Patients in Treatment

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Toothbrushing & Flossing | Elastic Bands | Removeable Appliances | Retainers


Fixed Braces


Now that you are actually in treatment, you will be well aware that you have certain responsibilities regarding the maintenance of your teeth and braces and progressing your treatment so that you can finish as soon as possible! You will have received plenty of instruction when the braces were fitted, whether fixed or removable, but this section will act as a reminder and a reference for you. Fixed or bonded braces are dealt with first and removable appliances and retainers later.

The braces have just been fitted:

Most people experience definite discomfort and will require the use of over-the counter pain-killers similar to those used for a headache or sore throat. After about three to five days, the teeth will have settled down and be much less uncomfortable. The braces also rub against the lips and cheeks and you will be given some wax and instruction on its use to cover any particular part of the braces that irritate. Again, after a few days, the mouth has toughened up and the rubbing will have improved.

After each adjustment appointment, the teeth will be stirred up again but this should not be as bad as the initial stage.

Eating and biting

The mouth is a very tough environment for braces which must be strong enough to stick on the teeth throughout all the biting and chewing that teeth are designed for - and yet these braces have to be removed from the teeth at the end of treatment without damaging the teeth. Instructions are given at the beginning of treatment regarding what can be eaten or not and various techniques for eating the harder foods that may damage the braces. As time goes by, patients do adapt and cope very well. Few patients lose weight during treatment!

Breakages

When the braces are first fitted, you will be asked to check them very carefully every day. The best time is when you have brushed your teeth at night (which should be the best brushing of the day) and you should stand in front of the mirror and pull your lips aside to carefully check your toothbrushing and to check that all the parts of the braces are in place. If something is broken, it is important that you phone the practice as soon as possible and we will arrange a time to see you promptly. Please do not just come into the practice on the chance that we will be able to see you straight away as we may be too busy at that time and may be unable to see you until later.

Something is sticking in!

As the teeth move, the ends of the wires at the back of the mouth may well become long and start to dig into your cheek. While this is a sign of progress, it is certainly not something that you should have to put up with – contact our office for an appointment time and we can usually make you comfortable quite quickly. Before the appointment, you may find the use of wax over the wire gives it some temporary relief.

It is of great assistance to us when arranging an emergency for a breakage if you are able to give a clear indication as to what part of the braces is causing the problem.

Have a look at the parts of braces feature so that you can inform our office so we can make the appropriate appointment.

Toothbrushing & Flossing

Toothbrushing

Obviously it is more much difficult to clean your teeth with braces on and instruction about brushing and flossing will be given. The main points about brushing are:

Brush at least twice a day, certainly after breakfast and after dinner, before going to bed. This night-time brushing (and flossing) must be the best brushing of the day.
Your toothbrush should be soft and should be quite plain, without any fancy bits in the middle or shaping.
The most important part to brush is the gum line, top and bottom, inside and out. Use short strokes and do not press hard, ensuring that the bristles get between the teeth and underneath the archwire. Then do the same action from the other side of the archwire. Don’t forget the biting surfaces and the inside of the teeth.
You may have to use one of the fine interdental brushes to get between the teeth.
Rinse your mouth and then stand in front of the mirror, pull your lips and cheeks aside and check that, in particular, the gum line is clean and the braces are shiny. Also, make this the time that you check that all the braces are in place and that nothing is broken.
We recommend that you use a mouthwash like Savacol or Listerine (which comes in a non-alcoholic solution) twice a day. Follow the instructions on the bottle, including not rinsing your mouth after using the mouthwash as this will reduce its effectiveness. If you notice that your teeth are getting a slight brown stain from the Savacol, stop using it and change to Listerine.

Flossing

Now that you have braces on, flossing your teeth is even more tedious than before! However, it is probably even more important than previously. You will be given instructions which involve threading the floss underneath the archwire between each of the teeth. The floss must be moved up and down the side of each tooth up into the gum. Because it is so time consuming, we recommend that you do this five nights per week and have two nights off!

Elastic Bands

Elastic bands are used to move the top teeth against the bottom teeth in order to coordinate and correct the bite. When we ask you to wear them, it is because they are essential and, unless instructed otherwise, they must be worn 24 hours a day.

When worn consistently, the teeth start to move and continue to move in the desired direction. When the elastics are only worn intermittently, the teeth start to move and then when the force is no longer applied, they quickly move back to where they were and the productive movement has been totally lost. If the elastics are left off for one hour, you may lose four to six hours worth of actual elastic wear. If you leave the elastics off for a day or so, you may lose a week’s worth of wearing them.

