At our office, we ensure that patients receive the most advanced care. Our goal is to provide orthodontic excellence that is second to none!

Your scheduled appointment time has been reserved specifically for you. We request a 24-hour notice if you need to cancel your appointment. We are aware that unforeseen events sometimes require missing an appointment, and appreciate your cooperation.

Here are some tips and products to help with good oral hygiene:

Interdental Toothbrush

A Proxabrush is an interdental (between the teeth) toothbrush that you may use to clean underneath and around your wires and braces. Use the Proxabrush gently to avoid damaging your wires. The Proxabrush will help you to clean your braces while maintaining healthy teeth and gums.

Antibacterial Mouthwash
Peroxyl, a hydrogen peroxide antiseptic mouth rinse, will reduce inflammation to your gums and cheeks. Peroxyl helps to prevent infection and decrease irritation that may develop from your braces. Rinse your mouth with two teaspoons of Peroxyl (half a capful) for one minute and then spit it out. You may use Peroxyl up to four times daily following your schedule for brushing: after meals (or after school) and before bed. Just like using peroxide for a scrape on your skin, Peroxyl helps the inside of your mouth heal. Peroxyl can be used for general irritation caused by your braces or for canker sores, cheek bites and other minor temporary injuries to the gums.

Topical Fluoride 

Phos-Flur is a sodium fluoride gel that helps prevent tooth decay while you are wearing braces by killing bacteria and replacing minerals in tooth enamel that have been exposed to harmful acids. The use of Phos-Flur does not replace daily brushing and flossing but should be done following your daily schedule at bedtime. Place a small strip of Phos-Flur on a toothbrush and apply it to your teeth for one minute and spit it out. You may not eat or drink for 30 minutes after you use Phos-Flur. It is important for the active ingredient to stay on your teeth for 30 minutes, so do not wash it away by eating or drinking.

Cleaning Your Removable Appliance

 Brush your removable appliance every day as a part of your regular brushing and flossing schedule. Because food particles and plaque can accumulate on your appliance just as they do on your teeth, soak the appliance daily. Dissolve a Polident, Efferdent or other denture-cleaning tablet in a glass of tap water at room temperature and soak your appliance once every day. Your appliance will taste better, and you will prevent plaque and bacterial accumulation.

The following is intended to provide general information regarding some of the more common orthodontic emergencies. Emergencies for patients in braces tend to be relatively infrequent and fortunately are not usually severely debilitating. Nevertheless, discomfort from a problem with the braces can occur. Listed below are some of the more common problems and some possible solutions to deal with the situation on a temporary basis. If you have concerns after attempting these repairs, please feel free to contact our office for further instructions.

Broken Braces

 Broken or loose braces are generally not considered an urgent problem in most cases. There are times when a loose brace may cause some problems, however, so it is best to call our office when the problem occurs. When a bracket comes off of a tooth, it is still normally attached to the wire with an elastics tie.

This will prevent the bracket from being swallowed, but it may move or spin around on the wire. If this is a problem for the patient, a little wax pressed against the bracket will keep it from moving around.

Loose Band

When a band (ring around the back teeth) comes loose, the patient is in no immediate harm. However, the band is normally cemented on the tooth with an adhesive that seals the inner portion of the band from saliva and plaque. If the band is left loose for a period of time (3-4 weeks), saliva and bacteria may enter into the crevice between the tooth and the band. The result could be a decalcification (white spot) on the tooth surface. It can form rather quickly, causing damage to the enamel, so a phone call to our office is recommended.

Poking Wire

Many times as the teeth move in the early phase of treatment, the wire used to straighten the teeth has no place to go except out the back of the molar band area. Also, if spaces are being closed or if the bite is being corrected, the wire will begin to get longer at the back of the braces. Fortunately, most times this can be handled at home very simply with some orthodontic wax. It is important to try and dry the area first (with a paper towel), then roll up a piece of wax into a ball. Place the ball of wax into the area of the poking wire. The wax will smooth the area and keep the tissue from getting caught on the end. If wax does not resolve the pain, please contact our office.

Orthodontic pain and discomfort

Pain and discomfort is a normal part of orthodontic treatment. The pain tends to occur about 4-6 hours after the braces are placed or after an adjustment appointment. Over the next day or two, the pain will progressively become worse. Then, after days 3-5, the pain will begin to subside. We recommend over the counter pain medication (preferably Tylenol) just prior to and after the adjustment appointments. This allows the medication to already be in the system before the pain begins, improving the effectiveness.

