Instructions

TOOTHBRUSHING INSTRUCTIONS REVIEW

Let’s review a few important points we talked about in the office today:

• Clean braces are bright and shiny. Dirty braces are covered with a white, milky film of bacteria called plaque.
• Plaque causes tooth decay, bad breath, swollen gums and eventual gum disease. As plaque builds up along the gumline, bacterial/germs irritate your gum tissue making it become red, puffy, sore and likely to bleed.
• Gums that bleed or swell have not been thoroughly brushed. Brush between the gums and the braces to massage gums and disrupt bacteria.

The best method for removing plaque is tooth and gum brushing, flossing and fluoride rinses. This daily oral hygiene home care program takes time- your time. But, it can also shorten the time you have to wear your braces and reduce the risk of developing white spots on your teeth.

A Few Reminders:

• Brush a minimum of four times per day- after breakfast, after lunch, after dinner and before you go to bed.
• Brush first with water, then brush again with a small amount of toothpaste.
• Floss once a day. Use a proxi-brush to clean under the wires.
• Never sit down in a treatment chair unless your teeth are clean. Braces and appliances cannot be adjusted properly when they are dirty.

OKAY… now it is up to you!

EATING HABITS AND ORTHODONTICS

Much work and effort has gone into the construction and placement of your orthodontic appliances. We encourage you to take care of your braces by keeping them clean and being careful with the types of foods you put in your mouth. Breakage of your braces results in extra appointments (usually during school hours) for repairs and will lengthen the total time of your treatment. Please read the following information and ask us for any clarification.

Watch Out For...

HARD FOODS: Hard foods may cause damage by bending the wires, loosening the cement under the bands or breaking the brackets that are bonded to the teeth. Some examples of those foods are listed below along with the ways that they may be eaten:

• CARROTS OR CELERY: Grate, cook or cut into thin pieces.
• APPLES: Cut into bite size pieces.
• FRENCH BREAD, HARD ROLLS, BAGLES: Avoid hard crusts.
• CORN ON THE COB, CHICKEN, RIBS: Cut off cob or bone.
• PLEASE DO NOT EAT NUTS, HARD PRETZELS, HARD PIZZA CRUST OR HARD CHIPS.
• TOP HALF (BUT NOT THE BOTTOM HALF) OF THE POPCORN BAG OR BOWL IS OK
• CHEWING ICE CUBES IS STRICTLY FORBIDDEN!!!

STICKY FOODS: Sticky foods can damage the appliances by bending wires and loosening the cement, actually pulling them off the teeth. PLEASE DO NOT EAT TAFFY, SUGAR DADDIES, PEANUT BRITTLE, CARAMELS, CANDY APPLES, LICORICE OR ANY OF THE CURRENTLY POPULAR TYPES OF STICKY CANDIES SUCH AS STARBURSTS OR NOW AND LATERS. The only gum permissible is one stick at a time of sugarless gum – no regular gum or bubblegum of any kind, please.

FOODS HIGH IN SUGAR CONTENT should be limited. The germs (bacteria) that cause tooth decay, decalcification and gum disease need sugary food on your teeth in  order to live. Please brush your teeth immediately after each meal, since most of the damage occurs within the first half hour after eating.

GUMS THAT BLEED NEED MORE BRUSHING – DO NOT AVOID THEM. Please use the pocket toothbrush which we have given you when you are away from home (at school etc…)

Trouble Shooting

POKING WIRE OR BAND: Use the wax we have provided to cover the irritating part and call the office for an immediate appointment. Please remember to dry off the area first so that wax will stick better. If you do not have wax with you, use cotton, tissue or gauze until we can take care of the problem. Moldable silicon ear plugs, available at any pharmacy, work very well. Sometimes the eraser end of a pencil can be used to push a small poking wire back into place.

LOOSE BAND OR BRACKET: Please do not wait until your next scheduled appointment, but call us immediately, even if you have an appointment the same day, so we can set aside the necessary time for the repair.

BROKEN WIRES: If it is a small tie wire, you may remove it and call the office. If it is the main arch wire (which connects all the teeth), try to move it so it is comfortable and phone the office for an appointment. If it is not possible to make it comfortable and you are unable to come to the office immediately, please cut the wire as close as possible to the nearest bracket it is still secured to (use a small wire cutter of fingernail clipper). Use wax over the area if necessary.

DISCOMFORT: When pressure is applied to the teeth, you may feel some tenderness which usually persists for 2-3 days. The intensity and duration of the discomfort will vary with each patient. If you feel an unusual amount of pain or discomfort, please call the office immediately. For after hour emergencies, a recorded message will tell you how to reach Dr. Bernstein or another orthodontist if Dr. Bernstein is out of town. If no one is reachable, please call your general dentist.

FIVE THINGS TO DO AT HOME WHEN YOUR JAWS HURT

Soft Diet

• Switch to a soft diet (baby food, soups, milkshakes, eggs, hamburgers, etc.) until symptoms improve.
• Cut all food into small bite-size pieces. Do not open your mouth any wider than the thickness of you thumb. Avoid biting hard with your front teeth.
• Do not eat hard crusts of bread, tough meat, raw vegetables or any other food that requires prolonged chewing. DO NOT CHEW GUM!!!

Ibuprofen

• Over the counter pain relievers (Ibuprofen, Motrin, Advil) have an anti-inflammatory effect in higher doses. Take 600 mg every six hours to reduce joint inflammation.
• Read warnings and follow directions on the bottle. Do not use higher doses on an empty stomach, with alcohol or if you have stomach disorders (colitis, etc.).
• Do not use this dosage for more than 10 days.

Moist Heat

• Moist heat is a very effective way to increase blood flow, which will promote healing, muscle relaxation and pain relief.
• Fill a basin with water as hot as the skin can stand and soak two hand towels in it.
• Take one out, wring it out and apply it to BOTH sides of the face, not just the painful side. When the first towel cools off, apply the second towel.
• This procedure should be carried out for 20 minutes, three times a day (or more), allowing at least a 20 minute interval between applications. Moist heat should be applied upon awakening and before going to bed at night.
• Moist heat packs (hydro-collars) or moist head pads (electric) are available at drugstores and are easier and more efficient to use.
• Use ice for acute injuries or if you don’t respond well to heat or are uncomfortable using it, alternate heat and ice (10 minutes each).
• While applying the heat pack, it helps to lie down in a dimly lit room with no distractions in order to heighten the relaxation effect and reduce stress.