Care of braces

It is very important to maintain a meticulous oral hygiene during your orthodontic treatment. Dr Daxter Yeo recommends that while you are having orthodontic treatment, you should brush your teeth immediately after breakfast, lunch, dinner, and any snacks. Permanent white decalcified areas of irreparable damage to your tooth enamel can occur if teeth and braces are not kept clean. You may also develop gum disease if gums are neglected.

Regular dental check-ups must be maintained with your family dentist during our treatment. Regular cleanings are especially important while wearing braces, and the frequency of check-ups will vary among patients. Generally, it is at least every 3 to 6 months. More frequent cleanings may be needed for those individuals with periodontal disease (gum) problems.

Brushing your teeth

It is important that you brush your teeth at least 3 times daily, and particularly after every meal and snack, using a toothbrush with soft bristles and a toothpaste that has fluoride in it. You should brush for no less than 3 minutes each time. There is no rush, taking the time to brush will help prevent future problems later. Brush every surface of the tooth, as well as the gums and gum lines. This will help remove harmful bacteria and food particles that can injure and damage your teeth.

Redness, puffiness, soreness or bleeding means you have to brush and floss more. Plaque is a yellowish build-up on teeth and braces. Good brushing, a mirror, and disclosing tablets will help you keep your teeth and braces clean. Disclosing tablets are used to disclose the areas where plaque accumulates. Using the tablets regularly will help make sure you are cleaning effectively. An example is Disclotabs by Colgate which helps stain food debris, plaque and poorly cleaned areas bright red.

Using a toothbrush:

Stimulate gum tissues by pointing the brush at a 45 degree angle toward the gum.

Brush the gums. Move the brush gently along the gum line using a circular motion. It is important to brush your gums as well as your teeth. Spend about 5 seconds on each tooth before moving onto the next tooth.

Brush the braces. Keep your brackets and bands nice and shiny. Press your toothbrush firmly enough so that the bristles spread into the gaps between the wire and the tooth. Brush in and around all of the brackets and wires of your braces. Angle your brush so that you can clean under your wires.

Brush the inside surfaces of your teeth. Do this using a gentle jiggling motion and systematically move the brush around your mouth, brushing the upper and lower teeth.

For the chewing surfaces, use a firm back and forth motion.

Brush your tongue gently from back to front. Tongue plaque is a common cause of bad breath.

Using an interproximal brush:

Use an interproximal brush with a tapered head to remove food and plaque between the braces where the toothbrush cannot reach.

Insert the brush underneath the wire of the braces between the teeth. Using a soft back-and-forth motion, lean and rub against the sides of each brace to remove plaque and food particles. As the brush is very flexible, you can manoeuvre it around the braces easily.

Flossing your teeth

Flossing is very important because it is very effective at removing plaque that can hide between your teeth and gums. It is important to remember that brushing alone is not enough to win the constant battle against cavities and gum disease.

Use floss that is waxed. Floss every night before you brush your teeth. This will clean the area between your teeth so that the fluoride in the water and in your toothpaste can penetrate all tooth surfaces.

To floss, gently rock the floss between your teeth so that the floss goes beyond the contact of the teeth. Scrape in an up-and-down motion each side of each tooth with the floss so that you are removing plaque from between each tooth.

You may like to use a floss threader to help you get floss between the wire and the teeth. Simply thread your floss through the threader loop, insert threader between teeth under the archwire, and slide floss up and down under the gum line and along the tooth surface. Alternatively, you may use a threading floss (eg. Superfloss). This floss has a stiffened end that allows it to be threaded in between your teeth.

Use a fluoride mouth rinse

A fluoride mouth rinse should be used every day for extra protection against permanent marks (decalcification). After brushing and flossing, use a fluoride mouth rinse before going to bed every night. Rinse your mouth thoroughly for 30-60 seconds. Do not rinse out with water after that.

Prior to using the mouth rinse, please make sure you rinse your mouth thoroughly with water after brushing and flossing. Then closely inspect your teeth and braces in the mirror to check that they are clean and shiny. Inspect the areas between the teeth, braces and gums to make sure all food particles are removed.

Use GC Tooth Mousse

GC Tooth Mousse contains Recaldent (CPP-ACP) which offers a multi-level strategy to help maintain a healthy oral environment for the duration of orthodontic treatment. It helps to prevent decay and white spot lesions.

Irrigating Devices Can Help

An irrigation device (eg. Oral B Oxyjet) uses a pressurised stream of water to clean around the gumline and areas that might have been missed by your toothbrush. It is very useful in removing debris from under fixed appliances such as palatal expanders or invisible lingual braces or patients who have difficulties in cleaning around certain parts of the braces. It has an adjustable setting for use on sensitive areas, and can be used with water alone or with a mouth rinse.

Your braces are delicately attached to your teeth and are very fragile. Special care must be exercised while eating and while playing so as not to loosen a brace or bend a wire. If a brace is loosened or a wire is bent, a special appointment is necessary to fix your braces. If not corrected immediately, this will usually delay your treatment. Be very careful about what you eat and how you eat it. If you damage your braces, this can delay your treatment time. If any of your braces become loose or broken between visits, please call our office as soon as possible. Do not wait until your next appointment to tell us about a broken appliance since it may require more time to repair than we have scheduled for you.