Injuries

Significant dental injuries while in braces can be traumatic to the patient. Immediate care should be sought from an emergency physician and dentist in these cases. Often the braces have been known to actually prevent loss of teeth, since the braces and wires had provided stability.

Lost/Broken Retainers

There are a number of variables that determine whether this is an urgent situation or not. For example, if the braces had recently been removed, there is a greater chance that the teeth will shift and move if a retainer is not replaced relatively quickly. However, every patient may differ with the potential amount of relapse. If a patient has been out of braces for a long period of time, and the teeth are in a relatively stable position, the chance of significant shifting may be low. Please call our office if your retainer is lost or broken to discuss your options.

Poking metal tie

 Occasionally, metal wires are used to tie the archwire to the brackets or bands. Sometimes during eating or brushing, this metal wire tie can accidentally be redirected and start to cause irritation to your lips or cheeks. You can try to push the poky wire back into place by using the end of a pencil eraser.

If that is not possible, you can place wax on the area causing the irritation until you can be seen at our office.

Mouth Sores

The braces have a tendency to feel rough against the cheeks, lips, and tongue, especially soon after the braces are placed. This will sometimes lead to soreness and cause discomfort. The tissues will develop a callous over time, so this becomes less of a problem while treatment progresses. In the initial stages of treatment, wax can be used in areas that are particularly painful. However, limiting the use of wax will help the patient build up the callous tissues. Temporary pain relief can also be obtained with topical anesthetics (i.e. Orabase®).

Underbite: An underbite is characterized by the lower jaw extending out, causing the lower front teeth to sit in front of the upper front teeth.

Spacing: Spacing problems may be caused by missing teeth, or they may only be a cosmetic or aesthetic issue.

Upper Front Teeth Protrusion: The appearance and function of your teeth are impacted by this type of bite. It is characterized by the upper teeth extending too far forward or the lower teeth not extending far enough forward.

Crowding: Crowding occurs when teeth have insufficient room to erupt from the gum. Crowding can often be corrected by expansion, and many times, tooth removal can be avoided.

Crossbite: The upper teeth sit inside the lower teeth, which may cause tooth stratification and misaligned jaw growth.

Overbite: The upper front teeth extend out over the lower front teeth, sometimes causing the lower front teeth to bite into the roof of the mouth.

Openbite: Proper chewing is impacted by this type of bite, in which the upper and lower front teeth do not overlap. Openbite may cause a number of unwanted habits, such as tongue thrusting.

Dental Midlines not Matched: This type of problem is caused when the back bite does not fit and match appropriately, which may negatively impact jaw and proper dental function.

Though an orthodontist can enhance a smile at any age, there is an optimal time period to begin treatment. Beginning treatment at this time ensures the greatest result and the least amount of time and expense. The American Association of Orthodontists recommends that the initial orthodontic evaluation should occur at the first sign of orthodontic problems or no later than age 7. At this early age, orthodontic treatment may not be necessary, but vigilant examination can anticipate the most advantageous time to begin treatment.

Early evaluation provides both timely detection of problems and greater opportunity for more effective treatment. Prudent intervention guides growth and development, preventing serious problems later. When orthodontic intervention is not necessary, an orthodontist can carefully monitor growth and development and begin treatment when it is ideal.

By the age of 7, the first adult molars erupt, establishing the back bite. During this time, an orthodontist can evaluate front-to-back and side-to-side tooth relationships. For example, the presence of erupting incisors can indicate possible overbite, open bite, crowding or gummy smiles. Timely screening increases the chances for an incredible smile.

Some of the most direct results of interceptive treatment are:

• Creating room for crowded, erupting teeth
• Creating facial symmetry through influencing jaw growth
• Reducing the risk of trauma to protruding front teeth
• Preserving space for unerupted teeth
• Reducing the need for tooth removal
• Reducing treatment time with braces

Orthodontics is not merely for improving the aesthetics of the smile; orthodontic treatment improves bad bites (malocclusions). Malocclusions occur as a result of tooth or jaw misalignment. Malocclusions affect the way you smile, chew, clean your teeth or feel about your smile.

