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Life with Braces
Life with Braces
Eating with Braces

What can you eat? Let’s talk about what you shouldn’t eat! For the first day or so, stick to soft foods. Avoid tough meats, hard breads, and raw vegetables. Before long, you’ll be able to bite a cucumber again. But you’ll need to protect your orthodontic appliances when you eat for as long as you’re wearing braces.

Foods to Avoid
  • Chewy foods: bagels, hard rolls, licorice
  • Crunchy foods: popcorn, ice, chips
  • Sticky foods: caramels, gum
  • Hard foods: nuts, candy
  • Foods you have to bite into: corn on the cob, apples, carrots
  • Chewing on hard things (for example, pens, pencils, or fingernails) can damage the braces. Damaged braces will cause treatment to take longer.
General Soreness

When you get your braces on, you may feel general soreness in your mouth and teeth may be tender to biting pressures for three to five days. It is very important to keep chewing as this will help reduce the tenderness. Chewing sugar free gum (stick type only i.e. Trident, Extra) can also help to decrease soreness. If the tenderness is severe, take Tylenol, 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 wax on the braces to lessen this. We’ll show you how!

Loosening of Teeth

This is to be expected throughout treatment. Don’t worry! It’s normal. Teeth must loosen first so they can be moved. The teeth will again become rigidly fixed in their new — corrected — positions.

Loose Wire or Band

Don’t be alarmed if a wire or band comes loose. This happens occasionally. If a wire protrudes and is irritating, use a blunt instrument (the back of spoon or the eraser end of a pencil) and carefully, gently push the irritating wire under the archwire. Simply get it out of the way. If irritation to the lips or mouth continues, place wax or wet cotton on the wire to reduce the annoyance. Call our office as soon as possible for an appointment to check and repair the appliances. If any piece comes off, save it and bring it with you to the office.

Care of Appliances

To successfully complete the treatment plan, the patient must work together with the orthodontist. The teeth and jaws can only move toward their corrected positions if the patient consistently wears the rubber bands, or other appliances as prescribed. Damaged appliances lengthen the treatment time.

Brushing

It’s more important than ever to brush and floss regularly when you have braces so the teeth and gums are healthy after orthodontic treatment. Patients who do not keep their teeth clean may require more frequent visits to the dentist for a professional cleaning.

Athletics

If you play sports, it’s important that you consult us for special precautions. A protective mouth guard is advised for playing contact sports. In case of any accident involving the face, check your mouth and the appliances immediately. If teeth are loosened or the appliances damaged, phone at once for an appointment. In the meantime, treat your discomfort as you would treat any general soreness.

Types of Braces
traditional braces

Traditional Braces

The most common and widely used brace is the traditional metal bracket, which is made of stainless steel and designed for predictable and optimized tooth movement. These brackets are low profile, very comfortable and can have colored ties added to them at every visit for a more colorful, fun and unique smile.

ceramic brackets

Esthetic Braces

Esthetic brackets are a great option for many adults and older teenagers.These brackets are clear and are made to blend in with the tooth, creating a more cosmetic look than traditional brackets. While these brackets are more visually pleasing, they do require increased care with oral hygiene as well as home maintenance because they are larger and more brittle.

Invisalign

Invisible Braces

“Invisible Braces” such as Invisalign, are clear plastic aligners that prefabricated to incrementally move the teeth into a pre-determined position. These aligners can also be great alternatives to traditional brackets for older teenagers and adults looking for a more cosmetic route to straighten teeth. These aligners are not only invisible, but they are also removable which allows for easier brushing and flossing. Patients also love this option because the trays are comfortable and do not tend to irritate the mouth as much as traditional braces. Dr. Periago is a Preferred Invisalign Provider. Check out more information at www.invisalign.com

Types of Appliances
Appliances Images Forsus Forsus Image Appliances

Forsus™ Fatigue Resistant Device

Class II correction (correction of an overjet/”overbite”) can be challenging for all parties involved. Many overbites can be corrected via removable elastics or rubber bands. Some corrections are so difficult that traditional elastics alone are not sufficient for full correction. When severity of correction and patient compliance is an issue, Dr. Periago recommends the Forsus appliance for overbite correction.