There are 4 types of foods that cause these delays in your orthodontic treatment:

1. Hard Foods: Hard foods may do damage by bending the wires, loosening the cement under the bands or breaking the brackets or tubes from your teeth. Certain foods may be eaten if they are served in a special way. Always cut tough foods (eg. meat, bread roll etc) into small pieces and chew them carefully. Whole fruits and vegetables such as apples and carrots should be cooked or sliced or grated and eaten carefully. Fresh corn may be eaten if sliced off the cob.
   Please avoid chewing hard candy, corn chips, crispy taco shells, ice blocks, crackling, bones, nuts, Nutrigrain, hard biscuits, pizza crusts or bread crusts. Please avoid chewing pen/pencils and fingernails.
2. Sticky Foods: Sticky foods cause damage to your appliances by bending the wires and pulling the cement seals from any bands you may have. Please don’t eat toffees, candies (eg. caramels, gummy bears), chocolates & gum as they all cause damage.
3. Carbonated Drinks: Cola type drinks and sports drinks are an absolute No-No. Please avoid these drinks to avoid damage to your teeth.
4. Foods with High Sugar Content: should never be eaten between meals. Please remember to brush your teeth immediately and very thoroughly after any meal in which sweet foods are taken.

Elastics are a vital part of treatment and are also contingent upon patient compliance. They add extra pressure to the braces to help move the teeth. Generally worn at all times (excluding eating and brushing your teeth), elastics should be changed at least once a day. They come in various sizes as they are each used for a specific purpose. We will provide you with the appropriate size. We will also tell you which direction to hook your elastics so make sure they are worn exactly in the correct position when you hook your elastics.

Change to a new elastic once every twenty-four hours or whatever duration we have told you. Remember rubber bands get tired, too! Only ever remove them while cleaning the teeth and replace them immediately afterwards. If one breaks, put on a new one on immediately. If you are running low on elastics, call us and we will mail more to you. NEVER run out!

Remember, wearing elastics to move teeth is like climbing a rope – it takes a continuous effort to accomplish both jobs; but if you let up, leave your elastics off for even a short time (i.e. one hour), you will lose all the movement gained in the past 24 hours – you’re back to the bottom of the rope! Thus, it is important to wear them consistently or treatment setbacks may occur.

REMEMBER TO:

• Wear your elastics full time:
  eg. During eating, in school, at home, when going out, sleeping etc.
• Change new elastics once a day.
• Always make sure elastics on placed on both sides. Therefore, if one elastic comes off during eating on one side, always put a new one back on.
• Never put more elastics than is recommended otherwise your teeth may be damaged.

Anytime orthodontic appliances are removed, retainers are worn by the patient to hold teeth in their new, corrected position until the gums, bone, tongue, and lips have adapted themselves to the new tooth positions. If retainers are not worn, teeth tend to relapse, or move back to their original position.

There are many types of retainers and different retainers are used depending on the orthodontic case. The removable retainers are typically worn full time progressing to a night time wear. The bonded retainer consists of a small metal bar behind the front six teeth so it is concealed from sight. It is meant to be worn permanently.

Caring for the retainer is relatively simple. A regular dental check-up appointment is necessary to ensure none of the bonding has come off. Care should be taken not to bite down on hard crunchy food where the retainer is. The removable retainer is carefully brushed with a lathered toothbrush to keep it clean. Efferdent for retainers can also be purchased at the Pharmacy and give the retainer a more effervescent cleaning.

When you need to wear your retainers

All orthodontic patients at Dr Yeo’s office are instructed to wear their removable retainers forever (just at night). Studies and statistics have shown that teeth can and will move at any time. This variable pattern of gradual shifting, called maturational change, probably slows down after the early 20s, but still continues to a degree throughout life for most people. Even children whose teeth developed into ideal alignment and bite without treatment may develop orthodontic problems as adults. The most common maturational change is crowding of the lower incisor (front) teeth. Sleeping in retainers at night forever ensures a healthy bite and fabulous smile will be maintained for life.

Simple rules to follow with your removable retainer include:

• Wear the retainer as prescribed to get the best results. Your speech may be affected for a day or two while getting familiar with the retainer. It is hard to lose or break your retainer while it is in your mouth.
• Wear the retainer when you sleep.
• When the retainer is not in your mouth, it should be in the plastic storage container you were given when you received the retainer.
• Make sure the plastic storage container has your name, address and telephone number on it in case you lose it.
• Clean your retainer daily. Don’t boil it to clean it as it will warp or melt since it is made of plastic.
• Don’t leave your retainer on the dash of a car in summertime, as it will warp.
• Don’t wrap it in a napkin and forget it on your lunch tray and accidentally throw it in the garbage. It isn’t much fun digging through the garbage in search of your missing retainer.
• Don’t flip or play with the retainer with your tongue because it may cause breakage of the appliance.
• Don’t leave your retainer in an area where your siblings or pets can find it. Dogs love to chew on retainers.
• Don’t put your retainer in your pocket or backpack unless it is in the retainer case.