Brace care and advice

/Brace care and advice
Brace care and advice2017-11-13T17:19:21+00:00

Brace Care and Advice

What happens at my first visit?

Your orthodontist will have a chat with you to find out what is concerning you about the appearance of your teeth. It is helpful to know this so that we can treat exactly what is bothering you. After the assessment, your orthodontist will advise whether they think you might be suitable for NHS orthodontic treatment and will discuss the treatment options available to you. If you wish to have orthodontic treatment on the NHS then you will need to have records taken of your teeth so that it can be sent to the health board for a decision on whether you are eligible for NHS treatment.

The final decision as to whether you are eligible for NHS treatment is the decision of the health board. It usually takes around 6-8 weeks to hear an outcome from the health board.

If you wish to independently fund the treatment, you will not need to apply for approval from the health board and can start treatment quickly. If you decide on this option, you can be assured that you will be informed about any costs beforehand and will be given a printed treatment plan with the cost breakdown before you consider embarking on treatment.

Is it painful to place a fixed brace?

No, it is not painful. We place a plastic guard between your cheeks and teeth to help keep your teeth dry. A gel is painted on your teeth and washed off.

Image showing the cheek retractor (guard) in position, the gel has been placed on the teeth and there is a ‘straw’ to aspirate the saliva to keep you comfortable.

A second gel is placed on your teeth and each bracket is placed on your teeth.

The wires are placed and rubber ties “modules” are used to hold the wire in position.

After the brace has been placed

It is normal to experience discomfort from the brace once it has been fitted. The discomfort usually worsens over 24 hours and will settle within a few days. During this time, it is really important to eat a soft diet and avoid chewing pen lids/fingernails. If painkillers are required then paracetamol is recommended.

You will need to buy a single tufted toothbrush), vegetable wax and fluoride mouthwash (available to purchase at our reception) to help keep your brace clean, keep you comfortable from any unruly wires and to ensure you are protecting your teeth with fluoride. You should use this tooth brush in addition to your own brush to clean in between the wires and the brackets.

Fluoride mouthwash can be used at lunchtimes to protect against decay.

The single tuft brush can clean between the wires and the brackets.

Wax can be placed on the part of the brace which is rubbing your cheek.

Breakages

Breakages can occur within 2 weeks of the brace being placed. This is because your mouth is still getting used to the appliance. The brace is fragile and will break if anything hard/crispy/crunchy is consumed. It is important that you make an appointment to have your brace fixed. If you are on holiday or our practice is closed, you can usually manage any discomfort yourself. For example:

The wax (shown in red) is rolled, the offending bracket dried and the wax moulded around the brace.

Wires which have come out of the molar tube– sometimes if you have eaten something hard, the wire can come out of the tube. You can replace this yourself (with tweezers) as shown in the pictures below.

Broken brackets- these can be left until you are able to see your orthodontist

Ulcers/ mouth irritation from the brace– wax is the best treatment in these cases. It is important to dry the part of the brace which is rubbing your cheek to allow the wax to stick. You will need to mould the wax around the brace to prevent it from coming off. It is recommended that you use the wax for at least 2-3 days to allow the ulcer to heal. Your cheeks will heal quickly, and usually heal with more resilience.

The brace should not continuously break, if this does happen then you might need to check your diet to ensure what you are eating is brace friendly.

Advice for musicians.

Braces may temporarily affect musical performance. This usually lessens with practice and motivation and most wind instrumentalists adjust to playing with braces. For more information please read the BOS guidance:

Non-nutritive habits

We encourage children to stop digit-sucking habits by the age of 7 to prevent abnormal tooth movement and development of the jaws. It is important to provide positive reinforcement to help your child stop their habit.

If this habit continues into adulthood it can affect how the jaws grow around the teeth and affect the position of the teeth. Most children and young adults who have a non-nutritive habit are unaware that they are doing this in their sleep. We encourage the use of elastoplasts or a “bitter” nail varnish on the offending finger to help make the child aware of the times they are doing this. If this treatment is not effective, your orthodontist can provide an appliance to help. There is some useful information available on the BOS website, please see the link below.

Fixed Braces Information

It is normal to experience some discomfort within a few hours of having your brace fitted. This usually settles within a few days. Here are some useful tips to help look after your brace.

