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Getting Braces? What to Expect

One of the ways you will know you are being well cared for at Levens Orthodontics is that we take extra and unique steps to make sure you are as comfortable as possible at each step of your treatment. For instance, the type of braces we use are almost always bonded (stick-on) instead of the bonded (rings) type of braces. This means they can be placed in exactly the proper place on your teeth, they are better looking (smaller), have no rough spots or extra hooks on them and best of all, they don't hurt you when we put them on. If your friends tell you about spacers and the discomfort associated with them, don't worry about it because you won't have them.

The whole thing takes less than 60 minutes, here's the process:

  • Polish your teeth with a small rubber cup. We use an almost tasteless paste.
  • Place a lip and tongue retractor - similar to when we take photos. Keeps your teeth dry (essential to bonding).
  • Dry your teeth with air.
  • Place blue conditioner liquid. It comes in a syringe, but there are no needles and it only will be placed on the front of your teeth. Totally comfortable.
  • Rinse your teeth with water, may have sour taste.
  • Dry and place braces, cleaning around them and let dry for four minutes.
  • Pick out fun colors for braces. You will be able to change at each appointment.
  • Place wires - most comfortable, best wires made by NASA.
  • Hygiene and compliance instructions will be given.

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Home Care Instructions

Wearing fixed orthodontic appliances can make oral hygiene a challenge, but proper care at home will reduce the chance of decay or gum disease. We want your smile to be straight and healthy when you finish your treatment, so follow these instructions carefully. Just to give you a little extra incentive any patient who has excellent home care and no broken brackets at their adjustment appointment gets to enter our monthly drawing for cool prizes like gift certificates to Borders Books, Starbucks and AMC Theatres!

  • Brush and floss in the morning, after lunch and at bedtime for three minutes each time. While at work or school, if you don't have access to toothpaste, at least brush with water to remove food from braces.
  • We will provide you with four tools for cleaning your teeth and braces: a regular toothbrush with soft bristles for home, a travel toothbrush to use when away from home, and a pointy "proxy" brush to get under and around wires and floss.
  • Make sure to slightly angle the bristles toward the gum line. Brush gently side to side. Spend extra time in each area of your mouth brushing. Pushing harder actually hurts teeth and gums. Braces should look shiny when you finish brushing.
  • Floss daily. Flossing around braces is difficult, but it is essential to remove plaque from between your teeth. Our assistants will show you how to thread floss through the wire so that you can clean around each brace. Just ask if you need help.
  • Use wax to cover any areas that are rubbing or scratching. We will provide the wax and show you how to take a little piece of wax, roll it into a ball and form it around the edge of a brace or wire.

During treatment it is important to avoid eating certain foods because they can break your wires or cause braces to come loose or break. This can harm your mouth and increase the time in treatment.

Examples of things to avoid: any type of gum, even sugarless, sticky candy such as Taffy, Airheads, Starbursts, Gummy Bears, Jellybeans, Licorice, Caramels, Tootsie Rolls, Sugar Babies, Snickers, Milk Duds, etc.

Examples of foods that should be cut into small pieces: apples, carrots, celery, radishes, steak, and corn on the cob. Please do not chew on pens, pencils, or ice cubes.

It is important to schedule regular cleanings and examinations with your general dentist during your orthodontic treatment. Although we will notice obvious dental needs during your orthodontic treatment, we do not take cavity finding x-rays or perform the routine cleanings your general dentist will perform. Many dental offices have special equipment that allows them to clean your teeth with your braces in place.

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Emergency Care

Most orthodontic emergencies can easily be taken care of at home. Here are a few tips on caring for orthodontic emergencies. Give us a call on the next business day when something is broken or missing. If you are unable to correct the discomfort or it continues to be bothersome give us a call to schedule an emergency appointment. We may not be able to fix what is broken at that time, but we will make sure you are comfortable and schedule accordingly.

In order to correct or describe what has occurred it is helpful to understand the parts of your braces.

Archwire - The main wire that acts as a track to guide the teeth along. It's changed periodically throughout treatment.

Elastic Tie - Tiny rubber band that fits around the bracket to hold the archwire in place.

Hook - Welded or removable arm to which rubberbands are attached.

Bracket - Small attachment that holds the archwire in place. Most often brackets are cemented on the tooth surface eliminating the need for a band

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Broken or Loose Bracket

If the bracket is still attached to the wire, leave it in place and try to put wax on it (see using wax below.) If the bracket is completely off call on the next business day to let us know which bracket is off - upper or lower back or front. We will then schedule your next appointment accordingly.

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Loose Wire

Try putting the wire back into the tube with tweezers. If you aren't able to reinsert the wire, clip the wire using fingernail clippers, small scissors or small wire cutters behind the last tooth to which it is still attached. Wax can then be used if wire is rubbing.

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Poking Wire

Use the eraser end of a pencil to push the wire towards the tooth. If that is not possible put wax on it (see using wax).

