FIXED BRACES
WHAT TO EXPECT
We receive your initial NHS referral through an automated online system, or by private arrangement.
We write you a letter asking you to contact us to book an initial appointment.
At your initial appointment we carry out a full assessment to determine if any treatment is needed, and if the treatment required is covered by NHS funding or requires private funding.
If treatment is required we then book you a “Records appointment”. At this appointment we carry out any X-rays, photographs, and scans of teeth that may be required.
If any tooth extractions are required as part of your treatment plan we would write a letter to your dentist requesting this.
We will then see you again to fit your Orthodontic appliance (known as "fixed braces").
The same day that you have your fixed appliance fitted, we highly recommended that you have a Dental Health Education appointment. This is to give oral hygiene instruction and dietary advice and advise on how to care for your new brace. (The Dental Health Education appointment is not part of your NHS treatment and does incur a charge).
We then see you for “fix” appointments. These are regular adjustment appointments and are usually booked in every 8 weeks.
When your teeth have moved to the correct position and your brace is ready to be removed, you will have a “debond” appointment.
We remove your fixed appliances, we then take photographs, impressions of your teeth for removable retainers, and if required place fixed retainers. We also scan your teeth.
Approximately 6 months after your treatment we will see you again for a retainer review.
At this point we give you further instructions for retainer wear.
AFTER CARE
We all look forward to your teeth looking and feeling as you would like them to be, so a little discomfort will, we hope, be worth it.
STARTING
You have just had braces cemented on to your teeth and you may initially experience some discomfort. The most common problem is that the brackets may initially rub the inside of your mouth. To help with this we recommend that you have a soft diet over the first few days. We recommend you cut up your food into small pieces and try to eat at the back of the mouth. This should help minimise any rubbing and discomfort
USING WAX
Any rubbing that you experience can be dealt with by using the small box of wax that you can purchase from reception. To use this wax, break off a small amount. Roll it in a ball to soften it then press directly onto the metal bracket on your tooth, pushing it snugly around the corners so that it covers over any sharp edges. This wax can be left in position, even during eating; it is perfectly harmless if you swallow it! Once your mouth becomes more comfortable you can return to your normal diet.
CLEANING AND BRUSHING
It is important to keep the fixed appliance as clean as possible. Failure to do this may result in permanent marks being left on your teeth once the brace is removed, while poor oral hygiene may also lead to gum problems. A small toothbrush is recommended. Brushing should involve a circular motion carefully around each bracket and then around the edge of your gum. Each tooth needs to be cleaned individually, paying particular attention to the gum edges around the side where there is only a small gap between the bracket and the gum.
You will find that tooth brushing takes you at least twice as long as it used to do, so please allow yourself extra time, particularly in the morning. We recommend that you buy yourself an interdental brush with either a small tuft of bristles on the end or a small bottlebrush attachment. This can be used for carefully cleaning under the wires between your teeth.
EATING
Care must be taken during the time that the brackets are in place. You must not eat toffees, chewits, cereal bars, hard sweets and the like during the time that you have the fixed brace in position, as these tend to pull off the brackets thereby prolonging your treatment. Most normal foods are fine, but take care! Please also take care when eating hard crunchy things such as apples, carrots and crusty rolls. These should be cut up into thin slices and small pieces and eaten at the back of the mouth.
PAIN RELIEF
Once the wires are fitted it is likely you will experience some aches and pains during the first few days because your teeth with start to move. You may take pain relief which you would normally use, provided that there are no medical contradictions
YOUR COMMITMENT
Once treatment has started it is important that it is completed, otherwise you may be worse off, especially if you have had teeth extracted. You must be seen for regular adjustments, so, please keep your appointments. Look after your appliances, keep your teeth clean, keep to a healthy diet, and avoid breaking your braces.
BREAKAGES
If any brackets or bands become loose, or the wires detach and rub your cheek, please do not hesitate to contact us for an emergency appointment. We will try to fit you in as soon as possible to deal with your problem.
PLEASE NOTE: Braces do not break themselves. It is the patient who breaks them by not taking adequate care of them. Someone is paying for your treatment, whether it is private or NHS. Considerable time, money and effort it involved in completing your orthodontic treatment to a high standard. This can only be achieved if you are 100% committed
FIXED BRACE ELASTICS (IOE)
You may have been given elastics to wear between your upper and lower fixed braces to try and improve your bite. This is a very common stage in your Orthodontic treatment, particularly during the last few visits.
The bite will only improve if the elastics are worn full time, day and night. Part time wear does not work with this type of treatment.
The following information gives advice on how to look manage your elastics
You have been shown how to place the elastics to produce the maximum improvement for your bite.
It is very important that your elastics are worn all day and all night.
Elastics can be removed for cleaning and eating if this makes it easier, but they need to be replaced immediately afterwards.
They need to be replaced every day, and should also be replaced immediately if they snap or detach.
During the first few days you will probably find the elastic bands rather annoying and they may make your teeth ache. Please persevere and these aches will disappear within a few days.
Should you run out of elastics before your next visit please call the practice and we can send some to you in the post.
If you experience any difficulties please do not hesitate to call us.
RETAINERS
Following treatment, you are given a retainer to keep your teeth in their new positions. This is a vital part of your treatment as the retainer prevents your teeth from moving out of position.
Inserting and Removing
Place your retainer over your front teeth first and then use your thumb to push your retainer into place. To remove your retainer, place your finger under the edge at the back and pull down firmly to disengage the back, and then ease it off at the front.
Looking after your retainers
Please look after these carefully as they are expensive to make, taking a highly skilled technician 1-2 hours to produce. They need to be used correctly and kept safe. When you are not wearing your retainers always keep them in their retainer box as this will help prevent accidental damage. If the retainer is lost or broken there is a charge for its replacement.
Keeping your retainer clean
Each morning when you remove the retainer, rinse it carefully in COLD water and gently brush it. Always store it in the box provided and keep it away from direct sunlight or heat, as the retainer is heat moulded. Excessive heat or using hot water will distort the retainers.
They need to be kept clean or they will start to smell. It is advisable to clean your retainers in a proprietary retainer cleaner e.g. Retainer Brite to avoid the build-up of a biofilm.
Replacement
Over time some tiny holes may appear on the biting surface of the retainer. This is normal, don’t worry, the teeth will be retained sufficiently. If cracks develop and the retainer is not fitting snugly to your teeth, or if it splits, then please telephone the practice as soon as possible as the retainer will need to be replaced.
Fixed/Bonded wire retainers
If you have a bonded wire behind your front teeth, please take care with very hard and sticky foods as these could dislodge the retainer. If the wires come loose or fracture please contact the practice.
How often do I have to wear my retainer?
Retention is not an exact science. The advice given will be based on your particular situation. For the first six months you need to wear your retainer every night unless instructed differently. At your six month review you will be given further instructions.
If the retainer feels tight or uncomfortable at any point as you reduce its use, you will need to increase back to the number of nights that keeps it fitting comfortably. If the retainer is fitting well and is comfortable then the teeth are not moving. Some patients can reduce the retainer wear easily others have to keep to every night. Every one’s teeth are different. The important thing to do is wear the retainer enough to keep it fitting comfortably.
More Information
The British Orthodontics Society have this short video to help explain the importance of wearing your retainer correctly:
Now that you have straight teeth, let’s work together to make sure that they stay that way by wearing your retainer which has been custom made for you.