Appliances Image RPE Appliance Image Quad helix Appliances Trex image

Palatal Expanders

Palatal expanders are fixed appliances that expand/widen the roof of the mouth. Sometime’s a patient’s upper jaw needs to be enlarged for a proper fit with the lower jaw and a healthy, stable bite. In such cases, Dr. Periago may widen the upper jaw with an expander.

Dr. Periago recommends two different types of expanders a Rapid Palatal Expander (RPE) or a Quad helix. The RPE requires adjustment at home whereas the quad helix is adjusted in the office. Dr. Periago will let you know which appliance is right for your child based on their growth and development. These devices spread the center of the palate into two halves thereby separating the upper jaw. New bone then fills in between the two halves and the upper jaw remains permanently wider. This procedure is very well tolerated by children and creates virtually no discomfort!

HOW LONG WILL EXPANSION WITH AN RPE TAKE?

This is determined by Dr Periago depending on your specific needs, but activation typically lasts several weeks. Once the activation period is complete, the expander MUST stay in place for 4-6 months. This allows new bone to form in the roof of your mouth which will insure that expansion will not relapse.

HOW WILL IT FEEL?

  • Some initial discomfort and “PRESSURE” may be felt: other times a tingling or itch under the expander may be experienced.
  • A tingling sensation or pressure may occur on the bridge of your nose.
  • You also might hear a “POP”; this is the suture separating and is completely normal.
  • The first noticeable effect of the “RPE” is that the front teeth may begin to separate creating aspace between the front teeth. This is a sign that the appliance is working properly, do not panic! The space between your front teeth is temporary and will close naturally after the key turning is stopped.

HOW TO ACTIVATE YOUR RPE:

  • Insert the key carefully into the hole or slot in the middle of the appliance.
  • Push the key gently and steadily from the front toward the back of your mouth.
  • Do not back the key up: remove the key back towards the throat. Make sure you can see the next hole come around to the front of the appliance for the next turn.

T-REX APPLIANCE OR PENDEX DISTALIZER

This appliance is used to create space in the upper jaw when crowding is present preventing full eruption of the teeth. This appliance is also used to correct mild class II bites by moving the molars back in the mouth allowing the top molars to properly fit together with the bottom molars in an ideal relation. While design of this appliance is intended to counter forward movement of the teeth, patient compliance is very important to avoid unwanted effects such as flaring out of the upper incisors. Working together as a team with our patients is a must with this particular appliance.

Appliances TPA Appliances Lingual Arch

Lower Lingual Arch

A lingual arch is an orthodontic device which connects two molars in the upper or lower dental arch. The lower lingual arch (LLA) has an archwire adapted to the lingual side of the lower teeth. In the upper arch the archwire is usually connected to the two molars passing through the palatal vault, and is commonly referred as “Transpalatal Arch” (TPA).

Lingual arches are typically used for space maintenance or for prevention of space loss. They are used to stabilize permanent molar position and can also be used to stabilize molar position in the attempt to avoid side effects that can take place during orthodontic therapy. As a space maintainer lingual arches are frequently used in cases where an early loss of the second primary or “baby” molar takes place. In such a case a lingual arch prevents the permanent molars from moving forward thus blocking off the eruption space for the premolar teeth. The lower lingual arch is also used in order to maintain the “Leeway space”, which is the extra space available in the arch when the primary or “baby” molars are lost and replaced by smaller permanent premolars.

Appliances Face mask Image

FACEMASK

One of the most pressing developmental problems of the mouth in children is a developing underbite. Underbites can be due to disharmony in the growth of the upper and lower jaws. Between the ages of 7-10, we have the ability to move the upper jaw forward in order to correct a deficient upper jaw. It is very important to do so at this time due to the fact that the upper jaw stops growing before the lower jaw. If the upper jaw remains behind the lower one, surgery may be required for full correction once the jaw growth is complete.

The facemask appliance can be worn by children in order to promote upper jaw growth. It is well tolerated by children and is composed of two parts: A fixed piece that is cemented into the mouth and a removable face frame portion that is worn at home in the evening hours as well as while sleeping. Treatment time typically lasts 9-12 months.

Oral Care
oral care

The best way to ensure a beautiful and healthy smile while in braces is through proper brushing and flossing. Plaque that accumulates on teeth can ultimately result in scarring of teeth, decay and gum disease. Dr. Periago and her staff will thoroughly instruct you on proper oral hygiene technique when you have your braces placed.