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Sore Teeth

Rinse with warm salt water and take Tylenol or Advil as necessary. Soreness is very common after the initial placement of brackets and monthly adjustments. Some patients compare it to having a headache or loose tooth; this is just part of getting used to having braces.

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Loose Appliance

Place Wax on it until you can get in to see us.

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Mouth Sores (Ulcers)

Rinse with warm salt water to aid healing and cover any rubbing areas with wax.

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Using Wax

Roll a small piece of wax into the shape of a ball. Dry the area completely with a Q-tip or cotton ball. This is very important the wax will not stick if the area is wet at all. Simply shape the ball of wax over the irritating bracket or wire.

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In the Case of an Emergency

If you still need help with your orthodontic emergency please call the pager and touch-tone in the number where we can return your call. One of our team members will return your call promptly. Emergency Pager: 314.751.1785

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Orthodontic Appointments

During the comprehensive phase of your orthodontic treatment you will most likely need to return to our office every four to six weeks. Your appointments are scheduled at these intervals in order to facilitate tooth movement, so missing appointments could significantly lengthen the time you will spend in braces. We pride ourselves on our dedication to seeing patients at their scheduled appointment times and appreciate patients who make the commitment to be in our office on time for their reserved appointments.

We understand that your time is very valuable, 95% of our patients either work or attend school and all have very busy schedules. We reserve our prime time, late afternoons and evenings, for shorter appointments so that we can accommodate as many patients as possible during those times. Longer appointments, such as placing or removing braces, will need to be scheduled earlier in the day. If you have the opportunity to schedule during a day off, lunch, gym class, study hall or early dismissal day please let us know as soon as possible and we will do our best to accommodate you. Patients who take advantage of these times find that they really enjoy not fighting the late afternoon traffic on the roads.

Until Dr. Levens has evaluated your progress he cannot determine how much time we will need to schedule for your next appointment. Therefore it is not usually possible to schedule more than one future appointment at a time. On the other hand, since most patients are seen every four to six weeks, our prime time appointments are usually booked a month or so in advance. That is why we strongly recommend that you bring your calendar to each appointment so that you can schedule your next appointment as soon as we know when you need to return and how much time we will need to schedule for your appointment.

In the unfortunate event that you miss or cancel a reserved prime time appointment, we may not have the same time of day available for your next appointment. This may mean missing work or school in order to keep up your treatment schedule. Again, skipping appointments could lengthen the time you will have to spend in braces so we encourage you to schedule missed or canceled appointments as soon as possible.

Please make us aware of any broken appliances ahead of your appointment. We will do our best to reserve enough time at your next scheduled appointment so that you will not have to make a separate appointment to rebond your appliances. Unless your wire or bracket is scratching or rubbing, you need not come in immediately. If anything is uncomfortable, we will be happy to see you and make sure you will be comfortable until you we can schedule time to rebond your appliance.

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Wear and Care of Retainers

Retainers are an important part of orthodontic treatment and at Levens orthodontics your initial retainers are included in your treatment fees. Retainers allow your teeth to settle into their new position so that you can enjoy your beautiful smile for life. The bone can take as long as a year to completely reform around the roots of your teeth after they have been moved. We will need to check your retainers periodically to be sure they fit properly and that they are doing the job they were designed to do.

It is important that you follow these instructions for wearing and maintaining your retainers, and that you keep all recommended appointments with our office.

  • Your retainers may affect your speech for a day or two, but this disappears with consistent wear of the retainers
  • When you start the retainer phase of orthodontic treatment your teeth may become a little sore and the tissue on the roof of your mouth may become a little tender. You may experience these symptoms for two or three days. If your retainer continues to cause discomfort or rubs, do not attempt to adjust it yourself. Please call our office to make an appointment for a retainer adjustment.
  • Retainers should be worn at all times except when eating, brushing, playing contact sports or swimming where they may be broken or lost. Not wearing your retainers consistently can allow your teeth to shift. If this happens your retainer will not fit properly and will have to be adjusted or even replaced. If your teeth shift significantly it could even require more time in braces to bring them back into proper position.
  • When you remove your retainers please store them in their case and in a safe place. Retainers have been mistakenly thrown away or left on a lunch tray because they were wrapped in a paper towel, napkin or tissue. Dogs and cats have been known to chew and damage retainers. Leaving your retainer near a heat source such as a lamp, curling iron, stovetop, or in a hot car can cause the retainer to warp and be ruined. Keeping your retainers in their case when they are not in your mouth is the best way to keep your retainers safe. Also the weight of a book bag may be heavy enough to crush your retainer case so be careful when you store the retainers in your bag.
  • Your retainers can be cleaned with your regular toothbrush and toothpaste. To remove stains you may soak them in denture cleaner. Use only cool water, hot water may warp the retainers.
  • Retainers are always a part of orthodontic treatment and are included in the original treatment fee. If your retainer is broken, becomes warped, or is lost, a fee will be charged for replacing your retainers. If you fail to wear the retainers and they no longer fit, you may also be charged to resolve this situation.

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2821 North Ballas Road, Suite 155  |  St. Louis, MO 63131  |  314-872-3218
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