Orthodontic Information Sheets: DO’S AND DONT’S

PLEASE READ CAREFULLY. All information regarding treatment, care, appointments, etc, is explained in detail. These instructions are for your benefit. Treatment will go much smoother for you and our staff if these instructions are followed.

One of the most important responsibilities of any orthodontic patient is proper care and cleaning of the appliances or braces. Proper cleaning means much more than just brushing the braces. It is important to understand that consistently poor hygiene may result in extended time in braces, expensive restorative dentistry, gum disease that may require gum surgery, or tooth loss. These written instructions are meant to outline for you or your child a program of home care, which will insure a healthy mouth throughout the course of orthodontic treatment, and hopefully establish oral health habits that will last a lifetime.

First we would like to give you a short course in the cause of dental disease. You’ve undoubtedly heard of PLAQUE. Plaque is a sticky substance produced by the bacteria which normally resides in the mouth, and which attaches itself to the teeth and gums. It forms continuously, and eventually builds into thick, cheesy-looking accumulations around the gum line of the teeth. Bacteria live in plaque. When we ingest sugar of any kind, the sugar diffuses into de plaque and is transformed into acid by the bacteria. The acid then attacks the teeth, destroying the enamel and causing decay, and attacks the gum tissue causing gum disease. It is bad enough that most of the processed foods we eat these days contain large amounts of sugar, but for those individuals who eat candy, drink highly concentrated sugar drinks, such as soft drinks, and who chew sugared gum several times a day, the disease process is accelerated. It is discouraging for me as an orthodontist to work very hard to achieve a beautiful, straight set of teeth, only to remove the braces and find white marks around the areas where the braces were attached to the teeth. These are scars in the enamel left by plaque accumulations around the brackets. Another insult to the mouth is loss of teeth from gum disease. The good news is that most dental disease can be prevented. CLEAN TEETH DO NOT DECAY, AND HEALTHY GUMS DO NOT BLEED. _____

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With this in mind, we want you to understand and support our program for wonderful, healthy smiles.

It involves a commitment to be persistent about cleaning, but we think you will agree the results are worth the effort.

You can also watch the following video: www.youtube.com/watch?v=GtSi2lcfynE

1.  We want to start the straightening process with clean, healthy teeth. Be sure to work very hard on cleaning teeth and gums before coming to your next appointment. Remember, bleeding gums are sure signs that plaque accumulations are not being removed_____

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2.  Brush your teeth with a soft bristled TOOTHBRUSH three times a day. Replace your toothbrush every 3 months. Brush your teeth for a full 2 minutes. Use a clock with a second hand, listen to a song on the radio, or use an egg timer to help track the 2 minutes. Check in the mirror after brushing to make sure your teeth are white and your braces shiny. A travel brush carried in the purse or placed in a locker is great for brushing after lunch when at school or work. ____

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3.  At least once per day (before sleep) FLOSS your teeth using either “floss threaders” or “super floss”. The “proxy brush” given to you is also very useful. These hygiene helpers are given to you the day you get your braces, you can also find them at a pharmacy. _____

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4.  Finally, we want all orthodontic patients to use FLUORIDE mouth rinse on their teeth once a day (ideally before sleep). After your 2-minute brushing, floss and then use it according to manufacturer. Spit it out, DO NOT SWALLOW. Wait at least 30 minutes before eating or drinking. Fluoride hardens the enamel, making it more resistant to decay. ____

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There you have it, a plan for a lifetime of super smiles! Remember, cleaning your mouth is YOUR responsibility.

And while you need to maintain regular six month visits with your dentist, unless instructed different by him or your orthodontist, YOU hold the key to your smile. _____

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We are always open to comments or questions regarding oral hygiene procedures in our office. Please don’t hesitate to ask if you are unsure of anything.

Signature:______Date:______

If patient is a minor:

Please, carefully check your child’s teeth morning and night. Be sure that the teeth look clean and are free of food debris and plaque. If the teeth are not clean, please send your child to brush again or take over and brush and floss the child’s teeth yourself.

