AFTERCARE

You have chosen to wear braces to make your smile beautiful and healthy. But braces can damage your teeth and gums if you don’t look after them. These instructions will help to deliver the end result safely. Please continue with your regular check-ups with your dentist during orthodontic treatment.

FIXED BRACES

Cleaning your Teeth

Before bed & after breakfast, clean under the wire and in between the brackets using a bottle brush. Then, brush all surfaces your teeth with a manual or electric toothbrush, applying a pea-sized amount of fluoride toothpaste. Clean the edges of gums thoroughly by running the brush in a circular action regardless of bleeding. Bleeding and swollen gums are a sign of gum disease from excess plaque. After snacks, lunch and dinner, use the bottle brush and fluoride mouthwash to rinse the food out, holding it in your mouth for 1 minute before spitting. Don’t rinse with water afterwards and let the fluoride work to harden the enamel of your tooth. Avoid eating or drinking anything for 1 hour.

Drinks

Sugary and fizzy (carbonated) drinks, including fizzy water, alcoholic drinks and natural fruit juices are very acidic in your mouth. They dissolve the protective enamel of your teeth and cause decay leaving permanent marks (or holes) when the brace is removed. These drinks are best during meals. In between meals, it is best to drink plain water, milk, or sugar-free juices. Avoid natural fruit juices too.

Food & Snacks

Each time you eat, your saliva breaks down the starch into acid, weakening the enamel. Grazing & snacking throughout the day increases these acid attacks on your teeth. Sticking to 4 meals is better. It is more comfortable to eat really soft foods for the first few days to avoid the pain from chewing. Broken brackets and wires can hurt the mouth. Avoid biting into sweets, nuts, apples, crusty bread, pizza crusts and burgers. Break your food, suck it until it is soft, chop it, slice it or squash it with a fork.

It takes 2 days for the glue to harden fully. Even then your brace is vulnerable to hard foods. Tea/coffee, red wine, curry & smoking stain the teeth and discolour the little elastics on white braces. Smoking impairs bone healing during tooth movement risking permanent loosening of teeth.

Sports & Musical Instruments (please ask us for advice)

An orthodontic gum-shield can be worn over a fixed brace to protect your teeth during contact sports. Ask us for more orthodontic wax if you play wind instruments; use it for the first few weeks.

Problems & Breakages

Use orthodontic wax (if you are stuck, Babybel wax or sugar-free gum) to cover the sharp edges which are making your lips and cheeks sore; dry the brace with a tissue first. Teeth may feel tender or loose for a couple of weeks. Eat soft foods and use normal painkillers. A broken brace does not work! Hard foods, nail-biting and chewing pens are common causes of breaking a brace. Wasting time to repair your brace will prolong your treatment by 4-6 weeks. If the broken brace is not uncomfortable, you may be able to wait until your next appt. Please let us know anyway, especially if many brackets are broken so that we can allow time to fix them all. Please call us for advice if you have any problems. If we are not available in an emergency, do whatever is necessary to ease the situation and we will repair the brace as necessary. Your dentist or the emergency dentist at The Jubilee Centre (St. Richards Hospital) may also be able to help.

ALIGNERS

Wearing Instructions

You have a limited time of 2 hours a day to eat, brush and kiss! After eating do a quick social clean and put your aligners in straight away. If you don’t have a brush handy, simply rinse with water and insert your aligner. Clean your teeth thoroughly twice a day.

When removing the aligner, please always keep it in your box. Please avoid putting them in your pocket as they may break. Avoid putting them in tissue as tissues get thrown away by mistake! Each aligner is usually worn between 7-10 days or sometimes longer until it is no longer active. Ritu will tell you what time interval is needed for you. Don’t change your aligner unless it is fitting perfectly and is no longer active.

Chewing silicone fingers is a simple and effective way to secure the fit of the aligners each time you insert them in your mouth. Please use the chewie for a good 5 minutes each time. This action also creates forces and electrical currents in the jawbone that stimulates the bone around the roots to change. Studies have shown that the teeth move faster and more precisely in patients who use chewies compared to those who don’t.

