View our Patient Care Video
Sixteen video segments about what to expect and how to care for orthodontic appliances. Some of the topics covered inlude proper brushing, caring for retainers and appliances, flossing techniques, minor emergencies, relief of discomfort and more.

Food particles and plaque naturally accumulate on the teeth and on braces. This process leads to tooth decay and gum disease. Oral hygiene is vital to prevent these problems from occurring during your orthodontic treatment. The extra effort you give to keep your teeth, braces and gums clean and healthy will result in a much better orthodontic outcome.

Almost everyone brushes his or her teeth. But with braces, it's more important than ever that you clean and protect your teeth. For your teeth, it's a battle to the death between you and the plaque germs. To win, you need the proper weapons:

• Glide dental floss and a floss threader or Superfloss
• Colgate Peroxyl oral mouth rinse or Glyoxide
• A soft or extra-soft toothbrush in good shape
• An interdental proxabrush
• Fluoridex prescription strength fluoride toothpaste

We recommend that you brush your teeth right after every meal and snack. You should brush within five minutes after eating. Don't wait! Just walk right into the bathroom and brush, even at school or work! Each time, your goal should be to clean away all food particles and tastes. After the final meal or snack of the day, you should proceed as follows:

Flossing
        

The first step is to floss your teeth. Flossing is most easily done using Superfloss. Feed the short end of the Superfloss through the space between the main archwire and your teeth. Now wrap the ends of the floss around your fingers on each hand, and pull your hands apart so that the floss is taut between them. Now use a gentle sawing motion to gradually work the floss down between two teeth, being careful not to snap the floss down into the gums. Next, use one finger tip on each hand to push the floss toward the left so that it begins to wrap around the left tooth of the two teeth you are working on. Use a back and forth motion to polish the side of the tooth and to remove any food debris. When the tooth is clean, the floss will squeak as you slide it along the tooth surface. Be very careful not to pull with too much force on your archwire.

Without removing the floss from in between the teeth, reduce the tension and lift it carefully around the gum tissue, then pull toward the right with both hands to wrap the floss around the right tooth of the two teeth you are working on. Use the same back and forth motion to polish the side of that tooth, then remove the floss. Follow this procedure to clean in between all of the teeth in both your upper and lower arches.

The second way to floss is to use Glide floss and a floss threader. The floss threaders are reusable. Begin by feeding the threader down a space between the main archwire and the sides of your teeth until it is half way through. Now take an eighteen-inch long piece of floss and feed six inches of it through the loop. Pull the loop all the way through and out of your mouth. You can set the floss threader on the counter. The floss will now be positioned the same as the Superfloss described above, and you can begin to work it down between the teeth.

This takes dedication, but is highly recommended for adults and teenagers who want the best possible results. Daily flossing is essential to your dental health. Often neglected, flossing helps improve the overall health of your teeth and gums. Flossing assists in cleaning many of the "hard to reach" spots in your mouth, spots that regular brushing generally misses. By flossing, you reduce much of the plaque buildup that causes gum disease.

Although flossing is more difficult with braces, it is especially helpful during your orthodontic treatment. Always floss at least once a day before bedtime. Proper flossing reduces the risk of periodontal disease and tooth decay.

Brushing
    

    

The second step is to brush your teeth. This is done in three parts.

Part One: Brush your teeth with your regular soft toothbrush and your regular toothpaste. Wherever there are braces attached to your teeth, you will need to angle your brush so that the bristles point downward down from the top. Then use a side-to-side stroke to clean out any food or plaque from under the wings of the braces. Next, angle your brush so that the bristles point upward from the bottom. Then repeat the gentle back and forth motion with short strokes. You don't want to saw your gums off!

Part Two: Next, in the areas where braces are not in the way, use the press-roll tooth brushing technique as follows. Start in one corner of your upper jaw with your toothbrush bristles pointing up, between your gums and the inside of your cheek. Now twirl the handle of the toothbrush so that the bristles of your brush sweep down the gums and then down and off the teeth. You should do at least ten strokes on the last two teeth and then move forward to the next two teeth until you have gone all the way around your upper arch. Now start on the insides of your upper back teeth and repeat the procedure, working your way all the way around. Do the same thing with your lower teeth, inside and out.

