaw joint or swelling around the soft tissues in
the mouth.
- Call your orthodontist or dentist and inform them
of your symptoms.
Food Caught Between Teeth
This is not an emergency. It can be resolved with a piece of dental floss. Try
tying a small knot in the middle of the floss to help
remove the food. Or use an interproximal brush to
dislodge food caught between teeth and braces.
Diagram of Braces?To help you accurately describe an
emergency situation to the orthodontist, use the
diagram below, which illustrates and names each part
of a typical set of braces.
Supplies
With these supplies on hand, you will be prepared to handle the most common problems with braces.
- Non-medicated orthodontic relief wax
- Dental floss
- Sterile tweezers
- Small, sharp clippers suitable for cutting wire (such as a fingernail clipper)
- Q-tips
- Salt
- Interproximal brush
- Non-prescription pain reliever (acetaminophen or ibuprofen or any over-the-counter medication typically used for a headache)
- Oral topical anesthetic (such as Orabase or Ora-Gel)
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