Sometimes you will be asked to wear the elastics part-time which usually means that we are trying to maintain an achieved position.

Usually you will be asked to change the elastics twice a day and you should carry a bag of elastics with you all the time as they can break. Do not worry if you swallow an elastic as they are totally safe.

Should you lose your elastics or have any problems like a broken hook or even because you think that your bite is going funny, contact us straight away and we will send you more elastics or arrange to see you promptly.

As with any adjustment, you may get sore teeth with the elastics at first but, over time and with consistent wear the teeth will settle and no longer be uncomfortable.

Removable Appliances

When a removable appliance has been fitted, it will feel like quite a mouth full particularly if it has a posterior bite plane, which only allows the back teeth to make contact on the plate. As the teeth start to move, there will be some discomfort, requiring the use of pain killers. After a few days, the plate will have settled in and the teeth will no longer be sore. It is essential that the plate is worn 24 hours a day and is only taken out for cleaning, sports requiring a mouth guard or swimming.

If it is taken out for sports or swimming, it must be placed in a safe container and not simply put in a pocket. We strongly suggest that the plate is worn during eating because as soon as it is out of the mouth, it is at risk of being broken or being thrown out with the kitchen rubbish. Also, the longer the plate is out of the mouth, the more the teeth will relapse to their previous positions.

Cleaning

The appliance must be cleaned well at least twice a day and, if something has been eaten, it should be removed and rinsed, the mouth rinsed and the plate replaced in the mouth. Cleaning only requires the use of a toothbrush and toothpaste and don’t forget to keep the teeth and roof of the mouth that are in contact with the appliance well brushed also.

Problems

If any part of the appliance breaks or you have trouble wearing the appliance, contact us promptly so that we can repair the appliance or make any adjustments.

Adjustment appointments are usually three to four weekly during active tooth movement. When the desired result has been achieved, the appliance may be worn at night only as a retainer. Appointments at this stage will be at much less frequent intervals. When you are only wearing the appliance part-time, it should be cleaned when removed from the mouth and put in a glass of cold water during the day. Note: dogs like these appliances and will chew them to bits if they find them lying around!

Retainers

When your active treatment has been completed and the braces have been removed, it is important to hold the teeth in this corrected position until they have settled. The teeth are still under influences from the surrounding bone, gums, tongue, lips and cheeks which may try to move the teeth slightly. Some pre-treatment features of the original tooth positions are quite prone to relapse. Retainers are used to allow natural settling of the bite and to resist adverse or unslightly movement or relapse towards the original problem. It is not possible to guarantee that your teeth will remain in a perfect position for the rest of your life. Every part of the body changes with growth and ageing and the teeth are no exception.

Retainers are therefore very important and consist of flexi-wires bonded behind the upper and lower front teeth and a removable appliance for the top teeth and sometimes for the bottom teeth.

The upper retainer will be worn 24 hours a day for three to six months and then at night time only for an extended period. If a lower retainer is provided, this will be worn at night time only.

Appointments

Retainer appointments are three to six monthly, initially, and then at longer periods as the teeth show good settling.

Breakages

If the retainer is lost or broken, contact the practice as soon as possible for a repair or replacement. There will be a charge for this.

When the retainer is being worn part-time, it should be cleaned when removed from the mouth and placed in a glass of cold water when not being worn. Remember that dogs like these appliances and will chew them if given the opportunity

The retainer must be worn 24 hours a day, even when eating. It should only be removed for cleaning, sports or swimming. If removed for sports, it must be placed in a safe container to prevent loss or breakage. The appliance should be cleaned with your toothbrush and toothpaste at least twice a day. After eating, the appliance should be rinsed in cold water and the mouth rinsed before replacing the appliance.

刷牙和牙线 | 橡皮圈 | 活动矫正器  | 固定器

固定矫正器

在戴固定矫正器时,你有责任很好的配合我们保护您的牙 齿和矫正器, 使您的治疗尽快的顺利结束。 通常戴完固定 矫正器以后会戴固定器。我们会给您很多信息和指导。

刚戴上固定矫正器后:

大部分病人在刚戴上固定矫正器后都会感到不舒服,疼痛,头痛或喉咙痛,需要用止痛药,但3-5 天后会缓解。另外也 会感到矫正器磨到嘴唇和面颊的粘膜,我们会给你口腔蜡包 在矫正器外面,过几天您就习惯了。

以后每次调整后,您也会感到痛几天。

饮食影响

口腔的咬合是非常有力的,所以托槽粘在牙齿上是可以承 受很大的咬合力,而且拿掉托槽后也不会损伤到牙齿。我 们会给您足够的指导让您远离容易损伤矫正器的食物,大 部分的病人都会合作良好。有些病人可能会体重减轻。

