While we can’t see you for your routine appointments, we still want to keep in touch with you. Please look after yourselves, your teeth and your braces.
• Make sure you brush your teeth and braces 3 times a day. Use your manual toothbrush or electric toothbrush, as well as your interdental brushes.
• If you have fluoride mouth rinse use it once a day.
• Avoid snacking on sugary foods as much as possible.
• To minimize the risk of breaking your braces (displacing a wire or a bracket coming off your tooth), avoid biting into hard and chewy foods. Don’t bite your nails or chew pens or pencils!
The British Orthodontic Society have issued a list of common orthodontic problems that may arise. Some of which could be handled at home:
Wires Digging In
• If the wire is thin and flexible, it may be possible for the patient or family member to use tweezers to place wire back into the tube (or band) or use tweezers and a nail clipper/scissors to shorten the long end.
• It may be that a thin wire is the correct size but may have rotated (slipped) round the teeth, through the brackets, so that it is short on one side of the mouth and long on the other. It may be possible to push the wire back round to prevent the long end digging in, by using tweezers or a pencil with a rubber on the end to push it back.
• If the wire is very thick and stiff (discuss with your orthodontist) it may not be possible to cut the wire with home instruments. If this is the case, it may be necessary to cover the wire to prevent the sharp end from digging in. Relief wax/silicone (Orthodontic Wax) can be used. Failing that you can use Blu tack or even sugar-free chewing gum to cover the sharp ends.
Bracket or Band Coming Off
This is not urgent unless it is causing trauma to your cheeks or gums.
• You can leave a fractured bracket it in place, attached to the wire. Please keep the tooth underneath it clean and stick to a low sugar diet as much as possible.
• You can cover it with orthodontic wax or Blu tack if it is irritating the cheek or gums.
• You can attempt to remove the bracket by removing the coloured elastic that holds it to the wire (discuss with orthodontist as we maybe able to talk you through removing the fractured bracket from the wire)
• If a band comes off (metal ring around the tooth), leave the band in place. If this occurs please ensure you adhere to good oral hygiene and a low sugar diet to prevent decay under the band and around your tooth (discuss with orthodontist).
Lost Module (coloured elastic holding the wire to the bracket)
• No action required – Try and secure the bracket with orthodontic wax, Blu tack or sugar-free chewing gum.
Elastic Bands
• Continue to use your elastic bands as instructed. When you run out of them, please stop wearing them until you see us again.
Fractured/Frayed Power Chain
• Accept situation– most powerchains will denature in 4-6 weeks and become passive.
• Remove powerchain with tweezers if necessary.
• Cut fayed end as short as possible to improve comfort.
Exposed End of Wire Tie – long ligature or short ligature.
• Re-tuck sharp end under wire/bracket using teaspoon or tweezers.
• Remove wire if broken with tweezers if possible.
• Cut fayed end as short as possible to improve comfort with nail cutters or scissors.
• Cover for comfort using Ortho wax, Blu tack or sugar-free chewing gum.
Separators
• I you have separators in place (Usually blue in colour and are placed between the teeth to create space) attempt to remove them with a toothpick, a small paper clip or a safety pin.
Removable/Functional Appliances
• Check for comfort and retention.
• If unsure about how much to continue to wear the appliance discuss with your orthodontist.
• If fractured or ill-fitting do not wear the appliance.
• If a spring lost or fractured and the removable appliance can still be worn comfortably then accept and continue to wear (discuss with orthodontist)
Band off Quadhelixes or Palatal arches
• Discuss with your orthodontist about the nature of the looseness and take advice accordingly.
• Push band back onto tooth if it will locate and ensure you adhere to good oral hygiene and a low sugar diet to prevent decay under the band and around your tooth.
Gold Chains
• If the gold chain was recently placed and is now dangling down, it may be possible to cut it short. Gold is quite a soft metal and it may be possible to cut the chain using some nail scissors or nail clippers. Always hold the loose end with tweezers or similar item. If possible, leave at least 5 links through the gum so it can used later by your orthodontic team.
• If you have a non-dissolvable coloured stitch discuss with your orthodontist about the feasibility of removing it at home using nail scissors to prevent a minor infection in the gum.
Lost Retainers
• It may be that your orthodontist has access to your final moulds and can make a new retainer remotely which can be posted out to you.
• If it is not possible to get replacement retainers, you could consider ordering online a ‘boil in the bag’ (heat mouldable) gumshield to use and wear at night to reduce the risk of relapse (unwanted tooth movement). It should be noted that these appliances aren’t specifically designed to hold teeth in position so the manufacturer cannot be held responsible for any relapse. Please contact your orthodontist before investing in this strategy to ensure all aspects of this compromise for retention are understood.
Broken Bonded Retainers
• Push wire back down towards the tooth as much as possible. (Fingers or tweezers).
• Cover with best medium available (Ortho wax, Blu tack, sugar-free chewing gum).
• Cut the exposed unbonded wire using tweezers and nail clippers/scissors.
• Gently pull the wire to remove the whole retainer.
• Use a removable retainer over the teeth if available.
Aligner therapy
• If your current aligner is in good order keep wearing it as much as possible.
• If your current aligner is broken or ill-fitting, step back to your previous aligner.
• If neither option is open to you, contact your orthodontist as it may be possible to have a new aligner at the correct stage made for you and sent out to you.