Orthodontist,Portland,OR - Drs. Jerry Rensch & Joseph Dugoni

Teeth and Braces
Brushing
Flossing
Fluoride Rinse or Gel
Appliances and Retainers
Rubber Bands or Elastics
Foods

Loose Brace
Poking Wire
Wire Out of the Back Brace
Poking Rubber Band Hook
Sore Teeth

Teeth and Braces
Good hygiene is important so treatment can proceed as expected and you can avoid damage to teeth and gums. Your most important job is to keep your teeth and braces clean and free from damage. Although teeth are more difficult to clean with braces, we will talk with you about techniques that will make your care more effective.

Make sure to clean your teeth thoroughly before your orthodontic appointment. If you must brush at your appointment arrive early to do this so you can be seen on time.

Brushing
You should brush your teeth 4-5 times per day.

Brush back and forth between the wires and gums on the upper and lower to loosen any food particles.
Next, brush correctly as if you had no brackets or appliances on.
Then brush with the bristles at a 45 degree angle toward the gum and scrub with a circular motion two or three teeth at a time using ten strokes. Repeat this on the inner and outer surfaces of all teeth.

Look in the mirror to see if you have missed any places. Your teeth, brackets and wires should be free of any food particles and plaque.

If your gums bleed when brushing, do not avoid brushing, but rather continue stimulating the area with the bristles. Be sure to angle your toothbrush so that the area under your gum line is cleaned. After three or four days of proper brushing, the bleeding should stop and your gums should be healthy again.

Flossing
Use a special floss threader or super floss to floss between your braces. Be sure to floss at least once a day. This is critical for optimal health of your teeth and gums.

Fluoride Rinse or Gel
Recommended for preventive measures and usually done at night. Follow instructions on the container carefully.

Appliances and Retainers
Clean your retainer or appliance by brushing with toothpaste, dish soap, or by soaking in white vinegar or a denture cleanser. If you are wearing a fixed retainer, be extra careful to brush the wire and all surfaces.

Things to remember include:

Always bring your retainer to each appointment.
Avoid flipping the retainer with your tongue as this can cause damage to your retainer and
teeth.
Place your retainer in its plastic case when it is removed from your mouth.
Never wrap your retainer in a paper or tissue, someone may throw it away.
Excessive heat will warp and ruin your retainer.

Rubber Bands or Elastics
Wear your elastics correctly, attaching them as you are told. Wear elastics all the time, unless otherwise directed. Take your elastics off while brushing and change them once or twice a day. If elastics are worn intermittently, they will continually “shock” the teeth and may cause soreness. Sore teeth between appointments usually indicate improper wear or inadequate hygiene.

Foods
Certain foods can damage teeth or braces, both of which cause unnecessary delays in your orthodontic treatment. Foods to be eliminated or cautious of include:

Sticky, sugary foods - most candy’s and candy bars
Hard foods - nuts, ice cubes, chicken wings, popcorn kernels
Foods to cut into pieces – apples, pears, carrots, corn on the cob, bagels

MANAGING ORTHODONTIC PROBLEMS

Most problems you experience can be self-managed; however, we are always happy to see you to provide assistance. Below are a few simple steps you can take for common problems.

Loose Brace
Occasionally, a brace may come loose. You can remove the loose brace by removing the attachment to the wire or leave it where it is. Consider applying wax to the loose brace to eliminate irritation. Call the office on weekdays to notify us or schedule an appointment so we can replace your brace.

Poking Wire
If a wire is poking your gums or cheeks there are several things you can try until you can get to the office for your appointment. First try a ball of wax, or a piece of sugarless gum on the wire that is causing the irritation. You may also try using a nail clipper to cut the piece of wire that is sticking out. Sometimes, a poking wire can be safely turned down so it no longer causes discomfort. To do this you may use a pencil eraser or some other smooth object.

Wire Out of the Back Brace
Please be careful to avoid hard or sticky foods that may bend the wire or cause it to come out of the back brace. If this does happen, you may use needle nose pliers or tweezers to put the wire back into the slot in the back brace. If you are unable to do this, you may clip the wire or turn it down with a pencil eraser to remain comfortable.

Poking Rubber Band Hook
Some brackets have small hooks on them for rubber band wear. These hooks occasionally become irritating to the lips or cheeks. If this happens, you may either use a pencil eraser to carefully push the hook in, or you can place a ball of wax on the hook to make the area feel smooth.

Sore Teeth
You may experience some temporary minor discomfort after beginning treatment or after orthodontic adjustments. This is normal and should diminish with 24-72 hours. A few suggestions to help with the discomfort:

Rinse with warm water
Eat a soft diet
Take an over the counter pain reliever

RETAINERS

At the completion of the active phase of orthodontic treatment, braces are removed and appliances called retainers are placed. Teeth must be retained or held in their new positions while the tissues, bone, gums, tongue and lips have adapted themselves to the new tooth positions. It is extremely important to wear your retainers as directed. Examples of retainers include:

Hawley: Removable upper or lower retainer used to maintain alignment after treatment.
Modified Hawley: Specially designed removable retainer used to maintain
alignment of the lower anterior teeth.
Bonded Retainer: Fixed or attached bonded retainer typically placed on the inside
of the lower front teeth.
Invisible Retainer: Clear removable retainer used to maintain the position of the
teeth.

TREATMENT APPLIANCES

Removable Appliances
Tooth movement is typically slower and done by gradually tipping teeth. Patients must cooperate to avoid loss or breakage of their appliance and wear their appliance as directed. Examples of removable appliances include:

Bite Plate: Appliances used to hold teeth apart so teeth can be moved and
the bite improved.
Crossbite: Appliance used to move a tooth or teeth into proper position
and occlusion.
Invisalign: Clear retainers used to move teeth and improve fit of teeth.
Mouth Guard: Appliances used to protect teeth from trauma.
Night Guard: Appliance used to protect teeth from clenching or grinding.
Retainers: Used to hold teeth in their position.
Splints: Used to manage jaw joint symptoms.

Fixed Appliances
Tooth movement is faster, precise, efficient, and with minimal patient cooperation. Examples of fixed appliances include:

Band and Loop: Used to hold space for a missing or unerupted tooth.
Braces: Metal or clear attachment used to move teeth and establish a proper
bite.
Expander: Used to widen the upper jaw or teeth.
Forsus: Used to move the teeth from an overbite position into a good occlusion or fit of
teeth.
Habit Appliance: Used to discourage thumb, finger, or tongue habits.
Headgear/Night Brace: Usually used to correct protrusion of the upper jaw by
inhibiting forward upper jaw growth while moving upper teeth back. A specialized headgear
can also encourage the upper jaw to grow forward. Headgears are worn at home and at
night and can be very effective.
Herbst/ Functional Appliance: Used to move the upper teeth back while
repositioning the lower jaw forward.
Lingual Arch: Used to maintain or move lower teeth especially when baby teeth
are lost early or when crowding exists.
Nance: Used to maintain the position of the upper molars.
Transpalatal Bar: Used to maintain or move upper molars.