I understand the importance of good oral hygiene and I will assist my child as needed.

Signature:______Date:______

IF SOMETHING BREAKS: Sometimes brackets do not break off immediately after they are loosened. Sometimes that hard candy, bread or pizza crust weakens the glue but not enough for it to come off. The next thing you know the bracket pops off while you are sitting in class or eating mashies. The important thing is that you call us ASAP to let us know. Loose and/or broken means the same thing, a repair must be made. Call our office and let us know when something breaks and if you are in pain. We will evaluate your situation and make you an appointment accordingly. If you are not in any pain the repair CAN WAIT until our office has available appointment time. If you are in pain, we will make an appointment to alleviate the pain and make you comfortable by removing the brace and/or clipping a wire. However, the repair WILL NOT be done at that time. A repair appointment will have to be made if it cannot wait until your next regularly scheduled appointment. Repairs CAN NOT be scheduled during prime office hours. We do understand that accidents happen and something might break, however, if you are constantly breaking your braces there will be a charge for repairs (You will be informed of charges before they occur). We recommend that the patient pay for his/her repairs. If you call our office and we are closed, please leave us a message. We will return your call when the office reopens. DO NOT call the emergency number to report broken appliances. This number is strictly for emergencies; such as pain, hit in the mouth, etc. alleviate _____ Initials

MATERIALS USED: Please be aware that our office uses ONLY the highest quality materials. When appliances break it is usually due to an accident and/or carelessness on the part of the patient. ____

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WHAT CAN DELAY TREATMENT: Broken appliances, broken appointments, not been seen every 4-6 weeks, not wearing rubber bands, poor oral hygiene, and mother nature (growth and development). ____

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MUSICAL INSTRUMENTS & BRACES: You can play an instrument while undergoing orthodontic treatment. If you played a mouth instrument prior to your braces it will now feel different and you may need to position your lips differently. _____

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CAMP & BRACES: Many of out patients leave during the summer for camp. We will supply you with plenty of wax and rubber bands (if needed). We prefer to see you right before you leave and as soon as you return. Most camps have an orthodontist nearby for emergencies_____

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MOUTH GUARDS: we encourage that the patient wears a mouth guard if involved in sports to avoid accidents if hit in the mouth. _____

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PAYMENTS:

Payments are due EVERY MONTH until your balance is paid. It does not matter if the patient is seen or not. The monthly payment plan is set up for your convenience. _____

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Parent/legal guardianinitials:______Date:______

FOOD TO AVOID: Following is the food list with some specific items listed. We ask that you stay away from foods that are sticky and chewy and/or hard and crunchy. Please use common sense to determine what you can or cannot eat, as it is not possible for us to list every single item to avoid by name. Foods that are sticky and chewy tend to pull and tug on the metal in your mouth. Hard and crunchy foods can loosen up a brace or break a wire immediately. Loose braces or broken wires are NOT AN EMERGENCY and do not require immediate attention, unless you are in pain. Loose braces not only slow up treatment but also cause us to use valuable office time to make repairs. Please be careful!! _____

