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become a Fan!What To Expect
Click on the link below to read about what you can expect
and what you need to know about
braces, expanders, headgear, lingual holding arches, and retainers.
CARE OF BRACES
Your First Few Days
Some general soreness of the teeth, jaws, and mouth is normal.
Usually this is not enough to interfere with your daily routine. However,
if tenderness is severe Acetaminophen (Tylenol) is the safest form of
pain reliever for children. Avoid harder foods that require chewing while
the teeth are tender so stick to soft, nutritious foods such as pastas,
cooked vegetables, soups, etc. This discomfort is usually worst for the
first few days after braces are first placed and then resolves. The teeth
may even appear loose which is a normal reaction so Don't Panic. Teeth
must loosen first so they can move but they will firm up again.
Eating and Braces
Protect your braces by avoiding the hard foods (some examples
are mentioned below). Loose braces or bands are not typically an emergency
but can delay your treatment.
Examples of Things You Should Not Eat or Chew...
• Ice: Can break your braces
• Pizza Crust: Bends the wires
• Corn Chips/Pretzels: Bends wires and loosens brackets.
• Hard or Sticky Candy/Bubblegum: Pulls off wires and can cause decay
(unless sugarfree).
• Nuts/Popcorn: The shells get caught between the gum and bands.
• Pens/Pencils/Fingernails: Can break braces and bend the wires.
• Corn On The Cob: Cut the corn off the cob before eating to avoid damage
to braces.
• Apples/Carrots: (and other hard vegetables/fruit) Cut up before eating.
Brushing/Cleaning
The bands /bonded brackets on braces create small nooks and crannies where food and plaque can hide and cause decay. This process can also cause permanent white lines and spots as enamel is dissolved by the acids! Bloody, swollen gums, bad breath, and food debris on wires can all be a real turnoff to your friends so:
Brush after each meal and snack.
Clean between your teeth and around each bracket daily.
Use toothpaste with fluoride.
Take time to brush THOROUGHLY with a timer.
After brushing, inspect your teeth and braces in a well-light mirror.
Floss daily with a floss threader.
See your general dentist at least every six months for professional fluoride
treatments and cleanings.
Braces won't interfere with most sports. You should always wear a mouthguard
for contact sports. A tight fitting custom mouthguard may interfere with
moving the teeth unless specially designed and manufactured. Discuss what
is best for your individual case with Dr. Fu if you have a concern.
Loose Wires Or Bands
If a wire, bracket, or band comes loose, do not be alarmed.
If a wire is protruding and irritating, use a blunt instrument (back of
a spoon, eraser end of a pencil) and carefully, gently push the wire out
of the way if possible. Wax may be placed over any irritating areas to
protect the lips, cheeks and tongue.
Please call the office to arrange for them to check or repair the appliances.
If a piece comes loose, save it and bring it with you to the office. When
calling with a concern, this diagram may help you to identify what part
of the appliance is broken or out of place.
Co-operation
Successful orthodontic treatment is a result of the technical competence of the orthodontic team, the co-operation of the patient, and good communication between us. Good co-operation and care of your appliances allows us to achieve the best results in the shortest period of time for you. It is very important that you keep your teeth and gums very clean so check them regularly. Thorough brushing, flossing, and regular use of an over-the-counter fluoride rinse reduces the risk of cavities and decalcification (white marks).
Rapid Palatal Expander
What is it for and how does it work:
The function of this appliance is to widen the upper jaw itself by separating the midpalatal suture to create more space for the permanent teeth to come in. For this to happen, your upper jaw must not be rigidly attached to the rest of your skull. If the sutures that attach your upper jaw to the rest of your skull are still open, this appliance will be able to widen the jaw itself. If your sutures have already fused, this appliance can only widen the upper jaw if you have had surgery to separate your upper jaw from your skull in key areas.
If your jaw is rigidly attached to the rest of your skull, you upper jaw can't widen and the RPE will likely have to be removed.
Instructions:
1. One full turn in either the morning or evening for 25 days (evening
is often better). It is important that you follow the turning schedule.
2. The patient should lie on a surface, such as a bed. It is helpful if
there is a source of light, such as a reading light, available so that
the inside of the mouth can be illuminated.
3. The appliance is activated by inserting the key into the hole at the
midline of the appliance. The key is rotated downward and backward as
the key moves toward the throat. The key should be pushed posterior until
the next hole in the expansion screw becomes visible.
4. The key should be removed from the appliance by pushing downward and
slightly inward on the handle. Do not deactivate the appliance by pulling
the key anteriorly as you remove it from the appliance.