Part Three: Now follow up with your interdental proxabrush, or "Christmas tree" brush. This brush is for cleaning in between two braces. You should use your regular toothpaste with this brush also. Starting between the last two braces on your upper right side, feed the Christmas tree down from the top and then up from the bottom between the last two braces. Use several up-and-down strokes from each direction, then move on to the next space between two braces. Work your way around your upper arch, then repeat the procedure in your lower arch. Then rinse your mouth thoroughly.

Rinsing
The third step is to rinse your teeth, if necessary. Peroxyl is an antiseptic dental rinse (active ingredient: hydrogen peroxide 1.5%) used in orthodontics to control minor inflammation and irritations from orthodontic appliances. It is also used to cleanse canker sores and minor wounds or other irritations of the mouth and gums such as mouth burns, cheek bites and toothbrush abrasions. It's oxygenating action removes debris, allowing natural healing to occur.

If your gums are the least bit puffy anywhere, rinse with half a capful (½ teaspoon) of Peroxyl mouth rinse or squeeze some Glyoxide under the gumline in all affected areas and leave it to fizz for a minute or more. Next, spit out and rinse your mouth thoroughly a few times. Ideally, these products should be used after every meal and at bedtime to produce the best results.

Fluoride Treatment
The fourth step is to brush Fluoridex toothpaste onto your teeth. This toothpaste not only cleans missed areas, but it also provides a prescription strength fluoride treatment at the same time. After brushing all areas, spit out but do not rinse your mouth out. The Fluoridex toothpaste which is left behind helps to protect your teeth all night long.

Cleaning a Retainer
The last step is to clean your retainer, if you have one. All orthodontic retainers and appliances tend to accumulate food particles, plaque and tartar just like teeth do. Every time you brush your teeth, brush your retainer or removable appliance. To give your retainer a fresh taste and to disinfect it, you should soak it in a denture cleanser at least once a week. Daily use is even better. First brush your appliance thoroughly. Next, soak it in Retainer Brite, Efferdent or Polident. Remember to use a cup full of warm water, but don't use hot water. Put the appliance in the water and then drop a tablet in. It will fizz up and clean the appliance and the water will turn blue. When the water turns clear again, your appliance is disinfected. You can then remove the appliance from the water. Be sure to rinse it thoroughly before placing it back in your mouth.

As with any device, there is always the possibility of things just happening with orthodontic appliances. Below is a list of problems that sometimes occur, as well as some remedies and instructions in case they do happen.

• If your teeth are sore after a visit
• If food becomes stuck
• If a wire causes irritation
• If the main wire comes out of the brace or tube
• If a bracket comes loose from a tooth
• Loose expander
• Injury to the mouth

If your teeth are sore after a visit, we recommend that you take a pain reliever such as Tylenol or Advil as long as you aren't allergic to them. Rinsing with a cup of warm water and a teaspoon of salt can also be soothing.

If food becomes stuck between your teeth, use dental floss or a proxybrush to dislodge the food.

If a wire causes irritation, push the wire away from the area using the eraser end of a pencil or a cotton swab. 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 us for an adjustment.

If the main wire comes out of the brace or tube on a back molar tooth, attempt to reinsert the wire with a pair of needle-nosed pliers, fingers, or tweezers. Otherwise, you can leave it alone if the wire is not poking you. If the wire is poking you, call the office or cover it with a piece of wax. If wax does not help, cut the wire with nail clippers between any two back braces and pull the loose piece out of the mouth. This is a last resort if professional help is not available.

If a bracket comes loose from a tooth, we need to replace it within one week so that the tooth it was attached to does not go crooked again. Call our office at 608/328-8160 or 815/232-7223 right away. We may need to schedule a separate visit to replace the loose bracket(s), since repairs of this nature take additional time. Meanwhile, the bracket usually remains connected to the main wire, so an emergency visit isn't necessary. You can use tweezers to reposition the bracket if it flips around the wire and becomes a source of irritation.

Injury to the Mouth - the office at 608/328-8160 or 815/232-7223 right away or call Dr. Patterson at home at 608/328-4746. If we are not available at either office and immediate help is needed, contact your family dentist or the hospital emergency room. If the injury is not serious, please leave a message and we will promptly return your call. We will let you know what to do.


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Monroe Phone: (608) 328-8160
Freeport Phone: (815) 232-7223
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