矫正器损坏

当您戴上固定矫正器以后,我们会指导您如何检查您的矫 正器。您必须在每天刷牙时仔细检查您的矫正器有无损坏,如发现有任何损坏请尽快联系我们。我们会尽快帮您预约 时间修复。请一定要先打电话预约,不要直接来诊所因为 我们已有病人就无法看您了。

刺痛感

当牙齿开始移动,钢丝的后面会长出来。您会感到刺痛非 常不舒服。请尽快打电话给我们,我们可以帮您修复。在 就诊前可以用蜡保护一下。

如果在您预约时能告诉我们是什么东西坏了,对我们很有 帮助。

请看“矫正器的组成”,告诉我们是哪一部分坏了。

刷牙和牙线

刷牙

下面是一些如何清洁的指导:

每天至少刷牙两次,早饭后和晚饭后。晚上睡前刷牙 应该是最好的。
您的牙刷最好是又简单又软的。
刷牙时最重要是靠近牙龈的部位,里面和外面轻轻的刷另外托槽之间和钢丝下面也都要刷干净,不要忘记 刷咬合面。
您可以用齿间刷清洁牙齿之间。
最后漱口然后拉开嘴唇检查一下,是否都刷干净了,特别是靠近牙龈处,同时检查一下矫正器是否完好无损。
您可以用漱口水每天两次。请根据说明书用,如 Savacol or Listerine (不含酒精)。用完后不漱口效果更好。如用了Savacol 出现黑斑,请停止使用改用 Listerine。

牙线

当您戴固定矫正器时,用牙线是非常重要的。我们会教您 如何用牙线,建议您每周5 天用牙线2 天可以不用。

橡皮圈

橡皮圈是用来纠正上下牙齿的咬合。当我们让您使用时,通常需要一天24 小时戴,除非我们给您特殊的要求。

当您一直戴着时,牙齿开始移动。您不戴时又回到原来的 位置,如果您一小时不带那您原来戴的4-6 小时都没用了。
如果您一天不带,那您原来戴的一周都没有作用。

有时候我们让您不是全天戴。 那是因为我们想要维持您现 有的咬合通常我们会让您一天换两次,所以您可以随身戴一包橡皮 圈。如果您不小心吞下橡皮圈也没关系。

如果您发现戴橡皮圈的钩子坏了或您的咬合变得奇怪,请 立即与我们联系,我们会尽快看您。

当您刚带上橡皮圈时可能会有些痛,但过一些时间就好了。

活动固定器

当您戴上活动矫正器后, 会觉得很不习惯。如果戴后牙抬高矫正器时,只有您的后牙和矫正器接触。当牙齿开始移动会感觉不舒服和疼痛,可以吃些止痛药,过几天就会好了。活动矫正器必须一天24 小时戴,只有刷牙或有些运动时可以摘下。

当您运动或游泳时摘下矫正器,必须妥善保管,不要随手放在口袋里容易损坏也容易丢失。活动矫正器不戴时间越长,牙齿就越容易移回到原来位置。

清洁

活动矫正器必须一天清洁两次。如果吃完东西也最好马上拿下来清洗。可以用牙刷和牙膏仔细清洁每一部分。

问题

如果发现活动矫正器有损坏或戴不上,请马上跟我们联系,我们会尽快帮您修理或调节。

活动矫正器通常3-4 周调整一次。当达到所需效果时,您可能只需要晚上戴。此时当您拿下矫正器必须清洁干净放进冷水中浸泡。

活动固定器

当您做完治疗,最重要是保持您的牙齿不移动,这时牙齿还没有在牙槽骨中生长牢固。 嘴唇的肌肉会让牙齿移动,而且通常会移回做治疗前位置。 戴固定器是唯一可以保证牙齿长期不移动的方法。人的身体一直在变化,牙齿也一样。 除了戴活动固定器以外,还要粘上固定钢丝在上下前牙的里面。

上牙活动固定器通常一天24 小时戴3-6 个月,以后只要晚上戴。下牙活动固定器只需晚上戴。 预约复诊时间在戴上活动固定器以后,通常3-6 月后来复诊。

损坏

如活动固定器丢失或损坏了,请尽快与我们联络,我们可 以帮您修理或重做,但有额外收费。

当您只是晚上戴时,白天可以泡在冷水中。小心如果家中 有狗的话,它会喜欢咬固定器。

活动固定器必须24 小时戴,包括吃东西时。如运动不戴时,请放在安全的盒子里,以免损坏或丢失,必须保持清洁。