5. During and immediately following the activation of the appliance, some
pressure may be experienced by the patient at the bridge of the nose,
in the region of the cheeks, or between the front teeth. This feeling
of pressure is to be expected as the appliance is activated.
6. After about one week of activation, a space usually opens between the
two upper front teeth. The appearance of the space is an excellent indication
that treatment is progressing as expected. The space will continue to
increase with subsequent activations. Occasionally, the front teeth will
become slightly mobile and sensitive. This will subside within a short
period of time. Discomfort can be relieved by taking Ibuprofen (Advil,)
or Tylenol.
7. After activation of the appliance has been discontinued, there will
be a gradual closure of the midline space spontaneously. The upper front
teeth will tend to drift and tip together. This closure of the space is
to be expected, because the fibers that connect the teeth have been stretched,
and the teeth will move together on their own. The closure of the space
is not a sign that the treatment is becoming unsuccessful.
8. If you miss a day, just pick up where you left off (do not turn twice).
9. Mark each day on the calendar as you go.
10. No hard or stickey foods (corn chips, hard candy, caramel, gum, taffy,
peanuts, popcorn, etc.)
11. Limit consumption of carbonated drinks and highly sweetened foods
and always brush after eating.
12. During the time of activation of the appliance, it is very important
that the patient is seen regularly. If for some reason you miss an appointment,
expanding the appliance should be discontinued after the prescribed number
of turns until the patient is seen. In that case, please call the office
promptly to reschedule.
13. If you have any questions regarding the management of this appliance,
or any other aspect of treatment, please call the office immediately.
14. The expander will likely be left in an additional 6 months following
full activation to allow the result to stabilize.
What to expect:
1. You will feel a mild pushing against your teeth and some
discomfort but it usually does not hurt very much. The discomfort often
decreases over the 25 days with each turn.
2. You may experience a headache.
3. You should expect to see a large gap open between the upper front teeth
and possibly some change in facial appearance. Although this is a good
sign from the standpoint that this means the two halves of your palate
are separating as they are supposed to, it can also be disheartening from
a cosmetic standpoint. By the time we tell you to stop turning the screw,
the space may look so large that you could fit another tooth in there.
After you stop turning the screw, the space will often close all by itself
within a month or so. In fact the space may close so much that the two
front teeth may cross over and overlap slightly. This will be corrected
after the braces are on and is a normal reaction to the expander.
4. You may find it easier to breathe through your nose after the expansion.
5. Your bite may feel off and that is normal.
6. Any speech or biting issues should resolve within 24 to 72 hours depending
on how much you like to talk.
7. It is helpful to eat softer foods for the first meal or two until the
patient has grown accustomed to this new feeling. Initially, a cold treat
of ice cream or popsicles may relieve some uncomfortable symptoms and
help the patient become accustomed to eating with the appliance in place.
This should not become a habit, however, due to the high sugar content.
Within a few days, the patient should be able to eat normally.
8. During meals, food may accumulate between the roof of the mouth and
the appliance. It works best to finish the meal or snack and then dislodge
the food by swishing around a mouth full of your drink.
9. It is very important that the space between the appliance and the roof
of the mouth be cleansed thoroughly each day, preferably with a WATER
PIK, if it is available. If the food particles remain under the appliance,
they may become a source of irritation to the roof of the mouth that will
become uncomfortable for the patient. In extreme circumstances, infections
may result. Please pay particular attention to the margin where the appliance
meets the gums on the cheek side and the tongue side. Improper brushing
can leave heavy plaque buildup, which will cause gingivitis. If you notice
the gums are bleeding, especially during brushing, this is a sign of gingivitis.
This can be eliminated within two to four days with adequate plaque removal
when brushing.
10. If the appliance becomes loose or if there is pain or extreme breath
odor, call the office immediately. If the patient thinks that the appliance
feels loose, even though not visibly, the patient should be seen.
Headgear
What is it for and how does it work?
Headgear is used to slow down forward growth of the upper jaw so that
the lower jaw can catch up. It also moves the molars back in the mouth
to help create space for the rest of your teeth. Headgear can move your
teeth in ways that braces cannot so be sure to wear it for as long as
Dr. Fu instructs. It should not be worn when participating in sports or
any activity in which the facebow could come loose and poke you in the
eye or cause injury to your face or mouth.
Wearing time
The Headgear is to be worn 14 hours per day. That means,
if you sleep 8 hours at night you only need to wear it 6 hours while you
are awake; sleeping time counts. Be sure to keep track of your time on
the headgear score card we gave you to be certain you are getting the
full 14 hours every day. Your molars will not begin to move until you
reach the 12 hour mark. Between 12 and 14 hours is when you will be getting
the most movement.
