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PATIENT INSTRUCTIONS
GETTING STARTED!
Before braces are placed you will need to have your teeth cleaned. This appointment should be
scheduled at least ten days before braces are placed as the bonding agent will not adhere properly
if fluoride has been recently applied.
You will need to continue to have dental check-ups and
cleanings with your general dentist every six months during orthodontic treatment. When you
schedule a cleaning appointment, also schedule appointments with us for removal and replacement of
your arch wires so a more thorough cleaning can be done. For greater efficiency, we will try to
coordinate these appointments with your regular orthodontic adjustment.
Following the Consultation, treatment can be initiated by scheduling a Banding appointment and any
other preliminary procedures. Banding (placing the braces) will take from 1½ hours to 2½ hours and
may need to be preceded by placement of spacers or impressions for other appliances. At the
Banding, the initial treatment fee will be collected and a financial contract signed. We will provide
you with receipts, payment coupons and other necessary paperwork.
APPOINTMENTS
After the Banding, monthly adjustment appointments that will generally take 25-30 minutes will be
scheduled at four to six week intervals. Please be on time so patients scheduled after you do not
have to wait. If you are more than 10 minutes late for an appointment, we may need to reschedule
for another date and time. When arriving for your appointment, please sign in on the computer in
the front office, go to one of the brush-up sinks and brush your teeth, then have a seat in the “on
deck” area until you are called back to the operatory. Parents are welcome to help themselves to
coffee or tea and reading material and to sit in the front waiting area.
Our office is open Monday through Thursday - Office hours are Mondays from 8AM to 3PM,
Tuesdays from 8AM to 5PM, Wednesdays and Thursdays from 7AM to 4:30PM.
We schedule regular 20-30 minute monthly adjustment appointments between 7-9AM and from
2PM to the end of our workday, so as many patients as possible can be seen during non-school and
non-work hours. (We call these “fast lane” times!) Repair of loose or broken braces may not be
able to be done during “fast lane” and may need to be scheduled for midday hours.
If you are unable to come to an appointment, please inform us 24 hours ahead of time. Every
missed appointment can lengthen treatment by one month, since appointments are made four to six
weeks in advance and you may not be able to reschedule for the time of day you desire. We will
work with you as much as possible without inconveniencing our other regularly scheduled patients.
There is an automatic charge of $25 for a third and each subsequent missed appointment.
CARING FOR BRACES
Excellent oral hygiene is very important during orthodontic treatment. Be sure to floss every day
and to brush your teeth after every meal and before bed. The doctor may recommend the use of a
soft bristle toothbrush and flossing with a floss threader, brushing the gums and around the braces
and flossing between your teeth and under the braces. A Sonicare toothbrush can be helpful, and
use of a Waterpic for removing loose food debris and massaging the gums. You may also choose to
use a fluoride mouth rinse (such as ACT). Fluoride brushing gel will be given at the banding, as well
as new toothbrushes and flossing aids. Without good oral hygiene, there is a great risk of gum
disease and decay and decalcification around the braces.
When you have braces, there are some foods you must avoid:
A.
Hard and sticky foods can cause brackets to pop off and wires to bend improperly.
Each loose bracket means an added month to treatment length. When wires are bent
improperly, they move teeth into a wrong position and extra time is needed to move the
teeth back into their correct position, extending total treatment time.
Some hard and sticky foods to avoid: popcorn (kernels can get stuck under your gums
causing pain and swelling), whole nuts, ice cubes, corn-on-the-cob, corn chips, crispy
tacos and taco chips, beef jerky, hard candies, pizza with hard crust, gum, taffy,
licorice, caramels, “Laffy Taffy”, “Tootsie Roll Pops”, popcorn balls, caramel apples and
other similar hard/sticky foods.
Some foods to cut into bite-size pieces or thin slices: carrots, celery, apples and other
crisp fruits and vegetables.
While avoiding the above foods, try to stop these habits which can break the braces:
chewing on pens, pencils or fingernails, thumb sucking and lip biting.
B.
All sugary foods should be avoided. Brushing and flossing with braces takes time.
Plaque left on the teeth combines with sugar to cause permanent white spots of
decalcification around the edges of the brackets. Fluoride brushing gel helps prevent
this, but not eating sugary foods or drinking sugary beverages, in combination with
thorough daily brushing and flossing, is the very best!
C.
Highly acidic foods and drinks such as lemon juice, lots of orange juice and soft drinks
are hard on tooth enamel and can cause the cement used with some braces to loosen.
D.
Staining foods (tomato sauce, mustard, coffee, tea, red juices and wines) may cause
clear and light-colored ties to discolor. We suggest choosing dark, opaque ties to avoid
lots of staining between appointments (we do change ties at each regular appointment).
WORKING TOGETHER
Cooperation with wearing orthodontic appliances (headgear, expanders, rubberbands, etc.)
significantly affects the amount of time braces are needed. The more you wear that headgear or
those rubberbands (if you are instructed to do so) the faster your treatment will get done! For
each week or month of missed headgear or rubberband wear, a week or a month of additional
treatment can be expected. The doctor may instruct you to wear these different orthodontic
appliances, but no progress will happen unless YOU DO IT!! YOU control how long the braces will be
on by your cooperation. The more we work together, the faster we will get you to that great smile!
It is important to communicate with our doctors and staff about any concerns or problems you may
have with your teeth. There are three particular areas of concern to watch for:
A.
Jaw joint pain or clicking. If you already have some of these symptoms in your jaw
joints, the doctor will be watching carefully for any addition symptoms. Please tell the
doctor if you notice any changes.
B.
Gum tissue recession. The doctor will tell you if you have a tendency for receding
gums. Please let them know if you notice any changes in how your gums appear.
C.
Root resorption. A minor shortening or blunting of root tips can sometimes occur as
teeth are moved. In some rare cases, severe resorption may occur and treatment must
be stopped early. Teeth will sometimes feel slightly loose as they move with braces,
but if your teeth seem extremely loose, please tell the doctor.
EMERGENCIES
If you have an accident and experience significant pain, swelling or bleeding in
your mouth, the doctor’s home phone number is _________. However, if a wire is poking and
causing discomfort, place the wax we have given you over the area and contact our office during
regular hours. A loose or broken bracket is also taken care of during regular hours. We have 24
hour voice mail, so a message can always be left and our staff will return your call the next business
day.
VACATIONS When you and your family are going on vacation, let us know and we will provide a list
of orthodontists in the area and a letter of introduction for emergency treatment. Please give us
some advanced notice so we can have the information ready for you.
RETENTION One set of upper and lower orthodontic retainers and two years of retainer check
ups are included in the treatment fee unless otherwise stated. Retainers must be worn full time
immediately after the braces are removed to stabilize your teeth while bone re-calcifies around
them. This will be discussed in more detail when you received the retainers. (YES, you WILL get
there!).
TRANSFERRING There is a fee of up to $150.00 for copying and sending transfer records if a
patient moves during active treatment. This fee covers the time required to write a detailed
transfer report outlining the original malocclusion and diagnosis, treatment procedures to date and
future treatment recommendations. Included with this report are copies of models, x-rays and
photographs and recommendations for an orthodontist after you move. If a move out of Anchorage
is in your future, please let us know so we can talk about it with you and prepare for it.
AND NOW IT’S TIME TO GET STARTED!