Orthodontic Care From Home
It is important for our patients to recognize minor orthodontic problems and understand how to solve them until it is convenient to return to our office.
Braces
Generalized Soreness
When you get your braces on and after regular appointments, you may feel general soreness in your mouth and teeth may be tender to biting pressures for three to five days. This can be relieved by rinsing your mouth with a warm salt-water mouthwash. Dissolve one teaspoonful of salt in eight ounces of warm water, and rinse your mouth vigorously. Placing Orabase on the affected area may also help; this can be found in your local pharmacy. If the tenderness is severe, take ibuprofen or whatever you normally take for headache or similar pain. The lips, cheeks, and tongue may also become irritated for one to two weeks as they toughen and become accustomed to the surface of the braces. You can put the wax we gave you on the braces to lessen discomfort during this process.
Brackets
PROBLEM: Loose bracket. Not secured on the tooth, and sliding along the wire.
SOLUTION: Apply wax to secure the bracket next to an adjacent bracket. If it is the last bracket in the back, you can remove the bracket and bring it with you to your appointment. You can attempt to cut the wire if it is poking or you can place wax over the end of the wire.
DO NOT attach elastics to a loose bracket. Call the office the next business day to let the office know about the broken bracket. **Please keep in mind that even if you have a regular scheduled appointment, it is important to call our office so that we may allow extra time, or schedule a separate appointment to fix the bracket.**
PROBLEM: Bracket off last molar tooth, causing wire to poke cheek.
SOLUTION: Clip the wire with fingernail clippers (if the wire is flexible) OR apply wax over the end of wire. Warm salt water rinses two to three times per day.
Wire Hooks
PROBLEM: Hook is poking lip.
SOLUTION: You can use a pencil eraser to tuck the hook towards the gums. If it is a molar hook place wax over it until it stops poking. Warm saltwater rinses two to three times per day.
PROBLEM: Gums are swollen around hook.
SOLUTION: Brush gums three times per day with a wet (no toothpaste) toothbrush. Discontinue elastic wear until tissue is not as swollen.
PROBLEM: Hook is wiggly.
SOLUTION: Continue to wear elastics, mobility is normal.
PROBLEM: Hook is no longer attached to the bracket.
SOLUTION: Call the office to schedule an appointment.
Hooks on Molar Brackets
PROBLEM: Hooks on molar bracket poking.
SOLUTION: Apply wax over the hook. Warm salt water rinses two to three times per day.
Buttons for Elastics
PROBLEM: Button is causing a sore on the tongue.
SOLUTION: Apply wax and use warm salt water rinses two to three times per day.
PROBLEM: Button is no longer attached to the tooth.
SOLUTION: Call the office to schedule an appointment.
Wires
PROBLEM: Wire poking or sticking out of the last bracket.
SOLUTION: 1. Attempt to slide wire back in to the tube on the opposite side or,
2. Attempt to clip the wire with fingernail clippers (if wire is flexible)or,
3. Apply wax, warm salt-water rinses as needed.
PROBLEM: Wire is out of the tube.
SOLUTION: Place wire back in the tube or clip the wire behind the last tooth that the wire goes through.
Lace and Ligature Ties
PROBLEM: Twist tie is poking lip.
SOLUTION: Use the end of a pencil eraser to tuck the tie away from the lip.
PROBLEM: Broken lace poking lips.
SOLUTION: Tuck the poking part away from the lip if lace is under the wire. If lace is on top of the wire, remove the broken lace.
Stops
PROBLEM: Sharp and rubbing lip.
SOLUTION: Apply wax, can attempt to file with a nail file, use warm salt water rinses two to three times per day to help with irritation of the lips.
PROBLEM: Stop is sliding around wire.
SOLUTION: Apply wax around the stop to secure it into place.
Chain
PROBLEM: Chain is broken and irritating the cheek.
SOLUTION: Clip chain with a pair of scissors and call the office the next business day to schedule an appointment.
Biteplate
PROBLEM: Can’t wear it because it impairs speech.
SOLUTION: Practice speaking as much as possible and continue to wear your biteplate 24/7.
PROBLEM: Biteplate will not stay in the palate when eating or talking.
SOLUTION: Apply a small amount of denture adhesive (ex: Fixodent or Polydent) to the biteplate and place in the palate.
Bite Blocks/Turbos
PROBLEM: Bite block/turbo is worn down and you are biting on brackets.
SOLUTION: Be careful when eating; call the office to schedule an appointment.
PROBLEM: One of the bite blocks has come off.
SOLUTION: This is okay and as long as you are not having any discomfort and you have one still attached, there is no reason to do anything. If you are having discomfort, please call the office to schedule an appointment.
PROBLEM: Patient is only biting down on one bite block/turbo.
SOLUTION: This is normal and as long as you are not having any discomfort, there is no reason to do anything. If you are having discomfort, please call the office to schedule an appointment.
Appliances
Carriere
PROBLEM: Upper part of the Carriere has detached from the tooth closest to the front but is still attached to the back tooth.
SOLUTION: Do not attach elastics. Apply wax to the loose part of the Carriere and call the office to schedule an appointment.
PROBLEM: Back part of Carriere has detached from the back tooth but is still attached to the tooth closest to the front.
SOLUTION: Do not attach elastics. Apply wax to the loose part of the Carriere and call the office to schedule an appointment.
Lower Lingual Holding Arches (Space Maintainers)
PROBLEM: The bar behind the teeth has detached from the molar band.
SOLUTION: Wiggle the bar with firm pressure until it breaks free from the opposing molar band. Apply wax to sharp areas around tongue. Call the office on the next business day to make an appointment.
Palatal Expanders
It is important to turn the expander all the way back until the key cannot turn any further. Make sure you do not turn the expander in the opposite direction (forward) while removing the key.
PROBLEM: The expander key will not go into the hole. The last turn was not completed all the way and therefore the hole is not completely open.
SOLUTION: Find the last hole from the previous turn and complete the push back towards the patient’s throat.
PROBLEM: Food stuck in the roof of the mouth.
SOLUTION: Brush the palate daily; use a Water Pik and rinse thoroughly.
PROBLEM: Space opening between two front teeth.
SOLUTION: This is normal; it will close within a few weeks.
PROBLEM: Impaired speech.
SOLUTION: Practice talking and placing your tongue at the roof of your mouth. Reading out loud is great too!
PROBLEM: Bands on the expander are irritating the cheeks.
SOLUTION: Warm saltwater rinses two to three times per day. Apply wax as needed.
PROBLEM: A band has become loose and unattached from the tooth.
SOLUTION: Push the band back around the molar tooth and call the office to schedule an appointment.
Bonded Retainer
PROBLEM: Bonded retainers are glued to the back of your teeth, and over time can become loose or broken. Check daily for any loose pieces of glue.
SOLUTION: Call the office to schedule an appointment to have it repaired. The gum tissue will become inflamed and swollen around the retainer without proper brushing and flossing.
Direct Injuries to the Mouth or Teeth
Following a direct injury to the mouth or teeth, whether undergoing orthodontic care or not, you should be seen by your family dentist as soon as possible. Usually, an X-ray of the involved tooth or teeth is needed to determine the extent of the injury. If a tooth has been fractured or broken, it is best to contact your family dentist first, since we may not have the necessary materials needed to treat these injuries. If orthodontic appliances are dislodged or displaced, we will need to replace or adjust them as soon as possible. Please call our office immediately after seeing your family dentist. If you are unable to reach your family dentist or an alternate emergency facility, call our office and we will assist you in locating someone to care for the injury.