Cleaning Instructions

To clean the aligners, you can use your toothbrush and toothpaste to scrub them. Please use cold water as they are made of plastic and can distort with hot water. Please remember that aligners don’t need to be sterile so avoid using harsh chemicals.

Rinse your mouth after meals before putting the aligners in but it is okay to have a drink of water to remove any large particles of food if you do not have access to a bathroom.

Do not eat food with your aligners in. Teeth and attachments can discolour with tea, coffee, red wine, turmeric (in curries, tagines & oriental soups), green tea and other herbal drinks. This staining is not permanent (just like a teacup) and can be cleaned by a hygienist. Adding more milk to tea/coffee will certainly help. You can also use a straw to drink virtually any cold or warm liquid to by-pass your teeth. Obviously, reducing the number of cups you have is best.

The saliva in your mouth breaks down your food into sugar, each time you eat. The bacteria on your teeth & gums digest this sugar & convert it into acid which dissolves the enamel covering. Your teeth are more vulnerable because the aligners are covering them and stopping the saliva from washing away the sugars and trapping the bugs and sugar against your teeth. I advise you to avoid snacking between meals and avoid drinking sugary, fizzy, or acidic liquids when you are wearing your aligners. Wash your mouth with water before you put them back in and brush twice a day.

Monitoring Instructions

Everyone is in a hurry to finish treatment. Speeding through the aligners may mean that teeth will not have time to move. Teeth move at a biological rate. Side effects are painful and loose teeth, week bone and gums, shortening of the roots and failure of tooth movement. For difficult movements allow 10–14-day changes and for easy movements 5–7-day changes. I will let you know how often I would like your aligners changed at each stage of your treatment. If you feel your teeth are not ready for a new aligner, then stay on the current one a few extra days. Be organised with your aligners so you don’t mess up the order. Keep the used aligners in the correct bag and put is back in your box. Each aligner has the number written in minute figures.

Every effort should be made to ensure each aligner fits perfectly before moving to the next. Errors will be magnified with each successive aligner and the tooth or teeth will fail to move. Look out for a loss in fit of your current aligners before you move to the next one. Take a photo and send it to me.

Please check daily if all your attachments are still present and the aligners fit well. Let us know if you suspect an attachment has been lost.

Please keep old aligners in case we need to move back a one (or more) steps in your treatment. Bring your old aligners in to us.

REMOVABLE RETAINERS

Wearing Instructions

Every night for 1 to 2 years! It takes a week to get used to wearing retainers. To get used to them quicker, you may wish to wear them 1-2 hours before you go to bed. They will feel tight for the first 10mins. Wear your retainers regularly every night to maintain a good fit and prevent harmful forces on the teeth caused by tight retainers. If you miss a night, wear it longer the following day.

Don’t eat or drink with it them in; don’t keep them in your pocket or leave them wrapped in tissue next to your plate. Dogs also love chewing them!

If you can’t wear your retainers for any reason please call us for advice as soon as possible! If you can’t wear it at night, put them in during the day otherwise your teeth will move out of line. Please tell us if your teeth are moving in the daytime despite wearing the retainers every night. If you lose or break your retainers call us immediately. There is a charge for making new ones. Broken or split retainers can still be worn in most cases - use your judgment.

If you have left your retainers out, they will feel very tight to wear or they may not fit at all if it has been a while. Call us for advice. Tight fitting retainers can move your teeth back into line if they are worn full time for a few days. This can also place damaging forces on the teeth. If it does not fit because your teeth have moved too much, then call us to discuss your options.

Bring your retainers to your next appointment so that we can check them. Some people grind their teeth at night and crack them. Keep them safely in a box and remember to take them on holiday, weekend away or school trips.

Cleaning Instructions

When you take them out in the morning clean them with a soft tooth brush under running cold or lukewarm water and put them in your box to drain & dry. You can use washing-up liquid or hand-wash soap daily if you need a detergent. Don’t use toothpaste or hot water. Once a month, soak them in a brace/denture cleaner or white wine vinegar. Dilute “Milton” is also fine.