According to studies by the American Association of Orthodontists, untreated malocclusions can result in a variety of problems:

• Crowded teeth are more difficult to properly brush and floss, which may contribute to tooth decay and/or gum disease.
• Protruding teeth are more susceptible to accidental chipping.
• Crossbites can result in unfavorable growth and uneven tooth wear.
• Openbites can result in tongue-thrusting habits and speech impediments.

Between the ages of 11 and 15 is the most common time for orthodontic treatment, and for good reasons. By 12, most if not all of the permanent teeth have erupted and are in place, and crooked teeth, gaps and bad bites can easily be detected. These problems will hardly ever correct themselves, so this is when most parents decide to seek orthodontic treatment.

This is also a good time for orthodontic treatment because many negative associations of braces are not present. Many children in this age range undergo orthodontic treatment, and children are very often able to be convinced to wear braces because they see their friends wearing them, too, and want to fit in.

Besides the benefits of fitting in with their friends, children at this age are growing rapidly, and orthodontists can usually take advantage of these growth spurts to help shape the bite and teeth correctly. And children at this age have high metabolisms, which can help shorten overall treatment time and reduce the discomfort of orthodontic treatment.

Braces aren’t just for kids anymore. Tooth alignment can be changed at any age if your gums and bone structure are healthy. We offer a variety of treatments that are designed for different age groups – including adults. A new smile can begin today.

Orthodontic treatment at later stages in life can dramatically improve your personal appearance and self-esteem. Improving the health of your teeth and gums is equally important. Crooked teeth and a bad bite can contribute to gum and bone loss, tooth decay, abnormal wear of the tooth enamel and surfaces, headaches and jaw joint (TMJ/TMD) pain.

Good news! The new techniques and appliances we use greatly reduce discomfort levels, decrease the frequency of visits, shorten treatment time and may allow you to choose from several options. Your options may include metal braces, translucent braces or transparent aligners that can be worn at night to improve mild cases of misaligned teeth.

During the initial examination, we will be able to determine the best possible treatment for your individual needs. During this initial examination, we can outline the treatment plan, time of treatment expected and the approximate cost.

A large percentage of our patients are adults, and they agree that it’s never too late to improve their greatest asset – their smile.

For most situations, common sense will tell you what to avoid. Hard foods, sticky foods and foods high in sugar must be avoided. Hard foods can break or damage wires and brackets. Sticky foods can get caught between brackets and wires. Minimize sugary foods; they cause tooth decay and related problems. Nail biting, pencil and pen chewing and chewing on foreign objects should be avoided.

Examples of Sticky Foods to Avoid:

• Gum (sugar-free or regular)
• Licorice
• Sugar Daddies
• Toffee
• Tootsie Rolls
• Caramels
• Starburst

Examples of Hard Foods to Avoid:

• Ice
• Nuts
• Hard taco shells
• French bread crust/rolls
• Corn on the cob
• Apples and carrots (unless cut into small pieces)
• Bagels
• Chips
• Jolly Ranchers
• Pizza crust
• Uncooked carrots (unless cut)

Minimize Sugary Foods like:

• Cake
• Ice Cream
• Cookies
• Pie
• Candy

Only Once a Day:

• Soda
• Sweetened tea
• Gatorade
• Kool-Aid
• Drinks with sugar

It’s important to regularly check your braces for bent or loose wires and brackets. In the event of a loose/broken wire or bracket, call our office immediately to arrange an appointment for repair.

Headgear

Headgear is often used to correct an excessive overbite. This is done by placing pressure against the upper teeth and jaw, which would hold the teeth in position or help move them into better positions. The severity of the problem determines the length of time headgear needs to be worn. The key to success with your headgear appliance is consistency. Headgear must be worn a certain number of hours per day, and if not, it must be made up the following day.

Headgear should never be worn while playing sports and should also be removed while eating or brushing your teeth.

Herbst 

One of the most common problems orthodontics treat is the discrepancy that occurs when the upper teeth protrude beyond the lower. Ordinarily, when we see a patient with the upper teeth protruding, we tend to think that the upper jaw and teeth are too far forward; but, more often than not, this condition is due to a small lower jaw that is further back than it should be. With these patients, we would like to encourage the lower jaw to catch up in growth, and braces like the Herbst appliance help this happen.

Even though the Herbst appliance prevents the lower jaw from moving backward, opening and closing movement still occur easily, and patients do not have any problems learning to chew their food with their lower jaw in this new position.