• Brush your teeth 2-3 times daily. You should always ensure your toothbrush bristles are pointing towards the gum to ensure the white-sticky substance (plaque) is effectively removed from your teeth.

• An alcohol-free fluoride mouthwash is useful to take to school/work so that you can rinse your mouth in an event that you are unable to brush your teeth.

• Hard/sticky or chewy foods should be avoided. Apples, carrots or celery should be cut into small pieces and placed at the back of your mouth. Avoid biting into anything.

• Plain milk and water should be consumed in between meals; it is the safest drink for your teeth. Fizzy juice and fruit juice can cause decay around the teeth and around the brace.

• White permanent scars can occur on the teeth if you consume sugary drinks and do not brush your teeth properly. This is a sign of early tooth decay and your braces may be removed if you are not caring for them properly.

• Continuous breakages of the brace should not occur, if this does happen you will need to review your diet. Repeat breakages of the braces can cause prolonged treatment times.

• Your brace will not be “tightened” at each appointment, what happens at each appointment is the wire is changed over which can make your brace feel tighter.

Functional Braces Information

These braces need your patience, they are wonderful braces and work beautifully to help correct your bite, although they can feel as if a double decker bus has been parked in your mouth at the first visit!

These braces take 2-3 weeks to get used to and it is important to wear them 24 hours per day (removing only to eat, clean and for sport). When your brace is not being worn then you must keep it in a hard box. To clean your brace, use a liquid soap and warm water. Avoid using boiling water as this will break the appliance.

If you lose or break your brace, there are associated costs to get one made/repaired. Please look after it.

Most patients with these braces become used to wearing them. It is important to stay positive throughout your treatment, if you wear them well then you will reduce the overall treatment time.

Removable Braces Information

These braces are often used to correct the bite, to move one or two teeth or to expand the jaws. These braces need to be worn 24 hours per day, removing only to clean and for sport. It is important that these braces are used when eating.

To clean the braces, use a liquid soap and warm water. Store the brace away from dogs (they love to chew them!), it is also important to store these retainers in a hard box when not in use to prevent unwanted breakages.

Retainers Information

Even though you have had your teeth aligned and have a beautiful smile, you must wear your retainers to prevent your teeth moving back to the original position (relapse). Orthodontic treatment is similiar to having your hair cut, your tooth position requires maintenance (like your hair!).

Removable retainers

These retainers are usually made from a clear thermoplastic material to help maintain the corrected tooth position. It is important to remove them for eating and drinking, otherwise food can get caught in them which can lead to tooth decay. Your orthodontist will provide you with instructions regarding how often you need to wear them.

The NHS will provide you with 1 set of retainers, these will not last forever and it is up to you to have them replaced. One retainer costs £53.45 (£106.90 for a set).

Fixed retainer

Fixed retainers comprise of a thin wire which is placed behind your teeth and should remain there permanently. Should any part of the wire break, you will need to contact your dentist or orthodontist to have it repaired as it means it is no longer working to hold your teeth in position. These wires can also attract plaque and food debris so your tooth brushing in this area must be perfect.

Sometimes these wires can distort when you are eating, and can place an unnecessary force on your tooth causing your tooth to move. Repeated orthodontic treatment on the NHS is not permitted and therefore fixed (wire) retainers are only used in specific cases. It is important to understand the risks and benefits of different types of retainers and your orthodontist will discuss this further with you.

Brace Friendly Food

The braces are relatively fragile and require care and caution when eating. It is advisable to avoid foods which may break the brace. After you have had your appliance placed, you should consider eating soft foods as your teeth might feel uncomfortable. This includes:

• Soup
• Soft cheese
• Yoghurt
• Scrambled eggs
• Noodles
• Soft pasta
• Soft bread

It is really important to avoid sugary/fizzy juice as this may cause damage to your teeth and braces. If you are having juice, limit it to mealtimes and drink plain milk or water between meals.

During the latter stages of your treatment, you may have clear chain placed on your brace to help close the spaces; this chain often discolours with turmeric, tomatoes, black coffee, black tea. This is perfectly normal and the chain will be changed at your next appointment.

There is a brace-friendly recipe book available in the link below:

https://www.bos.org.uk/NOWRecipebooklet