Please get into the habit of brushing after every meal. When this is impossible, you should at least rinse to remove loose food debris. You should brush as you normally do, but especially by the gumline. Food and plaque tend to accumulate along the gumline, so it is very important that this area remains clean and that the gums are massaged by the bristles of the toothbrush. As we have shown you at the end of the visit that your braces were placed, you should also angle the bristles so that they get in between the teeth and wires. Please do not rush! It is better to brush twice a day and do a good job than to brush five times a day and do a poor job. Otherwise, permanent white spots will form on the teeth, your gums will get red and puffy (the start of periodontal disease) and you might get cavities. It is very important that you continue your dental checkups. Please make sure that you see your dentist at least every six months for routine preventative and restorative care.
You do not need to wait a specific amount of time after the braces are placed before eating. The light that I use to set the glue for the braces makes the glue hard enough that you can eat right away after the braces are placed. Since your teeth will usually start to get sore about 6-10 hours after the braces are placed, I usually recommend that you have very soft foods to eat at that point, such as pasta, mashed potatoes, yogurt, apple sauce, etc.
There are certain foods that should be avoided while you have your braces on. These include foods that are hard and foods that are sticky. If a food is too hard or sticky, it will do damage to your appliances (bend or break a wire, or break off a brace). If you are eating something hard such as pretzels, bagels, apples, celery, carrots, pizza crust, etc., you should cut it to bite size pieces. Please do not have any of the followding:
You should also avoid Doritos (or other especially hard potato chips), corn on the cob (cut the corn off the cob), and you should not eat popcorn since the unpopped kernels will break your braces. Try to avoid biting into meat on a bone, since the braces may hit the bone and this may break a brace. Also, please avoid chewing on pens or other items which may break the braces or bend your wires, and do not bite your fingernails or play with the braces or wires with your fingers. You should drink soda only occasionally, since the acid in the soda can erode (chemically wear away) your teeth. This article shows a case where this happened.
If you have any discomfort, it will usually begin about 6-10 hours after the braces are placed. This occurs because the bone cells have not made space for the moving teeth yet and the pressure from the wires or elastics cannot be relieved. Acetaminophen (Tylenol) or ibuprofen (Advil) can be used in the dosages recommended on the label on the bottle. Most people will feel that their teeth are sore when they bite down, or that the braces feel rough to their cheeks and lips. This discomfort usually lasts a few days.
If the pain is from wearing elastics (rubber bands that I ask you to place between hooks on your braces), please realize that once the teeth get used to moving in the direction that the elastics are pulling, your teeth will no longer be sore. This usually takes a few (1-3) days. If you repeatedly start and stop with the elastics, you teeth will never get used to moving in a single direction and will always be sore. If you can tolerate the soreness for a few days, you teeth will become used to moving in that direction and will no longer be sore. In general, I start you out with a very gentle elastic that puts very little force on the teeth. However, if you are experiencing discomfort that you cannot tolerate, please call me so I can determine if an elastic of lighter force can be used.
After I see you for an adjustment, your teeth may be sore again for a few days. However, since the tooth moving cells are already present in sufficient numbers around your teeth, the soreness does not last as long, and is not is intense as after the first visit when the braces are placed.
Occasionally, as I am moving the teeth towards the correct positions, they do not fit together well. One tooth or a group of teeth may become sore because they are hitting against an opposing tooth too hard. The discomfort will subside as the tooth positions are corrected further.
As the teeth move, the become loose. This is normal. As long as you are cleaning your teeth properly, there is no permanent damage to the gums or bone, and your teeth will firm up again after they have reached their final positions.
The braces stand out from your tooth a certain amount. Some of the braces also have "hooks" that are used for wearing elastics. These factors can cause the braces to irritate your cheeks or lips. If the irritation is from an elastic hook, I can usually bend the hook in closer to your gum.
Occasionally, a wire will poke you in the back of your mouth, either because the wire came out of the back brace, or the wire shifted around to one side, or because the teeth are moving. The first wire that I use with your braces is a very thin, gentle wire. Since it is so thin compared to the slot in the brace that holds the wire, the wire sometimes shifts around and can stick out the back of the last brace. Also because it is so flexible, occasionally you will bite food into the wire and make it bend and come out of the last brace.
We give you wax and silicone which can be used anywhere in your mouth where the braces feel rough or if a wire is poking. To use the wax, soften it between your fingers and then place it on the brace or wire where it feels like it is rubbing. To use the silicone, make sure the area is dry (dry it with a paper towel) before placing it on the area. The silicone is reusable. If you start to run out of the wax or silicone, give us a call and we will send you some more. Alternatively, the wax is usually available at your pharmacy. If wax is not available, you can use a piece of sugarless gum (not the chew, just to cover the area that is bothering you) to smooth off the area. If you feel that the poking area is something that I can adjust (cutting the poking wire, placing the wire back into the last brace where it came out, bending in a hook, etc.), please call me and I will see you right away.
Occasionally, your top teeth may bite against a brace on the bottom and you may not be able to close your mouth all the way. Either your teeth will shift after a few days and this will not happen any more, or you may bite a brace off (see below).
If a brace breaks (is no longer attached to the tooth), it will still be attached to the wire. However, we should see you within a day or two so that we can either remove it or replace it. If the brace came off because you bit it off, we usually correct your bite somewhat before attempting to place it again. If a brace is no longer attached to your tooth, please call us before your appointment (even if you have an appointment the same day it breaks) so you can have everything ready should we decide to replace it that visit. This will enable me to stay on schedule and not make other patients wait. If the brace is out of your mouth, please bring it with you so I can clean it off and reuse it.
If a band (the ring around the back molar) is loose, sometimes it will just rock up and down, or it may fall off the back end of the wire. If the band is still on your tooth, I need to repair this right away (plaque can accumulate on between the band and tooth and start to form a cavity). If the band is no longer on your tooth, I may not be able to put it back on if there is not enough space between your teeth. I may need to place spacers again and re-appoint you to put it back on. If the band is no longer in your mouth, please bring it with you so I can clean it off and re-use it.
Sometimes one or more of the small elastics or wire ties which attach the main wire to your braces my come off. We will replace these for you at your next visit.
If have placed a chain elastic (the elastics are connected between the teeth) and it breaks, I need to replace this right away. If it is not replaced, it can cause a tooth to rotate (turn), spaces may open where I don't want them to open, and your treatment will be delayed.
If a brace looks crooked on your tooth, it is probably supposed to look that way. As I explain at the end of the visit when I put the braces on, the brace needs to go on a precise location on the tooth. If the tooth is crooked, the brace will look crooked. After the teeth are aligned, the braces will also appear straight.
Sometimes a space opens in a location where there was no space before the braces were placed. This is usually due to how the teeth are initially tipped. Usually, I can anticipate where this will happen and I will make you aware of this before the space opens.
Rarely, you may swallow a piece of wax or part of your appliance (a brace or elastic). Although this may initially seem worrisome, it is not a problem.