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FOODS TO AVOID DURING ORTHODONTIC TREAMENT

DO NOT EAT STICKY AND/OR CHEWY FOODS:
1.  GUM of any kind
2.  Caramels
3.  Jelly Beans
4.  Licorice
5.  Milk Duds
6.  Now and Laters
7.  Sugar Daddy’s, Mama’s & Babies
8.  Tootsie Rolls
9.  Gum Drops
10.  Bagels (too doughy)
11.  Taffy
12.  Soft pretzels (too doughy)
13.  Snickers
14.  Milky Ways
15.  Baby Ruths
16.  Butterfingers
17.  Almond Joys
18.  Twix
19.  Anything else that falls under this category / DO NOT EAT HARD AND/OR CRUNCHY FOODS:
1.  Chips
2.  Cookies (unless very soft)
3.  Hard candy (Lifesavers, Lollipops, Jaw Breakers, etc)
4.  Ice cubes, even if you are careful
5.  Peanut brittle
6.  Pizza crust (the hard outer edge)
7.  Hard toast and/or toasted English muffins
8.  Hard Fruit (Apples, pears, peaches- unless sliced or cooked)
9.  Hard vegetables (Carrots, celery, broccoli, etc- unless shaved/grated or cooked)
10.  Popsicles (too much like hard ice)
11.  Hard Ice Cream Bars.
12.  Hard and/or thick Buns or Rolls
13.  POPCORN
14.  Corn chips, crisp tacos. (Soft shells are okay)
15.  Ice Cream Cones
16.  Nuts of any kind
17.  Nerds
18.  Corn on the Cob (Remove corn from cob)
19.  Meat on the bone (Ribs, pork chops, steak, chicken- remove meat from bones first)
20.  Chewable vitamins
21.  Fruit Chews, gummy bears, etc
22.  Hard French bread. (unless taken in small pieces, carefully)
23.  Lemons (pure lemon juice can hurt your tooth enamel).
24.  DO NOT play with your braces. Keep your fingers out of your mouth
25.  DO NOT chew on pen tops or pencils
26.  Anything else that falls under this category

PLEASE USE COMMON SENSE - BRACES ARE BREAKABLE- BE RESPONSIBLE

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But Dr. I thought you told me…..

How long will my teeth be sore?

Expect the teeth to be somewhat tender the first few days after your braces are adjusted. You can take what you would take for a headache to alleviate the discomfort. The sooner you start chewing, the faster you will adjust. ______

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Will the inside of my lips be sore forever?

Expect from time to time, that your cheeks and lips become irritated. You will eventually build-up a callous. If an ulcer forms, use the wax that we gave you and place it over the braces that seem to be causing the problem. The wax will stay in place even while eating if you make sure that the area is dry before putting the wax in place. Pull off a small piece, roll it up in a little ball, stick it over the braces and mold it around the braces. ______

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Do I still have cleanings and check ups?

YES, YES, YES. This is very important. We usually do not recommend removing the wires for a cleaning unless the treating dentist will requests it. What we can do is coordinate your cleaning appointments with an orthodontic visit so we can remove your wires for the cleaning and checkups. ______

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Why did I get this space between my front teeth?

Sometimes things look worse before they will look better. The teeth will move in different directions as the teeth are straightening out. You may see a space between your front teeth that was never there before or teeth that seemed perfectly straight before the braces were placed may not seem as straight. Please be patient and things will start to improve. That space will close and those teeth will line up, I promise. In order to straighten the worst of the teeth, the straighter teeth may be pulled out of alignment but eventually they all work together to give you that great smile we are all working towards. ______

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I was only eating mashed potatoes when the braces broke off

Sometimes brackets do not break off immediately after they are loosened. Sometimes that hard candy, bread or pizza crust, weakens the glue but not enough for it to come off. The next thing you know the bracket pops off while you are sitting in class or eating mashies. The important thing is that you call us ASAP to let us know (not on the weekends, ha, ha). The brace does not necessarily have to be replaced right away but we want to know about it, even if you leave a message on the recorder. IF YOU WAIT UNTIL THE DAY OF YOUR APPOINTMENT TO TELL US THAT YOU HAVE A BRACE OFF, WE MAY NOT BE ABLE TO FIX IT. IF WE KNOW AHEAD OF TIME, WE CAN MAKE ARRAGEMENTS. ____

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My teeth are loose, Are they going to fall out or this is OK?

Yes, it is all right, so do not worry about them falling out, unless it is a baby tooth of course, that is natural. If they get too loose we will let you know, but this is rare. Most people notice this after they have been hit with an elbow, basketball or some form of trauma to the mouth. (No horse playing with braces, please!) _____