After Orthognathic Surgery
You will notice that it is much harder to keep your teeth clean with braces. Food compacts in the brackets and between your teeth, and can only be removed by brushing and flossing. If plaque remains on the teeth for any length of time, it will leave a permanent white scar on the surface. Brushing after meals should become part of your daily schedule. Use a soft toothbrush with firm pressure and brush at a 45-degree angle to the tooth; brush in small circles above and below the brackets. Click here for visual instructions. Your toothbrush will wear out faster because of your appliances, so be sure to replace it whenever the bristles start to fray. A Waterpik can be a useful addition but it cannot remove the sticky plaque that adheres to the teeth. Interplak toothbrushes are great. Flossing is important and should be done every day. The floss threaders are reusable.
Please do not eat hard foods: nuts, ice, crisp taco shells, whole apples and carrots (cut them into pieces first), hard French bread crust and rolls, spareribs, corn on the cob (cut the corn off the cob before eating), and popcorn! These foods risk breaking brackets and wires. Also beware of nail biting and pen or pencil chewing habits, since these can damage your braces. Do not eat sticky foods: taffy, caramels, bubble gum, or sticky candy of any sort. Use common sense about most foods.
- No Gum:
- Sugarless or otherwise
- Sugar Daddies
- Caramel Apples
- Sugar Babies
- Tootsie Rolls
- Now & Laters
- Corn on the Cob
- Pizza Crusts
- Carrots (uncooked)
- Minimize Sugar Intake
- Eat Much Less
- Ice Cream
- Cake, Cookies
- Foods with Sugar
- Drink Much Less
- Drinks with Sugar
Check braces once a week for anything loose or bent. If a bracket or band comes loose or you break a wire, please call our office so that we can arrange an appointment long enough to repair it. Try to explain what has happened by using the diagram provided. Be as specific as possible with the receptionist. If you lose your rubber bands, call us so we can mail you some more or drop by the office and pick some up.
After braces are placed in the mouth it is normal for the teeth to be sore for about 2 or 3 days. Tylenol or Advil will help relieve this discomfort. Some irritation to the cheeks and tongue is normal, but if you feel anything sharp is poking you or any sores are developing, please call our office at (617) 731-8888.
Attached to your braces, elastics (rubber bands) exert the proper force that creates the right amount of pressure to move teeth. In order for this force to remain constant, elastics must be worn all the time and changed every day. Any time missed in wearing your elastics will only make your treatment take longer, so remember these things:
You are responsible for placing the elastics on your braces between appointments. Make sure to wear them as instructed. Remove them only when brushing your teeth, gums and braces after meals. Then put them back on immediately.
Always carry a few elastics with you, so if one breaks you can replace it right away. If your supply is low, call the office and we will mail you an additional supply of elastics.
If you forget to insert your elastics one day, don’t double up the next day — just follow your regular instructions.
Elastics become worn out. When they lose their elasticity, they don’t provide the proper pressure on your teeth and jaws. It is very important to change them as directed, even when they are not broken.If your elastics break frequently, a wire or band loosens, or a hook breaks off — call our office immediately. Don’t wait until your next appointment. These problems need to be corrected as soon as possible!
The removable appliance is carefully designed to move or to hold your teeth. It is important that it is worn according to instructions and brought to each appointment.
Wear your appliance at all times, even while you are asleep. It may be removed while eating, swimming, or playing vigorous sports activities. In two or three days your speech will return to normal with the appliance in place. Avoid flipping your appliance with your tongue. This can cause damage to your teeth or breakage of your appliance.
Your new appliance may make your teeth sore for a day or two, especially after an adjustment. If you have a sore spot on your gums call our office so that we can adjust the appliance.Clean your appliance by brushing it daily with toothpaste. Denture cleaner can also be used for a more thorough cleaning. If you are wearing a bonded wire retainer behind your front teeth, be extra careful to clean the wire and the area around it. Flossing should be done every day.
Never wrap your appliance in a paper napkin or tissue and set it down on the table. You or someone else may throw it away. Don’t put it in your pocket when playing or you may break or lose it. Whenever it is not in your mouth it should be in its plastic appliance case.
Keep your appliance away from dogs or cats as they love to chew on them. Avoid storing them near any source of heat. Do not boil your retainer to sterilize it! If needed, bring it to the office and we will be happy to disinfect it for you.
An additional charge will be incurred for lost or broken appliances.
Orthodontic Brushing and Flossing
Brush after every meal.
(pictures are displayed on website corresponding to the instructions)
Use a toothbrush with a small amount of toothpaste.
Use circular, vibrating motions around the gumline for about 10 seconds on each tooth.
Brush every tooth slowly.
Brush the lower teeth up and the upper teeth down. Also brush your tongue and the roof of your mouth.
Floss nightly after brushing to remove the plaque missed by brushing.
Carefully pull waxed floss between wire and braces.
Floss carefully around the braces.
Floss carefully around the gum area.
Floss around each tooth.
Proper Oral Hygiene
Improper Brushing and Flossing
If a wire causes irritation, push the wire away from the area using the eraser end of a pencil or a Q-Tip. If the wire cannot be tucked away, cover the end of the wire with a small piece of wax, a cotton ball, or a piece of sugarless gum until you can see Drs. Nissenbaum and Sacks for an adjustment.
If the main wire has come out of the tube or pipe on your back molar tooth, attempt to reinsert the wire with a pair of needle-nosed pliers or tweezers. If the wire is not sticking you, place a piece of wax over the area. If the wire is sticking you and wax does not help, the wire can be cut with a small wire cutter or toenail clipper close to the back of the last brace. This is a last resort if professional help is unavailable.
In case a rubber spacer falls out, take two pieces of dental floss and insert them through the spacer. Pull on both pieces of floss to stretch the spacer, then slide the spacer back and forth between the two teeth where it belongs. Once the bottom half of the spacer slips under the tight spot between the teeth, release and remove the floss and the spacer will fit back properly.
If a bracket becomes loose, it usually remains connected to the main wire by a little rubber colored ring. Eyebrow tweezers can be used to reposition the brace if it flips around the wire and becomes a source of irritation. Call our office and inform us of your situation.
If a piece of your braces breaks, save the piece and call our office to schedule a repair visit.
Remain calm if you swallow a piece of your appliance. This will usually go into the stomach, passing out of the body in a bowel movement. However, should difficulty breathing be experienced you should seek immediate medical attention. X-rays will be taken to determine the location of the swallowed piece.
If a retainer cracks, remove the retainer from your mouth and bring all the pieces to our office for professional repair.
Take Aspirin, Tylenol or Ibuprofen (unless allergic) if your teeth are sore after a monthly visit.
Rinsing your mouth with a cup of warm water and teaspoon of salt can also be soothing. If you teeth get sore suddenly in the middle of the month, give us a call. It is unusual for the teeth to get sore several weeks after your last office visit.
If food becomes stuck between your teeth, use dental floss or a proxy brush to dislodge the food.
If you cut your gums, tongue or the inside of your cheek, apply finger pressure to the bleeding site for several minutes. If the bleeding does not clot, call your orthodontist or family dentist.