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Patient Letter Virtual Appointment

Braces Care Guide

With proper care, dietary restrictions, and compliance with regular appointments, issues with braces and orthodontic appliances are rare. There are times when you may need to address a poking wire or loose appliance. Please use the information on this page to learn how to recognize minor orthodontic problems. This will allow you to learn how to solve them until it is convenient to return to our office. As always, never hesitate to contact us with any questions!

Below you will find our list of potential issues that may arise as well as solutions available for correcting them:


TABLE OF CONTENTS:

DIRECT INJURIES TO YOUR MOUTH OR TEETH


BRACES

In this image, you can see the main components of your braces:

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GENERALIZED SORENESS
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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 saltwater 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
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PROBLEM: Loose bracket. Not secured on the tooth, and sliding along the wire.

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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. Further instructions for help with a missing back bracket are listed below.

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.**

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PROBLEM: Bracket off last molar tooth, causing wire to poke cheek.

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SOLUTION: Clip wire with fingernail clippers (if wire is flexible), OR clip with small sterilized wire clippers. Apply wax over end of wire. Warm saltwater rinses two to three times per day. 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.**

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WIRE HOOKS FOR ELASTICS
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PROBLEM: Hook is poking lip.

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SOLUTION: You can use a pencil eraser to tuck the hook towards the gums away from your lip. If it is a molar hook place wax over it until it stops poking. Warm saltwater rinses two to three times per day can help heal any irritation.

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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
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PROBLEM: Hooks on molar bracket poking.

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SOLUTION: Apply wax over the hook. Warm saltwater rinses two to three times per day.

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BUTTONS FOR ELASTICS
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PROBLEM: Button is causing a sore on the tongue.

SOLUTION: Apply wax and use warm saltwater 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
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PROBLEM: Wire poking or sticking out of the last bracket.

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Be mindful that wire may have shifted to one side:

Braces Brackets Help Orthodontist in Grand Rapids

SOLUTION: 1. Attempt to slide wire back in to the tube on the opposite side or,

Braces Help Orthodontist in Grand Rapids

2. Attempt to clip the wire with fingernail clippers (if wire is flexible) OR clip with small sterilized wire clippers or,

Braces Help Orthodontist in Grand Rapids

3. Apply wax, warm salt-water rinses as needed to heal any irritations.

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PROBLEM: Wire is out of the tube.

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SOLUTION: Place wire back in the tube or clip the wire behind the last tooth that the wire goes through.

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LACE AND LIGATURE TIES
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PROBLEM: Twist tie is poking lip.

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SOLUTION: Use the end of a pencil eraser to tuck the tie away from the lip.

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PROBLEM: Broken lace poking lips.

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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.

POWERCHAIN
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PROBLEM: Chain is broken and irritating the cheek.

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SOLUTION: Clip chain with a pair of scissors and call the office the next business day to schedule an appointment.

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APPLIANCES
LOWER LINGUAL HOLDING ARCHES (SPACE MAINTAINERS) and LOWER EXPANDERS
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PROBLEM: Band on one side of the appliance has come loose from the tooth.

SOLUTION: Push the band back around the molar tooth or bite it back into position with a toothbrush handle. Placing toothpaste or dental repair cement from a pharmacy on the inside of the band can help it stay in place. Call the office to schedule an appointment to repair the appliance.

PROBLEM: Bar behind the teeth has detached from the molar band.

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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.

PALATE EXPANDERS
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It is important to turn the expander key 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.

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PROBLEM: Expander key will not go into the hole. This is usually caused by an incomplete turn of the expander when it was last turned

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SOLUTION: Find the hole from previous turn and complete the push back towards patient’s throat.

PROBLEM: Food stuck in the roof of mouth.

SOLUTION: Brush the palate daily; use a Water Pik daily and rinse thoroughly.

PROBLEM: Space opening between two front teeth.

SOLUTION: This is normal and signifies good expansion; it will close within a few weeks.

PROBLEM: Impaired speech

SOLUTION: Practicing talking and placing tongue at the roof of your mouth. Typically after a week, this will return to normal

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.

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SOLUTION: Push the band back around the molar tooth or bite it back into position with a toothbrush handle. Placing toothpaste or dental repair cement from a pharmacy on the inside of the band can help it stay in place. Call the office to schedule an appointment to repair the appliance.

HERBST APPLIANCE
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PROBLEM: Herbst arm is unscrewed

SOLUTION: Rescrew arm back into appliance using a 0.05” Hex wrench

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PROBLEM: Herbst crown/band comes loose

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SOLUTION: Unscrew and remove Herbst arms for comfort, call office to schedule an appointment to re-cement the appliance.

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REMOVEABLE RETAINERS
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PROBLEM: Retainer is too tight

SOLUTION: If retainer hasn’t been worn regularly, teeth can shift and retainer will feel tight. If possible, wear retainer day and night for a few days to allow it to move your teeth back into the appropriate position. Then resume wearing your retainer as previously instructed.

PROBLEM: Retainer is too loose

SOLUTION: Apply a small amount of denture adhesive (ex: Fixodent or Polydent) to the retainer and place in the palate. Call the office to schedule an appointment for your retainer to be tightened.

PROBLEM: Retainer clasp has broken

SOLUTION: It is not uncommon for a small wire clasp to break off of a retainer. As long as retainer stays in place and does not appear to be placing extra pressure on certain teeth, continue to wear your retainer as instructed. We will determine if your retainer needs to be repaired at your next visit.

PERMANENT RETAINER
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PROBLEM: Permanent 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: Continue to wear your clear retainer over it at night. Call the office to schedule an appointment to have it repaired. Gum tissue will become inflamed and swollen around the retainer without proper brushing and flossing.

BITEPLATE
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PROBLEM: Can’t wear because it impairs speech.

SOLUTION: Practice speaking as much as possible and continue to wear your biteplate 24/7. Within a week you will be talking normally!

PROBLEM: Biteplate will not stay in when eating or talking.

SOLUTION: Apply a small amount of denture adhesive (ex: Fixodent or Polydent) to the biteplate and place in the palate.

DIRECT INJURIES TO THE MOUTH OR TEETH
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Following a direct injury to the mouth or teeth, whether undergoing orthodontic care or not, you should contact 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.