How to put on your headgear
Look in the back of your mouth at the big tubes on your upper
molars. The Headgear goes into those big tubes. It will only go in as
far as the bend. Put one side in first, then press the inside bow slightly
to get the other side in. Then push both sides in all the way back. Hook
one side first. To hook the other side, HOLD BOW INTO FACE AS YOU ARE
HOOKING!!! This is very important because if the bow is not held securely
in the front, it can pull out of your mouth.
How to take off your headgear
To remove Headgear pad, press the bow toward your face and
remove one side, then the other side, releasing gently. To remove the
bow, NEVER TAKE HOLD OF THE OUTSIDE BOW. That part can become distorted
if removed that way. It is important to remove it gently so you do not
loosen your bands. Take hold with two hands on the loops on the INNER
BOW next to the molars. Press in gently towards teeth and pull straight
forward. IF THE HEADGEAR DOES NOT COME OUT RIGHT AWAY, RELEASE TOTALLY
AND GO BACK AND START AGAIN. You may need to do this several times until
the Headgear comes out. NEVER JUST YANK ON THE HEADGEAR!
What to expect
The first 3 days will be the hardest for you because your
teeth will be sore as they getting used to the headgear. Tylenol can be
used until the soreness goes away and you can wear the headgear comfortably
-- usually 3 to 5 days. Wear your Headgear as close to 14 hours in a row
those first 3 days until you get used to it. You can alternate your time
during the day -- but be sure to keep track of your time to be sure you
are getting the full 14 hours. It might be easier to get used to wearing
the Headgear at night if you put it on an hour before bedtime.
Caring for your headgear
When not being worn, keep your headgear in its protective
bag. Your Headgear pad may occasionally be washed in warm sudsy water
by and left to dry. If it does become soiled just ask us for a new one.
Brush the facebow with toothpaste every day and wipe the straps with a
damp cloth.
Additional Instructions
If you feel your Headgear is crooked or bent, call the office to schedule an appointment so we can adjust it for you. Bring your headgear to each visit so that Dr. Fu can make adjustments as needed.
If you are unable to wear your headgear for any reason, give the office a call and schedule an appointment immediately. Do not wait until your next appointment.
Lower Lingual Holding Arch
What is an LHA?
This is a type of retainer designed to hold space to alleviate
some crowding and for eruption of the permanent teeth and keep the lower
front teeth in position. It stays in place until all of the permanent
teeth are in and is usually very well tolerated.
Diet
No hard or sticky foods (corn chips, hard candy, caramel,
gum, taffy, peanuts, popcorn, etc.)
Limit consumption of carbonated drinks and highly sweetened foods and
rinse afterwards with water.
Always brush after eating.
Care
• Brush teeth at least 3 times daily and floss regularly.
• Use a water pick or floss, to remove food caught underneath the appliance.
•Contact our office if the appliance comes loose or anything breaks.
These are not comprehensive lists so please call if you have any questions
about your appliance or treatment.
Retainer
Congratulations!!! You have finally completed your orthodontic treatment and have your amazing smile! In order to keep your great smile, you need to wear your retainers or else your teeth will move back. The teeth will not stay exactly where we have placed them unless you wear your retainer and it must be worn as long as you want your teeth to remain straight (i.e. for life). They will make small changes to function the most efficiently and this is normal. Please follow these directions to take care of your retainers and your amazing new smile!
• Wear your retainers FULL TIME for two months (unless otherwise instructed by Dr. Fu). You may remove your retainers while eating and brushing but you must replace them afterwards.
• After wearing your retainers for two months, you will then go to wearing them only at night. You need to wear your retainers every night for about 10 to 12 hours. If you only sleep eight hours then put them in a few hours before bed.
• Keep retainers clean by brushing them with your toothbrush. Use toothpaste on your brush and rinse; never rinse with hot water. Make sure to clean retainers before storing them in your case.
• Always bring your retainers with you for your appointments. If your retainer is lost or broken, please call us IMMEDIATELY! Again, if you do not have your retainers your teeth will move back.
• If you have pets, be sure to keep your retainers out of reach from them as they make a great chew toy. Never wrap retainers in a paper towel as they could get thrown away. If there is a rough edge, you can use an emery board to smooth it.
• If you have a permanent lower retainer, your lower retainer is glued to your front 6 teeth and will be left in for life. To clean this retainer, you simply brush it well. Use floss to get behind your retainer and in between teeth. If your lower retainer should come out, call us immediately to have it glued back in or remade. The sooner you come in, the more likely that it can be glued back in rather than having to be remade.