Brushing

It is important that while you are in braces that you brush your teeth after every meal…even after snacks. It is important that you pay close attention to thoroughly clean all tooth surfaces paying special attention around the bracket. It is imperative that you brush above the bracket and at the gumline thouroughly. This is the most common spot that white spots or scars are found when braces are removed

Flossing

For areas between the teeth that a toothbrush can’t reach, use dental floss to remove food particles and plaque. Flossing takes more time and patience when you are wearing braces, but it is important to floss your teeth every day. Dr. Periago also recommends an air flosser for tough to reach spots. Flossing your gums will decrease swelling that can occur around brackets and attachments and should be done every evening before going to bed.

Retainers
Retainers

Once orthodontic treatment is completed it is necessary to maintain the teeth in their final position with retainers. There are several types of retainers that Dr. Periago recommends: the Hawley Retainer, the Essix Retainer and a Fixed Retainer. Dr. Periago will let you know which retainer she recommends for you or your child.
Retainer wear is extremely important to maintain a stable bite and smile for a lifetime; therefore Dr.Periago recommends indefinite wear of retainers. When braces are removed Dr. Periago will give detailed instructions on how much the retainers need to be worn. Typically retainers are worn full time except while eating and brushing for 8 weeks following the removal of the braces. At this point, Dr. Periago will decrease the amount of time retainers must be worn until night time only wear is appropriate.

Basic Retainer Guidelines:

  • Store your retainer only in your retainer case…do not place them in your pocket because they can break!
  • Do not wrap your retainers in napkins or place them on lunch trays…they almost always end up in the garbage!
  • Keep retainers away from dogs and pets…they love to eat them!
  • Clean your retainer every time you brush your teeth! Clean retainers with a separate tooth brush and antimicrobial soap. Retainer cleaners can be used no more than once every several months. Do not boil or place your retainers in the dishwasher as they will warp and no longer fit!

PLEASE call us during regular business hours if you lose or break your retainer so that we can schedule an appointment for a replacement retainer. Remember your teeth can relapse quickly in the first few months after braces are removed so please do not forget to let us know! You’ve worked hard for your smile! Please wear your retainer to keep your smile beautiful and healthy for the rest of your life!

Emergency Care

What to Do in Case of a Problem with your Braces

Call our office as soon as possible during regular business hours if you break or loosen any of your appliances. Please do not come directly to the office – by calling us, you will allow us to create a time to see you. Even if you have a regular appointment scheduled, call us immediately to notify us if you need an appliance repaired.

Loose Brackets or Bands

Call our office during regular business hours for advice if a bracket or wire is loosened. The bracket may need to be re-fitted as soon as possible. If you need to cut a wire in while at home, you may use clean craft clippers or fingernail clippers. Please call our office the next day during regular business hours so that we may schedule an appointment for you.

Wire Irritations

Sometimes discomfort caused by a wire on your braces can be resolved by moving the wire away from the irritated area with a cotton swab or clean pencil eraser. If the wire will not move, try covering the end of it with a small piece of cotton or a small amount of wax. Sometimes you will need to dry the area before with a cotton swab before you apply the wax so the wax will stick. If the wire is painful, you can cut it with nail clippers or scissors that have been washed. If you cannot resolve the wire irritation, call our office during regular business hours for an appointment.

Lost Separators

Most patients lose a separator during their treatment. Do not worry about losing a separator, but call our office during regular business hours to see if it needs to be replaced.

Discomfort with Orthodontic Treatment

During the first week after your braces are in place and routine adjustments are complete, you will likely feel some soreness or discomfort. While adjusting to your new braces, you may take the same pain reliever that your family doctor recommends for a headache. A warm wash cloth or heating pad may reduce the soreness in your jaws.

Accident involving a chipped, or knocked out tooth

Most accidents involving a slight chip to a tooth is best handled initially by your general dentist. However if you are in active orthodontic treatment and experience severe trauma to the teeth resulting in tooth mobility, please call our office immediately. If it is not during business hours please leave a message on the emergency line and your call will be returned by Dr. Periago.

Please see the following links for some helpful videos for taking care of problems that may arise while in your braces: www.bracesquestions.com