As with all kinds of braces, patients with Herbst appliances need to be careful about what they eat. For instance, cold foods such as ice slushes, Popsicles and ice will freeze the cement and make the brace loosen. Sticky foods such as caramels, bubble gum and candy suckers will pull the brace away from the teeth. 

Hard foods like crisp vegetables and hard candies will bend and loosen the Herbst appliance, too. So stay away from these foods during your orthodontic treatment.

Your Herbst appliance will be checked and adjusted at your appointments. If, sometimes between appointments, you develop some sore areas on the inside of your cheeks, please do not try to adjust the appliance yourself. Call for an appointment so that the necessary adjustments can be made.

At first, your mouth will feel unusually full and speaking will be awkward. But if you practice reading aloud, your ordinary speech will return quickly. You may also notice more saliva than normal, but this will decrease as you become accustomed to the appliance.

Interproximal Recontouring

Interproximal recontouring refers to a procedure in which we will reshape your teeth by sculpting the sides of the teeth. This can correct cracked, chipped, crooked or misaligned teeth. Instead of braces, crowns or veneers, you can choose to have interproximal recontouring to change the shape and look of your teeth to enhance your smile!

Lip Bumpers

 We like to avoid pulling teeth as often as possible, so we use lip bumpers on our patients who need to create more room for their crowded teeth. The lip bumper is a wire on the lower jaw that extends from one molar to another and keeps lips and cheeks from touching your teeth. When you move your mouth or speak, your lips and cheeks push on the bumper, and the bumper applies pressure to the teeth. This pressure pushes the molars back, creating more space for overcrowded teeth.

If you have a lip bumper, please remember to leave it in while eating, but do not eat hard or sticky foods. Proper, thorough brushing should remove any food that gets stuck in your lip bumper.

Retainers

When we remove your braces, we will begin the retention stage of your treatment. The retention phase lasts for a minimum of 24 months. Your final orthodontic result depends on your retainers, so follow through with the hard work you’ve put in so far. Remember to remove your retainer before brushing, and brush your retainer before placing it back in your mouth.

Tongue Trusting Appliance

 Tongue thrusting occurs when the patient presses his or her tongue against the front teeth, usually when swallowing, speaking or resting the tongue. If thrusting is constant, this can cause problems with teeth alignment and must be fixed.

We prefer to correct tongue thrusting by giving patients a tongue thrusting appliance. This appliance, similar to a mouth guard, is usually worn at night. Other times, a more permanent appliance is prescribed and can be only be adjusted by our office.

Spacer Instructions

This is the first and one of the more important steps in the beginning of your orthodontic treatment. Follow these simple instructions:

1. DO NOT REMOVE THESE SPACERS. Spacers are designed to “make space” for the back molar bands. This will make your next appointment easier and faster.
2. Spacers feel like something is caught between your teeth… that’s because something is caught between your teeth. If you ever had popcorn or meat caught, you know the feeling.
3. Brush normally – you cannot brush the spacers away.
4. Floss normally – but DO NOT floss the spacers.
5. If a spacer is lost, it does not need to be replaced.
6. If necessary, take aspirin or Tylenol (or your regular pain medication as directed). Rinse with warm salt water (1 tablespoon of salt in 8 oz. of warm water) three to four times per day.
7. The spacers will be removed on the day your braces are placed.

Elastics Instructions

 Wearing elastics (rubber bands) is a critical phase of your treatment. Cooperation and following instructions can speed up your treatment. This could mean finishing braces faster. NOT cooperating and NOT following instructions could mean wearing braces LONGER and not getting the result you want!

1. Elastics are to be worn 24 hours per day, 7 days a week; no vacations.
2. Change them 2 times a day; morning and night.
3. If one (1) breaks, change them both; always carry some with you because they will break.
4. DO NOT wear more than one on each hook. Too much force is as bad as not enough force.
5. The package of elastics should last from one appointment to another. If you are running low CALL and we will mail you some more. Don’t run out, because…
6. Missing one (1) hour takes three (3) hours to catch up; missing one (1) day takes three (3) days to catch up.
7. If worn as instructed, it will feel funny and uncomfortable to be WITHOUT your elastics.

We know you can do it. Think of you elastics as the key to the motor that, when turned on, gets your braces OFF!