Replacement Retainers

Call us immediately for new moulds before your teeth start moving. The fee will be collected when we take the impression (£100.00 each)

What happens after I have been discharged?

In the long term retainers need to be worn at least 3 nights a week or as many nights as you feel it necessary to keep them fitting comfortably. It is better to wear them more often than less. You will be discharged from our care 1 year after completing treatment. Thereafter it is your responsibility to wear your retainers, buy new ones or seek advice as required.

We hope that you are happy with your smile! Life-long retention is now recommended to keep your teeth straight for the future. Please contact us or any orthodontist for advice if you are experiencing any problems or need new retainers.

FIXED RETAINERS

Eating with your Fixed Retainers

You will need to be careful not to bite into anything too crunchy with your front teeth as you may shear the wire off. Please use your back teeth to chew crunchier foods.

Cleaning your Fixed Retainer

Clean the wire with your toothbrush as usual. Use teepee brushes to clean under the wire to avoid plaque build-up.

Please get your dentist and hygienist to check your wires when you go for a check-up, sometimes it is hard to tell if they are broken.

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Hold That Smile - Why are retainers so important?

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BOS Retention Campaign- Hold that smile

My fixed brace is broken

Teeth can be moved by applying constant gentle forces. Braces are tools which help us to move teeth in the direction we choose. There are many types of braces and they all have different uses. with their own advantages and drawbacks. Orthodontists choose a brace which will deliver the best results in their hands. Braces are not a modern invention; they have been around for more than 100 years.
Can I have braces on the NHS?

Children below 18 years of age may be entitled to have brace treatment through the NHS. Your dentist will assess you and make a referral to the local NHS clinics. Adults generally do not qualify for NHS treatment unless their problem is very complicated and likely to require treatment in a hospital setting. This often involves a combination of braces and surgery or management of compromised teeth. Adults cannot be referred directly to the hospital department without seeing an orthodontist to assess the suitability for referral. A private consultation will be necessary to see if you are suitable for hospital referral.
Am I too old for braces?

There are no age limits. Teeth can be moved at any age, provided there are enough of them to allow a brace to be placed effectively. It is never too late to consider orthodontic treatment, if you would like to change your smile. The only requirement for orthodontic treatment is good dental health and a willingness to wear a brace. More adults are choosing to wear braces later on in life. In most cases orthodontic treatment does not have to be done in the teens. However, it is true that some problems are best treated earlier. Generally, teeth tend to move faster in children than adults.
Will my brace look ugly?

Modern braces are invisible or certainly discrete. At your consultation appointment we can discuss which brace may be most suitable for delivering the result you want. People from all walks of life have orthodontic treatment; from celebrities and career people to students and busy mums etc.
Doesn’t orthodontic treatment take years to finish?

Most treatments take 9-18 months to compete. Mild problems can be treated in less than 9 months and complex problems can take 2 years or more. Treatment time also depends on the treatment aims and the type of brace used. We can discuss all options and braces with you to help you make the best decision for your needs.
Will my brace be painful?

Wearing a brace is uncomfortable during the first week whilst you are getting used to it. Regular painkillers can help during this period but not many people require them. The brace can rub on the lips and cheeks and the wire can sometimes dig in but all these problems are temporary. We will give you dental wax to ease the rough areas. Eating soft food also helps. Most people are able to cope with the inital soreness.
How will I eat?

Eating can be difficult at the beginning as the teeth are tender for a week or two after starting of the treatment. It is best to have very soft foods that do not require chewing. As you get used to the brace, you will manage to have a more normal diet. However you will always have to avoid biting into hard chewy or sticky foods (eg. nuts, toffee, whole carrots) because they are likely to break the brace. You can have most things as long as you make it easier to eat by cutting it into small pieces. Fizzy or acidic drinks (including natural juices and sparkling water) and sugary snacks need to be avoided because they dissolve enamel and cause tooth decay.
Will brace treatment interfere with playing sports and wind instruments?

A gum shield must be worn when playing contact sports. A removable brace can be taken off for contact sports. A gum shield can be worn over a fixed brace. When playing wind instruments the lips can press against the brace, however it is rarely a major problem unless you are career grade.